I can’t tell you how often we see consultations for patients who have taken excellent care of their face and the skin of the face but for some reason have completely neglected the neck! A recent survey of RealSelf users cited only 10% of the population use sunscreen daily. Of people who use sunscreen at least once a week, 93% of them apply it to their faces. Only 74% of those same people apply it to their necks.
The skin on your neck is significantly different than the skin on your face. It is prone to wrinkling, sagging, and banding. Why is that? The skin is the largest organ in the body but there are different kinds of skin. Think of the palms of your hands compared to your armpits or lower eyelid skin. Very different!
Skin isn’t just one sheet. It is actually quite complex. Skin as a structure has 7 layers! And to make it even more complicated, the top layer of skin, or epidermis (what we see and feel) is made up of 5 more layers! Skin has what we call “adnexal structures” too. These include oil glands (sebaceous glands), hair follicles, sweat glands (apocrine glands) and nails.
So back to the neck. The reason the neck is prone to age faster than the face is that:
1. The dermis (strength layer of the skin) is thin and therefore contains less collagen and elastin. These are substances that I’m sure you’ve heard of but basically we want lots of it so that our skin bounces back and keeps tight and firm.
2. There are fewer oil glands and hair follicles. Oil keeps the skin moisturized and supple. And hair follicles are chock full of stem cells that help regenerate skin so it stays fresh and young.
3. We overuse our necks. Not only do they support our heads, but also the platysma muscle is flexed every time we crane our chins or bend our necks or grimace or grin. Over time, this muscle gets strung out and loses its ability to hold everything in place.
I plugged in “neck” on the Sephora website and it returned 93 products. I did the same for “face” and 3729 products popped up! I think that more than anything reveals the emphasis we put on caring for our faces but not necessarily our necks!
Interestingly enough though, the neck is one of the most frequent concerns of patients who come into our medspa and office. You can’t hide an aging neck here in sunny California!
More and more people are searching for a way to fix their necks. They are looking for solutions for neckbands, horizontal necklines (tech neck), sagging and crepey skin, turkey gobbler neck, sun damage. And more and more of those people are looking for nonsurgical ways to tighten, lift, and correct.
As a surgeon, I have yet to find a device or topical treatment that effectively treats the neck as well as a neck lift. Granted, these devices and products are very important for maintaining results, but unless you are at the very early stages of neck aging, I find that most patients are disappointed by the results. I understand that surgery on the face and neck is intimidating to most people. They worry about scarring and not looking natural. They’ve seen bad plastic surgery results and heard horror stories from friends or celebrities. It’s a leap of faith to trust your surgeon with your face!
I spend a lot of time during my consultations making sure that I understand your goals and that what you want is realistic and achievable. I aim for natural. I want you to look like yourself, just better. I tell patients that the result should bring you back 10-15 years and that if well maintained, it should last you 10-15 years.
Neck lifts are done under twilight sedation. That means that you’re sleepy but awake. No general anesthesia! You go home the same day without drains and after I see you the next day, you can shower and do your hair. Most of my patients have very little swelling and bruising and the majority don’t need any pain medication stronger than Tylenol. I’ve treated patients as young as their 30s all the way to the late 70s for neck concerns and you know what, the most common feedback after surgery is “if I’d known how easy this was I would have done it years ago”!