This information is of a general nature only and is for public information and education. Your individual problem needs to be assessed by your family doctor who will advise you on appropriate further steps.
The drooping of skin, muscle and fat in the neck occurs with the passing of time, but earlier in some than in others.
Although it is commonly felt that the problem is caused by drooping skin, the main cause is the stretching of the Platysma muscle layer in the neck. This muscle, on either side, meets in the middle of the neck with the muscle of the opposite side, to form a continuous sheet and acts as a corset for the neck. With time, there is stretching of the muscle and eventual separation of the attachment in the middle, leading to herniation of deeper fat and muscle.
Corset Platysmoplasty
A direct approach is through a horizontal incision on the underside of the chin. This gives access to the midline and fat from deep to the Platysma muscle. This is removed before the Platysma is brought together again in the midline. The neck skin is widely mobilised (undermined) and some of the fat from the neck skin is also removed through this incision and two further cuts around the lower part of the ear. Some skin is removed but most of the improvement will be by shrinking and tightening of the skin. This method is used when the patient wants surgery to be restricted to the neck.
Combined MACS Facelift and Platysmoplasty
A direct approach with a modified face lift of the lower third of the face, where the incisions are in front and behind the ear (MACS or Minimal Access Cranial Suspension type of facelift) or a neck lift in combination with a full face lift, where the incisions are in front and behind the ear and across the scalp into the hair line, are alternate approaches which can be used when the patient seeks improvement in the neck and the face.
The suspension technique is one where a strong suture (stitch) is used across the middle of the neck to get a sharper outline of the neck
