With his extensive experience, Dr. Neurohr has developed great skill and versatility in the neck lift which allows him to precisely identify which structures are creating the contour problems, and he is adept at making the surgical corrections which best restore the inherently youthful curves of each individual’s neck. He is one of the few aesthetic surgeons who performs neck lifts without doing a facelift.
Dr. Neurohr performs the neck lift to rejuvenate the lower third of the face, the jawline and neck. It has a wide range of technical options available depending on the nature of the patient’s presentation. In a young patient, under 40, a double chin can cause concern, and in those cases, the problem is generally localized to fat deposits in the area. Kybella is a new injectable product that Dr. Neurohr uses to melt chin fat. It usually takes multiple sessions, but it avoids surgery. Liposuction is another method to treat a double chin. Dr. Neurohr usually performs this procedure under local anesthesia, and it is typically a virtually painless, one time operation. It isolates the fat pad under the chin, and using a 2 mm cannula, it is very effective at improving the contours and flattening the offensive bulge under the chin with minimal (3-4 days) down time in a young person.
As people age, the problems under the chin and in the neck become more complicated. The platysma muscle loosens, particularly at it’s attachments where the chin and neck meet. The hyoid defines the junction. The platysma pulls away and becomes the instigator of the most prevalent aging change of the neck which Dr. Neurohr calls “the gobbler.” Fat also accumulates under this muscle, beyond the reach of Kybella and liposuction. The only effective solution to fixing this problem is surgery, and Dr. Neurohr has at least three techniques he uses depending on the patient’s individual anatomy. Skin laxity compounds the problems, but Dr. Neurohr exercises surgical maneuvers, which are designed to preserve natural hairlines and remove the extra skin in hidden seams behind the ears.
The neck is much more dynamic area than the face so, the surgical corrections must be very secure to withstand turning and flexing. Still, the corrections must be done without tension, and with correct anatomical alignment in order to look natural. Many surgeons won’t even operate on the structures under the chin. They only pull the skin to the sides to “tighten it up.” Unfortunately, that only works in a small percentage of the cases.
There is almost always minimal discomfort after a necklift. Still, after surgery, time is needed for the healing process to stabilize the layers. Therefore, Dr. Neurohr has his patients keep their chin-neck angle at 90 degrees for 9 days. That means sleeping on their backs with a small pillow roll under their neck and shoulders. When looking down they bend at the waist, rather than at the neck, and so on. The first stitches come out on the 4th post op day, and the final stitches come out on the 8th day. Driving commences on the 9th-10th day, easy jogging at 2 weeks, and full exercise at 3 weeks. Patients usually return to work at 10 days to 2 weeks. The tissues stay firm under the chin for 6 to 12 weeks as the collagen of the healing tissues matures. A hyperactive platysma muscle sometimes requires Botox and or mild steroid injections to help speed the healing process during this time.