As one gets older, the development of a significant neck waddle or turkey neck is inevitable for most. At age 70 and beyond, the sagging neck is often one of the most bothersome cosmetic issues for men and women alike. While there may be numerous physical affirmities that are troubling, the loose hanging neck is a visible reminder of advancing years.
While many older people have overiding medical issues that make dealing with a neck waddle insignificant, some would if the procedure was not unduly extensive and expensive. While a traditional facelift is the gold standard for aging neck issues, this may be more than the elderly person wants to undergo. They would like a procedure that is effective, quick and easy to perform, involves no significant recovery, and has very few risks….an operation that fits better with the needs of their age.
This is why the direct necklift for the older patient may be a good choice. It is a 90 minute procedure that can be performed under local or IV sedation. It involves no dressings or drains. The risks of infection, hematoma, or any other significant postoperative problems is as close to zero as any operation can conceivably get. There are no restrictions or physical limitations after surgery. One can shower the next day and go on with life. Ironically, it also produces a neck result in large neck waddles that is unmatched by even a traditional facelift. I have done patients as old as 88 with this neck method and they have been very appreciative.
The direct necklift is not perfect however. The tradeoff is a midline scar that runs from under the chin down to the adam’s apple. While this scar generally looks very acceptable and I have yet to find a patient that has complained about it, thorough presurgical education about it is important. Showing pictures of the scar is the best way to determine one’s potential acceptance of it. You either find it no problem or are uncertain about it. Any uncertainty makes you a non-candidate for the procedure. The straight line scar will also tend to contract and get a little tight in the first few months afetr surgery. This may require some steroid injections to soften it as it heals or a minor in-office z-plasty can ultimately be done in the central portion of the scar where it is tightest if this issue continues to be bothersome.
Dr. Barry Eppley
Indianapolis, Indiana