Many patients come into our office wanting to have neck tightening. The frequent descriptions we hear from our patients are “turkey neck”, “waddle”, and “sagging neck.”  In most cases, the physical exam reveals a significant amount of excess skin and fatty deposits.

In many patients, facial tightening is also needed. They often present with jowling, deep nasolabial folds and marionette lines. The facelift operation addresses all the above concerns in addition to neck tightening and neck liposuction; this accounts for about 90% of the neck tightening treatments we perform.  However, not everyone is a good candidate for facelift and not every facelift can solve the problem of neck laxity.

Direct excision of the excess skin presents an attractive alternative in some people. This method can effectively remove the fatty tissue and skin. We use Z-plasty closure to tighten the neck and to reduce the scar visibility. The scar is the biggest downside to the procedure.  However with time, the scars can become very difficult to see. I use the Z-plasty for neck tightening more frequently for men than women. Men can hide the scars under facial hair while they fade. Remember, these post-op photos were taken at about 3 months and the scars will continue to fade with time.

In summary, I believe that neck tightening with Z-plasty is a very good option in our quest for neck contour improvement in certain individuals.