Neck liposuction is quite straightforward. As popular as it is, it is surprising it is not done even more often.

 

(Before and after: next day)

 

Several key points:

• The great majority of neck fat lies quite superficially under the skin. Beneath the fat there is a layer of muscle called the platysma, which acts as a barrier between the fat we liposuck and the vital structures of the neck. So trained and specialised doctors can perform liposuction to the neck with safety.

 

• Neck liposuction is performed with very fine cannulas, even finer than those used elsewhere on the body: generally only 2mm in diameter.

 

• Thinking about a face-lift? As you can see in these cases, liposuction alone, first, can improve neck contours and lighten the whole face.
• Many patients undergoing a lower face-lift would get more natural results, would avoid  scars, and would save thousands of dollars if they had liposuction first.
• Liposuction can defer your need for a face lift and improve the final outcome of any face lift you may eventually undergo.
• Face-lifts don’t deal well with jowl fat. Merely pulling up jowl fat doesn’t remove the fat, and in most patients the jowls just return back down after facelift.
• All patients in these photos had LIPOSUCTION ALONE.

 

At Peach we use a FOUR incision approach. The commonest text-book approach to liposuction of the neck involves THREE incisions: one under the middle of the chin, and one under the lobe of each ear. Such an approach, though, means that most of the work is done through the central incision, which then tends to stretch and become abraded as the treatment proceeds. Treating the central area on the front of the neck from this central incision tends to create vertical ridges, which are difficult to criss-cross from the rather distant incisions under the ears. It is awkward to treat the jowls from this central incision, and, finally, a horizontal incision directly under the chin is something of a give-away to the informed observer that liposuction has occurred. On the other hand, a FOUR-incision approach, with the central two incisions placed under the mandibular line and a little lateral to the mid-pupillary line brings several advantages. Less work needs to be done through each incision, so the incision is less stretched and abraded. The area directly under the chin is treated obliquely from each of these two incisions with thus less chance of vertical ridging and easier criss-crossing. There is easy access to the jowls from each of these incisions, easy access to the lateral portion of the anterior triangles and easy criss-cross against the sublobular incisions. The incisions heal very well and generally look no worse than acne scars and, if placed in a wrinkle, can virtually disappear altogether.

 

The neck recovers faster than anywhere following liposuction, but then again it needs to: it’s on display. Immediately following liposuction patients need to have an elastic, compressive garment applied. This garment helps to reduce swelling and bruising and hasten recovery. By pressing the neck skin against the underlying platysma muscle as recovery and healing occurs there is less chance of persisting neck skin redundancy and looseness. Ideally the garment would be worn for a week continually but most patients find they can manage only a few days of continual use and then, due to work commitments etc, restrict garment use to time spent at home. This is usually a reasonable compromise.