Dr. Dirk Lazarus

Plastic, Reconstructive and Aesthetic Surgeon

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

Neck

The neck can be problematic for women or men of any age.

Younger patients may have a full neck often due to excess fat, but sometimes because of a low hyoid bone or fullness of other structures.

With age, the skin of the neck may sag, fat may accumulate and structures may descend into the neck and become visible. The platysma muscle can descend and cause muscle bands. The skin thins, becomes wrinkled and folded, may sag and develops pigment issues and loss of elasticity. The cervico-mental angle, the angle between the more vertical component of the neck and the more horizontal component under the chin, can become lost. Considered with the neck is the jawline and face above.

In profile view the neck is concave and so debulking the full neck can increase the concavity and give some degree of skin tightening. This is a good thing, desirable. Debulking can be achieved with neck liposuction or with an open neck procedure.

Neck Liposuction. Read more:

In the correct patient, neck liposuction is still to my mind one of the good ways of dealing with a full neck. The procedure can be performed under oral or intravenous sedation with local anaesthesia. Usually 5 small (3-4 mm) cuts are made; one where the earlobe meets the face, one under the chin and then one over the jawline or just above (the scar left is not noticeable). Fat is then sucked out with syringe liposculpture using a fine, blunt tipped cannula. The procedure not only removes excess bulk and tightens skin, but also gives me a source of fat for fat grafting. Since deflation or loss of volume is an early change of facial aging, even evident in younger patients, I often recommend to put fat back in – under the eyes, temples, naso-labial folds, forehead, lips, etc. The recovery from neck liposuction is relatively quick. The little cuts are merely taped, not sutured and heal fast. Usually, I will either give a neck band to be worn for about a week, or tape the under chin area.

Open neck

An open neck procedure involves a (2-3 cm) cut under the chin. The skin is separated from the underlying tissue and through this incision excess fat can be removed, muscles can be trimmed or tightened and even protruding glands can be managed. The procedure can also be performed under either oral or intravenous sedation with liposuction, and can be done in conjunction with other procedures, frequently with facelift or eyelid surgery.

Anterior Cervicoplasty. Read more:

In men, and sometimes in women too, I perform and anterior cervicoplasty. This procedure, again possible under local anaesthesia and sedation, is used simply to trim away excess skin that may be hanging, turkey gobbler style. All the open neck maneuvers can be performed through an anterior cervicoplasty too. Anterior cervicoplasty involves an incision from the chin to the bottom of where the skin excess is and so leaves a scar in that position. Sometimes little Z cuts are made in the cut.

With facelift, the neck muscles are also tightened. After dissection, I use sutures to put traction on the platysma muscle to pull the muscle up and improve the neck.

Neck bands can be due to either gravitational descent or increased tone in the platysma muscles. Botox can help reduce the tone in the muscles, but will not help with gravitational descent. For that you would need surgery.

Neck correction can be a rewarding procedure.

Page last updated: 20 October 2024

Testimonials

We have met before – about 10 years ago – I was kicked in the face by my horse and you performed the surgery (rather brilliantly). Now I am interested in something else…

All 6

I just want to thank you again:) I’m super happy. Could you please send the before and after u fixed it pics, I would like to show my mum.

All 7

From a cleft patient who had secondary surgery to help her speech:
It is one year ago that i was blessed to meet and know you. Thank you very much for the support you rendered to me while I was in South Africa. I will never forget your acts of kindness. I am fine now and my speech has greatly improved! I think I don’t need another operation. Even though I don’t communicate that often, you are always at heart.

Cleft

I would just like to take the opportunity to say THANK YOU to Dr. Lazarus and his team.
I have had a very good experience due to the pleasant staff and of course Dr. Lazarus himself.

All 9

I am feeling uncomfortable and not very proud of myself! I did not get round to expressing my gratitude and appreciation to you.! Dirk, thank you so very much for all your kindness and understanding throughout my dealings with you and it has been always been a pleasure dealing with your entire practise.

All 8

Actually drove past your surgery this morning and thought I should pop in to say hello. Am very happy with the way the surgery has turned out, has made a huge difference and am very grateful. I will endeavour to pop in sometime in the near future to let you have a look.

All 6

Dear Anneli

I came to Capetown from UK about 9 years ago and sought out Dr Dirk for cosmetic surgery. He performed a tummy tuck, lipo, and facelift on me during my time there and I don’t think I have ever written to thank him for the wonderful work he did. Thank You to him and all you ladies on his staff. I attach 2 shots of me on the beach in France, showing my nice flat tummy.

All 5

Hello again, Dr. Lazarus!
Once again I would like to say how pleased I am with the result of your handiwork!

All 4

You are such a STAR thank you for all your assistance.

All 3

Just a quick thank you to all the staff – felt in safe professional and caring hands from the moment I walked through the door this morning.

All 2