Neck Liposuction vs a Structural Neck Lift in Austin
I think neck liposuction is an outdated procedure for most people. That might surprise you, because it’s still widely offered in Austin and everywhere else, and I used to do it all the time in training. It was common in younger patients and sometimes in older ones.
Those of us who do a lot of neck lifts and facelifts are now seeing what happens years later. In this post, I’ll explain what neck liposuction does and doesn’t treat, who might still be a candidate, and why a structural neck lift is often the better long-term choice.
How Neck Liposuction Works
Neck liposuction can be done a few ways. The most basic is a standard liposuction cannula passed under the skin to remove fat. Many offices do it under local anesthesia. It can be subtle or very aggressive.
I have a device in my office called FaceTite. It uses a cannula under the skin that delivers radiofrequency heat to melt fat and tighten skin. I see it as one step up from plain neck liposuction, because one of the big problems with liposuction alone is loose skin over time.
FaceTite tightens the skin a bit, but subtly. It won’t give you a neck lift result. How much fat it reduces depends on how much energy is delivered and whether I follow it with a little liposuction to clear the melted fat, which I usually do.
What Liposuction Can’t Reach
This is the part most people don’t hear. Neck liposuction and FaceTite only treat subcutaneous fat. That’s the fat between the skin and the platysma muscle.
Many people carry fullness in deeper structures that liposuction can’t touch:
- Fat beneath the platysma (subplatysmal fat)
- Enlarged digastric muscles
- Prominent or sagging submandibular glands
- A loose or banded platysma muscle
A review in Facial Plastic Surgery on deep neck contouring makes the same point. Traditional approaches that only treat subcutaneous fat and occasionally the platysma can leave less-than-ideal results, and may even make some contour problems worse, because the deeper structures are often the real cause of an obtuse neck.
The Problem I’m Seeing
I’m seeing more young women who shouldn’t have much skin laxity yet but do. They’ve had overly aggressive neck liposuction, and now they have loose, crepey skin under the chin. Nothing was done to tighten the skin, and fat wasn’t the only problem to begin with.
One recent patient was in her 30s and came to me for a face and neck lift because of this. If she’d never had neck liposuction, she probably wouldn’t have needed surgery. She didn’t need deep structural work either. She needed the skin tightened. The liposuction had made her neck look older than she was.
Who Needs a Structural Neck Lift
Others think they need neck liposuction when what they really need is a structural neck lift. Unless someone is significantly overweight, and we generally don’t operate on those patients, most of the fullness under the chin sits deep to the platysma.
In a structural neck lift, I go beneath the platysma and reduce fat based on the dynamics of your chin, tongue movement, and speech.
Muscles can contribute too. People can hold tension in the neck muscles and in the muscles under the tongue. That can enlarge them over time. It’s more common with a recessed chin or in people who habitually push the tongue forward. Speech therapists can help retrain that tongue motion.
Those patterns can enlarge the digastric muscles and the platysma. During a structural neck lift, I sometimes trim the digastrics. Sometimes I also reduce the submandibular glands. To get a sharp jawline, I address every component that’s contributing and then tighten the skin at the end.
If a recessed chin is part of the picture, my post on correcting a recessed chin explains how that affects the neck.
So, Should You Get Neck Liposuction?
My general guidance:
- In your 40s or older: I would not recommend neck liposuction.
- Younger than that: Proceed with caution, and choose your surgeon carefully.
Whoever you see should do a full evaluation of what’s causing the fullness in your neck. They should be able to offer every option, from minimally invasive treatments to a structural neck lift. Not every facial plastic surgeon debulks the deeper neck structures, so ask.
Look at before and after photos, and make sure some are long term. In the first couple of months, a lot of results look great. At one year, you can see whether everything relaxed and the skin loosened.
It’s tempting to think a quick office procedure will do the job. Sometimes it does. Sometimes a smaller procedure creates a bigger problem, and the right operation from the start would have been simpler.
Frequently Asked Questions
Does neck liposuction cause loose skin?
It can, especially when it’s aggressive and nothing is done to tighten the skin. That’s the problem I’m seeing in younger patients.
Is FaceTite better than neck liposuction?
It adds some skin tightening, so for the right young patient with subcutaneous fat it can be a better option. It still can’t treat fat or structures beneath the platysma.
How do I know if my neck fat is deep or superficial?
A hands-on exam is the best way to tell. I look at how the neck changes when you swallow, move your tongue, and tense the platysma.
Can a neck lift fix loose skin after liposuction?
Yes. Depending on what’s causing the laxity, that may mean skin tightening alone or a full structural neck lift.
Before Anyone Removes Fat From Your Neck
Fullness under the chin usually has more than one cause, so get a full evaluation first. If you’re weighing neck liposuction against a neck lift, come see me in Austin and I’ll give you an honest opinion about what’s driving the fullness in your neck.
You May Also Like:
- Combining a Lower Face and Neck Lift
- How to Get a Better Jawline
- Getting Jawline Definition Without Surgery
- Correcting a Recessed Chin
- Why a Deep Plane Facelift in Your 40s May Be the Perfect Time
- EmbraceRF and FaceTite Gallery
