San Francisco Bay Area Facial Plastic Surgery in Walnut Creek, CA
San Francisco Bay Area Necklift (Platysmaplasty) Surgery by Board Certified Plastic Surgeon Joseph A. Mele, MD, FACS, in Walnut Creek, CA
Loose neck skin is caused by many factors. While primarily associated with aging, the process can be accelerated by genetic predisposition, sun exposure and smoking. Wrinkling and sagging are caused by excess skin, loss of support and a loss of elasticity of the neck skin. For many, such damage can result in an appearance that does not match how they feel inside. While turtle necks and high collars can help disguise the problem, a Necklift can provide improvement, regardless of apparel.

Regardless of the cause, loose neck skin and plastymal bands can be reduced with surgery. Dr. Joseph A. Mele, MD, FACS, a San Francisco Bay Area necklift surgeon, can improve the appearance of your neck including:
The primary goals of a neck lift are an improved cosmetic result with a natural look. The best planned Neck Lift keeps both goals in mind. Because the skin loses elasticity as we age, it does not behave like the skin of our youth. There is some art involved in the correction of the aging neck. An attempt to remove every square inch of loose skin, can result in over tightening and the dreaded wind-tunnel look. This is made more likely by the loss of youthful skin elasticity. This, and the fact that there is usually less loose neck skin, is the reason why Necklifts performed at a younger age tend to look more natural.
The Necklift and Facelift are very similar. While the presentation below is titled Your Guide to Face Lift, the information applies equally as well the Neck Lift.
At his practice in San Francisco Bay Area, Walnut Creek, Necklift patients anticipate beautiful outcomes and a rewarding experience. With a balance of Art and Engineering, the goal is always to obtain the best possible results with the fastest recovery possible.
The Necklift can be accomplished using a skin only lift, a dual plane technique using a skin lift with SMAS/platysma elevation, or thirdly a deep plane technique. Each method can be used alone or combined with a Platysmaplasty to address problems with platysmal banding in the front of the neck. The Necklift method chosen will vary from neck to neck. The patient above has had a Facelift and Necklift using the dual plane technique with a Platysmaplasty.
In general, the Necklift incision is the same as that for a Facelift. The usual Facelift incision is made around ears and along the inferior hairline behind the ear. When the goal is limited to rejuvenating the neck, the incision is not extended as far anteriorly, and in some cases, may not need to made in front of the ear at all. When a Platysmaplasty is indicated, a short incision is made just under the chin, hidden by the submental crease. This allows access to the neck fat, and the platysma muscle. Removing excess neck fat can help improve the overall contour of the neck. Sometimes Liposuction is used for this part. Tightening the platysma muscle allows for minimization of the long folds extending from the chin to the lower neck. A platysmaplasty improves and prolongs the smooothing results in cases when the muscle is separated. The incisions are closed with absorbable sutures placed beneath the skin to give the best possible closure, and the thinnest possible scar.

An alternative approach to the Neck Lift takes the direct approach. The downside to hiding the Necklift incision around the ears is that the effect we desire, tightening the neck skin, is located remote from the incision. This makes maintaining the desired tension more difficult as the skin tends to relax. It also makes visualization of the operative field harder during the procedure. The majority of the time, the trade-off is worthwhile, but in cases of severe redundancy, the incision can be placed on the front of the neck.
Placing the incision down the front of the neck has several advantages. It allows for maximal tightening, right where it is needed. The platysmal muscle, which causes the pair of bands that run down the front of the neck, can be easily seen and repaired for maximal tightening. The muscle is closed like a corset under the skin to support the deeper structures, and to prevent recurrence of platysmal banding.

The scar in above is fully healed, and can be seen in the picture on the right running down the middle of the neck. Because of the scar location, a Direct Neck Lift is not the most popular type of neck lift; however, it is very effective method for tightening the loose neck skin, and any underlying muscle laxity.
Neck lift surgery usually incorporates a Face Lift. Since the two procedures share the same incision, and the face and neck age at similar rates, the Facelift and Necklift are usually merged into a single procedure. The emphasis can be placed on the area that needs the most help catching up. This allows for a balanced rejuvenation and a natural result. When combined with an open Brow Lift, the incision in front of the ear is extended up within the hair.
For more information on Facelift Surgery, please visit our Face Lift and Rhytidectomy Page.

In the Mini-Facelift before and after photos above, the lateral facial laxity, jawline, jowls and neck are all significantly improved. The platysmal band running down the anterior neck is also improved, but not gone. A full Necklift with platysmaplasty would provide additional improvement in this area. Every patient is treated as an individual. After a careful consultation, reviewing the pros and cons or each procedure, this patient decided a shorter recovery was more important than the best possible result. She proceeded with a Mini-Rhytidectomy and was very happy with her improvement, a speedy recovery, and just a few days of downtime, something a full Facelift/Necklift cannot provide.
Every necklift is individualized. Dr. Joseph Mele is a Board Certified Plastic Surgeon, with years of experience. He wants to achieve great results every time, but he does not do the same operation every time. Sometimes we need to use every technique in the book, while other times keeping it simple will achieve excellent results.
For large amounts of excess skin and well defined platysmal bands, a full Facelift with Necklift is needed get the best results. When the neck has problems isolated to the lateral neck and jowls, and when the extra skin is not excessive, a Mini-Facelift may be sufficient. The benefits of Mini-Facelifts include a shorter scar and shorter recovery, but being Mini-Facelifts they cannot provide as much improvement or as long lasting a result as the traditional Face or Neck Lift.
For more information on Mini Facelift Surgery, please visit our Mini Face Lift and Mini Rhytidectomy Page.
Many patients choose to combine their face lift procedure with a Brow Lift and Blepharoplasty (Eyelid Surgery) to take full advantage of their surgical time and recovery period, and to further enhance their results. Combining Facial Plastic Surgery procedures, leads to more balanced facial aesthetics, and the appearance of an evenly youthful face. To see examples of Dr. Mele’s excellent cosmetic surgery results, please view our before and after plastic surgery photos.
Dr. Mele is board certified by the American Board of Plastic Surgery (ABPS) and the American Board of Surgery (ABS). He is an active member of of the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS). He has published articles on both cosmetic and reconstructive plastic surgery and has presented his research at national, state, and local plastic surgery conferences. If you are interested in cosmetic surgery, our San Francisco Bay Area Necklift surgeon can help you achieve pleasing results, while providing you with excellent patient care.
If you are interested in Necklift Surgery in the Walnut Creek area, please contact San Francisco Bay Area Necklift and Plastic Surgery professional Dr. Mele by calling (925) 943-6353, or ask a question by filling out our contact form.