There is a very effective procedure called a direct neck lift in which the loose skin is removed at the site of the "turkey gobbler".  This is more appropriate for the male patient who doesn't mind having an incision under the chin and neck in the front.  Most patients are tired of the loose skin interfering with shirt and tie wear.  The incision heals with minimal scar visibility and avoids incisions around the ears.

If you have a direct neck lift performed, there will be an incision line down the midline of the front of your neck.  You will probably want to wait 3-4 weeks after your surgery to wear a buttoned shirt with a tie.  Soon after this, you will certainly enjoy wearing a tie because of your new neck contour and younger look.

A neck lift and neck liposuction are surgical procedures that can both provide a substantial improvement in the aging neck. Patients who have only a mild to moderate amount of excess submental fat and/or jowls are good candidates for liposuction only. This requires only a single small incision under the chin to introduce the liposuction instrument. A neck lift is recommended in patients who have more substantial aging of the neck resulting in moderate to severe jowls, sagging and visible banding of the platysma muscle, and loss of skin elasticity with skin excess. This is a more invasive procedure, because more work is required. I perform a neck lift by making a small incision under the chin and also a short incision around each ear. In general, a neck lift includes removal of excess neck fat, tightening of the platysma muscle, and excision of redundant skin to achieve the desired neck contour.

Posted by William E. O'Mara Jr., M.D.

The nomenclature of these procedures can be confusing. Neck liposuction can be performed as an isolated procedure. A facelift can be performed as an isolated procedure as well, but a facelift operation includes addressing the neck in one way or another. Depending on the patient, I either perform neck liposuction or direct fat excision with platysmal muscle tightening as part of the facelift surgery. It is not a matter of can they be done at the same time. They should be done at the same time.

Posted by William E. O'Mara Jr., M.D.

I have always used an external incision under the chin for neck liposuction. The resulting scar is often hard to find, once healed. I do not see any benefit in making an intraoral incision. Nevertheless, I ask my patients refrain from vigorous chewing for one week to limit movement beneath the chin.

Posted by William E. O'Mara Jr., M.D.

Liposuction of the neck is a procedure in which a very small incision is made under the chin and sometimes under the earlobes. The liposuction instrument can be inserted and the fat removed. I recommend this procedure in individuals who have a small to moderate amount of sub mental fat excess and good skin elasticity. Patients who have more substantial fat and skin excess in the neck require a neck lift. During this procedure, an incision is made under the chin and behind each ear in the post auricular crease. Through these incisions, fat is removed, the platysma muscle is tightened, and excess skin can be removed. Physical examination will determine which operation will best suit you.

Posted by William E. O'Mara Jr., M.D.

It sounds like you have excellent health and take pride in maintaining it. Most patients your age  start to see that small amount of skin sagging beneath their jawline and chin, and that can be very distressing to someone who has never had that before! Nevertheless, I try to councel my patients to start rejuvenation strategies of the face with conservative measures...good consistent skin care, minimization of lines with injectables, and adequate hydration. However, in patients with isolated neck aging, I will possibly recommend submental liposuction or a limited neck lift to correct their problem. 

Posted by William E. O'Mara Jr., M.D.

Liposuction of the neck is a good procedure in individuals that have excess fat beneath their chin and also have good skin tone or elasticity. Patients who get good results from submental and neck liposuction are usually in their thirties to early fifties. Patients who have excess skin sagging in the neck usually will require a neck lift or lower facelift to tighten the deeper soft tissue laxity and remove the excess skin to achieve the desired result. 

Posted by William E. O'Mara Jr., M.D.

Liposuction of the neck, also termed sub mental liposuction, is a very safe and easy procedure. I usually perform it in conjunction with other procedures, such as lower facelift. However, in young healthy patients who have only an excess of sub mental fat, this procedure alone is very effective. I usually perform neck liposuction in an office based setting under sedation, and the procedure usually lasts approximately  thirty minutes. As with any procedure you are considering, research your surgeon and their credentials. To this date, I have not experienced any serious complications from liposuction of the neck.

Posted by William E. O'Mara Jr., M.D.