Side Profile Of Young Lady

Youthful Neck Anatomy and Neck Lift Surgery

The neck is a common area patients seek improvements in with surgery. Signs of aging in the neck are the result of loosening muscle and skin and sometimes the accumulation of fat. The medical literature recognizes youthful contours and angles to the neck and jawline which surgeons can strive for. However, all patients are not born with these features. In fact, there probably is no true “ideal” neck which every patient possesses in youth.

There are many approaches to a neck lift. My approach is through a deep plane neck lift in the central neck in addition to a deep plane lift of the sides of the neck through the extended deep plane facelift. I feel this approach can provide the most comprehensive and longest-lasting improvements in the appearance of the neck. Seek a fellowship-trained facial plastic surgeon if you have concerns about your neck. It is important to have a discussion with your surgeon about what can and cannot be accomplished with surgery to treat age-related changes to the neck.

Tight Muscle and Skin

Tight platysma muscle and skin contribute to a youthful-appearing neck. The platysma muscle is a long, thin muscle that wraps around the front and sides of the neck. It is weakest at the center. Most age-related changes to the platysma muscle occur when the center of the muscle weakens. This results in a separation of the muscle fibers from the center of the neck resulting in banding. Banding appears as thick, ropy folds in the center of the neck that can be more limited to the upper part of the neck or extend down low in the neck. The skin follows the loosening of the platysma muscle.

Sharp Angle between the Jawline and Neck

The angle between the more horizontal jawline and the more vertical neck is called the cervicomental angle. An aesthetically “ideal” angle is acute, with the soft tissue under the jawline tucked up between the jaw bones and the skin and platysma muscle tight against the neck.

Age results in a blunting of the cervicomental angle, regardless of where it started. This can be due to loosening of the platysma muscle resulting in banding, the accumulation of fat deep to and superficial to this muscle, and loosening skin. The horizontal location of the soft tissue – whether it is tucked up under the jawline or rests below it – is dependent on the patient’s natural anatomy. Some individuals may have more soft tissue that sits below the jawline from an early age.

Visible Thyroid Notch

The thyroid notch is a small depression above the cartilage, called the thyroid cartilage, and below the cervicomental angle. It is less visible in women versus men because men have a more prominent thyroid cartilage. The thyroid notch reflects the tight attachment of the soft tissue of the neck just below the cervicomental angle. Loosening of skin and muscle in the neck due to aging reduces the appearance of the thyroid notch. Tightening of the muscle and skin can improve the appearance of it.

Every Neck is Different

Every individual is born with different neck features. Some individuals were born with a sharp cervicomental angle and little soft tissue hanging below the jawline. Others were born with a blunter cervicomental angle and, therefore, a more poorly defined neck.

A blunted cervicomental angle can be due to the location of a bone, called the hyoid bone, which sits above the thyroid cartilage. When the hyoid bone sits up and back in the neck a sharper cervicomental angle is possible. However, some individuals are born with a hyoid that sits down and forward, creating a naturally more blunted cervicomental angle. All the deeper muscles of the neck radiate from this bone, which is what sets the cervicomental angle in the first place.

Trust Your Face to a Facial Plastic Surgeon

It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck.

Request a Consultation

Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more!

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