As one ages, the neck changes for everyone. While some will eventually develop loose skin as they get older, many people develop excess fat in their necks giving it a full or sometimes double chin look. A few people actually have a full neck due to fat even though they are young and this is a congenital predisposition to this problem.
Whether liposuction of the neck can produce a good result will depend on what structures of the neck make up the problem. As what lies inside influences how the neck looks on the outside. One key question is how much loose skin does one have? If enough skin exists that one has a ‘turkey gobbler’ neck, then a facelift is most likely needed . How much fat exists between the skin and the platysma is the next important question. That can only be determined by fee. Since liposuction cannot tighten the platysma muscle to any degree, there has to be some significant fat under the skin to make the procedure worthwhile. In addition, there are other underlying structures that can make the neck angle more obtuse no matter how much fat is removed. A low hyoid bone or ptotic or low lying submandibular glands (both lie under the platysma muscle) can make a contribution to a fuller neck can affect the results of neck liposuction.
Traditional liposuction of the neck does work fairly well, even though there can be some significant bruising and swelling afterawards. And the neck area can be quite firm and swollen for some time before the final full result I seen. I have changed neck liposuction recently to a Smartlipo (laser liposuction) technique. This is done by first passing a laser probe through the subcutaneous fat layer in the neck. It is important to keep the laser energies low and not get the neck too hot internally. This is easy to do when powers of 30 watts or greater are used. I like to do power levels of no greater than 12 joules with blended equal wavelengths of 1064nm and 1320nms. Once the neck begins to get warm to the tough, it is time to convert to traditional aspiration for the fat and lipid evacuation.
My observation has been that the heat from the laser probe adds an increased level of effectiveness over traditional liposuction due to the accumulated heat. This generation of heat may help skin shrink down or contract better. This would be of particular benefit in thinner skin or neck in which there really is an excess skin component to the problem but the patient does not want any variation of a necklifting procedure.
What I can say for sure is that there is definitely less bruising and swelling of the neck with laser liposuction. With the decreased swelling and bruising is that patients report less pain also. (although neck liposuction is not a particularly painful procedure for most)
Smartlipo of the neck can be done fairly comfortably under local anesthesia for most patients. If the amount of neck area to be covered is extensive or if there are other procedures to be done at the same time (which is most common), then some form of anesthesia would be a better choice. You don’t want to limit the result that could be achieved because one is feeling discomfort or is very nervous.
Dr. Barry Eppley
Indianapolis, Indiana