As the face ages, so does the neck. For some, the neck is often one of the biggest areas of facial aging concern particularly as one gets older. The loss of the once smooth jaw line and a more well-defined neck angle are telltale signs of the effects of gravity and time. By definition, the use of the term ‘turkey neck’, which almost everyone knows what that means (as unflattering as it is), means an older neck problem as it implies a lot of loose hanging skin. This is usually seen in the 50+ age range and much more common in the 60s and 70s.
When the loose skin in the neck area makes up the biggest part of the problem, the options for treatment become surgical and need to be more aggressive to get a satisfactory result. Forget about non-invasive options or ‘lunchtime’ type procedures. These simply will not work no matter how they are marketed. If the neck and jowl problem is mainly fat, as often occurs in the younger patient, then fat removal methods alone will be successful. Whether it is non-surgical lipodissolve or surgical liposuction, good results can be had as the skin has the ability to shrink and tighten up. When the skin is loose and floppy, that is a sign that it has lost any ability to contract and fat removal methods alone with only be met with disappointing results.
With considerable excess neck skin, variations of a facelift procedure are what is needed. Using the term facelift for many patients is confusing as this procedure often conjures up images of extensive facial surgery throughout the whole face. In reality, a facelift only effects the neck and jowl area and will do nothing for the face above the jaw line. It is a poorly named procedure and a facelift should be called a neck-jowl lift. It is really less extensive and easier to go through than most patients actually think. There are many facelift names and procedures today but most of them are just variations on marketing and advertising. For the turkey neck it takes a full facelift to make a significant improvement.
An uncommon but highly effective treatment for the big turkey neck deformity is the direct neck lift. As the name implies, this incomes a direct excision of the loose skin and far with muscle tightening right down the center of the neck. In the properly selected patient who can tolerate a fine one scar down the middle of the neck, this can create a dramatic improvement with far less recovery than a traditional facelift procedure.
Dr. Barry Eppley
Indianapolis, Indiana