Direct Neck Lift  

In most people, loose skin and fat are gradually deposited below the chin until the so-called “double-chin” develops. This hanging pouch of fat and skin obliterates the ideal angle of the chin-neck profile and definitely contributes to the appearance of aging. Other people develop a “turkey-gobbler” deformity, which consists of fat and vertical bands of loose skin (and sometimes muscle) extending from the chin to the base of the neck.

Some double-chins may be improved by a procedure known as submental suction assisted lipectomy (or cervicofacial liposuction) alone or in combination with a standard neck lift.  Younger patients with double chins are the patients that respond best to submental suction assisted lipectomy alone because their great skin elasticity allows the skin to snap back tight against the underlying bony jawline.  Older patients have poor skin elasticity thus generally also require some simultaneous skin tightening via a neck lifting procedure.

In the case of severe “turkey gobbler” deformities, a standard neck lift may not be sufficient to remove the redundant skin under the chin.  In these instances, it may be necessary to remove skin directly from the front of the neck – a procedure called a direct excision neck lift.

In male patients with “turkey gobbler” deformities who prefer to not undergo a facelifting procedure, a direct excision neck lift by removing skin from the front of the neck is also a valid option.

What can a direct neck lift accomplish?

A direct neck lift can correct:

  • Severe turkey gobbler deformities
  • Lose skin in the neck
  • Fatty accumulations in the neck
  • Neck banding

What happens during a direct neck lift?

A direct neck lift can be performed under local anesthesia in our clinic’s procedure room or under general anesthesia.  It can be performed alone or in combination with other procedures.

Based on the anatomy of the patient, the severity of the deformity, and any concurrent procedures being performed, Dr. Velargo designs the direct excision on the front of the neck.  This usually takes the shape of a zig-zag, multiple zig-zags, or an inverted “T” for optimal scar camouflage once healing is complete.

After the redundant skin has been removed, Dr. Velargo addresses any excess fatty tissue with a combination of liposculpture (sculpting the fat by hand with sharp instruments) and suction assisted lipectomy (liposuction).  Next, the neck bands are typically addressed (the platysma muscle) by a suspension technique (See Dr. Velargo’s SMMS article).  Finally, the incision is closed in a meticulous manner with sutures.

What can I expect during recovery from a direct neck lift?

If combined with a facelift, recovery will be dictated by the facelift instructions.

Regardless, you will feel some tightness when the anesthetic wears off.  Dr. Velargo does NOT use drains.  Pain will be minimal.

Swelling, bruising, and soreness are to be expected after a direct neck lift, but post-operative instructions and recommended medications will be given to ease any discomfort.

Frequent application of these cool compresses for the first 72 hours helps to speed the healing process along.

Incisions are cared for 4-6 times per day by cleansing the incision lines with hydrogen peroxide and applying bacitracin ointment.

All sutures are removed at one week.  After all stitches have been removed, the scars will appear deep pink in color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink should become white, the firmness of the scar should soften, and they should become less noticeable.  Each individual varies with respect to healing, but it takes approximately one year for these changes to occur and for scars to “mature.”  But if you stretch the fresh scars, expect them to respond by getting thicker in order to “protect” themselves.  Keep in mind that all incisions are designed by Dr. Velargo to minimize visible scarring.

You must avoid turning the head or stretching the neck for two weeks.  When you turn, move the shoulders and head as one unit or as though you had a “stiff neck”.  This is important to prevent stretching the healing incisions, which may cause scars to widen, as well as putting tension on the deep sutures beneath the skin, which may cause them to pull loose.  Because of this, we advise patients to not drive for two weeks following surgery.

Patients are advised to sleep with the head of bed elevated or in a recliner for 2-4 weeks post-op.  This helps to minimize swelling.

Lumps and bumps may be present in the initial phases of healing. These usually go away with time, but we can often speed the healing process along with local injections of steroids.

Parts of the neck will feel weak or “numb” after the direct neck lift operation.  This is to be expected and is usually temporary.  It may take several weeks or, on rare occasions, months for this to subside.

How long do the results of a direct neck lift last?

The duration of the results achieved with a direct excision neck lift cannot always be accurately predicted. If the “turkey gobbler” deformity was severe, it will obviously take years before the condition becomes as bad as it was before surgery.

A direct neck lift turns back the clock of the aging process, but does it not stop the ticking.  Having said that, a patient will generally look forever younger than had they not had the procedure done at all.  Any neck drooping seen in the post-operative period is a result of continued aging. Had the surgery not been performed, the patient would have the “new” neck drooping on top of the “old” neck drooping, which was corrected at surgery. Tuck-ups help maintain a youthful appearance in the patient who chooses to have addi­tional surgery. Tuck-ups are generally less extensive, less expensive, and quite effective.  Dr. Velargo is also experienced in performing revision neck lifting as well.

Does insurance cover direct neck lifts?

Neck lifts are considered cosmetic procedures. Therefore, insurance companies do not generally cover the cost of surgery.


Contact the New Orleans Center for Aesthetics and Plastic Surgery today to find out more about expert direct neck lift surgery.