Is The Scar From A Direct Neck Lift Acceptable?

Q: Dr. Eppley, I am a 63 year old female who is interested in a direct neck lift but am concerned about the scar that will result. I have had two facelifts but each one has failed to really improve my neck like  I want. I have been recommended now to have a direct neck lift because they say there is no more loose skin to tighten. I value my face and neck very highly since I had double mastectomy years ago and never had any type of reconstruction. What is your advice about the direct neck lift scar?

A: As I always say to patients with difficult scar choices, the only way to be sure of having no regrets is to never have the scar in the first place. In listening to you, I just don’t see that the scar no matter how it is done is every going to truly be acceptable. And you don’t merely want to tradeoff one problem for another and then just dislike your neck for a different reason. The only way any form of a direct neck lift would even be acceptable to any patient is when they can unequivocally say that the scar is absolutely better, no matter how it looks, than what it is a substitute for. This is clearly not the case for you. As a plastic surgeon I would certainly not be comfortable placing a scar in an aesthetic operation when the patient is very equivocal about its trade-off. This is magnified in you who now values the importance of how their face and neck looks as a some form of ‘compensation’ having lost other body parts.

On a  different note and tact, I would question why none of your facelifts could not adequately address this neck issue. That is very uncommon/rare in my experience. I suspect this is a technique issue and thus I would question the statement of ‘ there is no more loose skin that can be tightened’. You may merely have reached the limits of what your surgeon can do. I would not take that as gospel that further neck improvement can not be obtained by a facelift approach.

Dr. Barry Eppley

Indianapolis, Indiana