I just saw an older gentleman who had a direct neck lift just one week ago. What impressed me, and continues to do so with each male patient that undergoes one, is how well the neck scar looks. The great fear, and understandably so, is the scar that runs down the middle of the neck from a direct neck lift. If it were not for the consideration of the scar, the direct neck lift has a lot of advantages over a traditional facelift in the older male.
The direct neck lift offers simplicity, a quick recovery, no pain other than some initial tightness, and its tremendous effectiveness at reshaping the neck. The neck lift is much more effective than the more common facelift because it is removing the problem directly, rather than ‘chasing’ it back to the ear where it is removed. Because the operation is smaller and only treats the actual loose skin in the neck, it has none of the bruising and swelling that comes from raising long skin flaps.
Carving out the neck directly produces a much sharper neck angle above the adam’s apple and will have little, if any, rebound relaxation. (mild loosening of the lifted and tightened neck and jowl skin) Because the operation is in the neck, it can be performed in any older male, regardless of his hair pattern around the ears and the back of the neck.
Because the direct neck lift creates a scar, one has to carefully select the patient who may find a neck scar objectionable. (there is no magic eraser afterwards!) While one can debate all day long whether the neck scar is a good cosmetic trade-off or not, and many plastic surgeons have their opinions, the reality is that it is a patient’s choice. My experience has been that the patient’s select themselves. Given the alternative between a bigger facelift procedure or a more limited direct neck lift, the patient has to choose between each procedures advantages and disadvantages. This choice will be easy in most men under 60 as the thought of a neck scar is objectionable for most. But for the 60 or older male with a neck wattle, a fair number are more interested in a simpler procedure than they are concerned about a neck scar.
And there is even a simpler method to determine about the concern about a neck scar…watch the patient’s expression. If they say, what do I care about a neck scar when I have this? (pointing or grabbing their neck wattle) Or if they are slowly shaking their head or are unsure if a neck scar might be a problem, or even have to think deeply about it, then a neck scar is likely not to be a good choice. Using this method, I have yet to have a male who has ever regretted their decision.
Dr. Barry Eppley
Indianapolis, Indiana