Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg

Neck Rejuvenation

The aged neck may exhibit some or all of the following features:

  • Skin descent resulting in excess, loose skin and creating a sloppy neck or jowls
  • Fat excess of the neck and lower face
  • Muscle banding in the neck, which created abnormal contours

This may result in excess wrinkling of the neck skin, a “turkey wattle” or double chin, and jowl lines.

Surgery is usually the most effective way to improve the neck. Excess fat can be removed with liposuction which also provides some skin tightening. While this is okay in younger patients and patients who mainly have excess fat, usually further skin tightening and muscle suspension is required as well. An incision around the ear and behind the ear will provide the additional skin tightening and allow the muscles to be suspended and improved. The procedure then becomes a facelift which is modified according to your individual anatomy. The neck is therefore lifted from above and attention needs to be given to all the tissue layers: skin, fat and muscle.

Suture suspension of the neck alone, without skin removal, usually provides only a short-lived solution and is not one that I usually recommend. Some forms of resurfacing can help the skin of the neck and sometime prominent bands can be helped by relaxing the muscles with neurotoxins like Botox or Dysport.

Surgical neck rejuvenation, usually with facial rejuvenation, can provide a satisfactory outcome and an improved neck appearance.

Before and After Surgical Neck Rejuvenation


This email comes late as I have purposed to do this since the beginning of the year. I came to you in January 2009 to have reconstructive surgery for a scar on my face. For many people it did not seem a big deal but somehow, I had failed to accept as I could not even look at my face because of it. You did an excellent job. With the limitations you explained to me, the scar has now healed with a year of plaster/ tape. I still see where the scar originally was but it is now almost unnotice…