David Y Globerman MD PLLC
Board Certified Plastic Surgery
(954) 987 - 0222
The following issues must each be analyzed before a plan can be made to treat the neck. These are the skin of the neck, fat collections under the skin, and the platysma muscle of the neck. Protruding salivary glands also must be identified.
Fat collections in the neck can be removed in several different ways; by injections of a fat dissolving chemical; by externally applied cold or ultrasound energy; by liposuction; or by direct surgical excision. Liposuction requires a small incision under the chin; surgical excision under direct vision requires a somewhat larger incision.
In all cases, removal of large amounts of fat will leave an empty skin envelope (previously filled with fat), that will hang loosely. In a younger patient, with elastic skin, the skin can be expected to retract, producing a pleasing appearance. In the older patient, where the skin is less elastic (more stretched out, and droopy), the skin will hang loose, and must be tightened to produce a satisfactory appearance.
The skin can be tightened in several different ways: surface treatments like lasers will tighten the skin slightly, as will chemical peels. For greater tightening, or where excess skin must be removed, surgery is necessary. Incisions are made behind the ears. The skin is lifted off of the underlying muscles and pulled backwards below and behind the ear where the excess skin is removed and the skin is reattached. If there is no excess fat, this may be the only procedure necessary to tighten loose skin.
In some cases, the patient has muscle bands that are visible in the neck (the platysma muscle). These bands are released and repaired through an incision under the chin.