Thick Neck? Tech Neck? Why Neck Liposuction Often Fails in Younger People

thick neck, tech neck, streamlining neck lift, Inland Empire

Are you one of the millions who have a thick neck?  Or do you find you’ve developed a “tech neck?” Whether it’s caused by your genes or your work, a neck that is overly thick and bulky can take away from your good looks.  To remedy their naturally thick neck or their tech neck, many consider neck liposuction.  Is that always a good idea?  Will neck liposuction really cure their problem?  Will it cure yours?  Or does a completely different solution make more sense for you?

When neck liposuction is the best solution for your thick neck

In determining whether neck liposuction is your best option to streamline your neck, it’s important to understand how the procedure works.  According to the American Society of Plastic Surgeons, this is the general outline for a liposuction procedure:

First, diluted local anesthesia is infused to reduce bleeding and trauma. Then a thin hollow tube, or cannula, is inserted through the incisions to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the cannula.

Neck liposuction uses two small incisions behind the earlobes and one under the chin to remove fat below the skin.  It does not go under the platysma, a thin muscle layer often tightened in neck lift procedures.  Nor does it tighten sagging muscles.  It just removes excess fat below your skin.

neck liposuction, neck liposuction Inland Empire
As shown in this simulation, neck liposuction can eliminate fat under the skin

So, if your primary issue is a double chin or too much fat under your neck skin, neck liposuction could make a big difference for you.  That’s especially true if you’re in your 20s or 30s, have healthy elastic skin, and don’t have sagging neck muscles.  Once the excess fat is removed, your elastic skin will follow your new neck contour.  Just remember, to retain your sleek new neck you’ll need to avoid gaining weight.

When neck liposuction will not streamline your thick neck or tech neck

If your thick neck is not due to excess fat under the skin, neck liposuction will not do much to streamline it.  It won’t address the real issue.  And if you’ve got tech neck, liposuction is probably not an option that will work.  Cosmetic dermatologist Sarah Sawyer explains:

[Nowadays], we spend so much time in the neck flexure position that it causes changes in the cervical spine, and then there’s less space for the skin to sort of stretch over the jawline. The effect on the skin and the other three layers of tissue in the neck are that it becomes lax.

The platysma is troublesome, cosmetically speaking. It is a very thin muscle…What often happens is that as the muscle starts to herniate, [it causes] the loss of that 90-degree angle. It can also create a downward force on the facial muscles, which is going to blunt the jawline.

So, tech neck is a problem of the muscles and skin, neither of which are addressed by neck liposuction.

Could a Streamlining Neck Lift be the right answer for you?

A Streamlining Neck Lift is a procedure developed specifically for people whose thick neck is primarily caused, not by excess fat under the skin, but by bulging muscles and other tissues in the layers below.    It requires one incision hidden under the fold of your chin and two tiny incisions behind your earlobes.

Using the incision under your chin, your surgeon can explore the underlying structures to determine what’s causing your thick neck.  A bulging digastric muscle may be a prime culprit.  The digastric muscle is part of a muscle group that forms the floor of your mouth.  These muscles help you open your mouth and control your tongue.  They also move and hold your U-shaped hyoid bone out of the way while you’re chewing or swallowing.  If that’s part of the reason for your thick neck, your surgeon can trim the digastric muscle back to normal size so it can do its important work without making your neck bulge.

You may have fat deposits under your platysma muscles that traditional neck liposuction can’t reach.  The Streamlining Neck Lift can reach them, often using liposuction to liquify and remove unwanted fat.  Since fat above the platysma is often a thin layer that provides a smooth neck contour, it’s often far better to leave that fat in place and focus on the fat that’s causing your thick neck.

Streamlining your thick neck using a long-established procedure

Sometimes a big reason for a bulging neck is an oversized submandibular gland.  This gland is located under your chin.  It’s one of your six salivary glands.  Shaving bulging muscles and removing deep fat deposits won’t streamline your neck if you have an oversized submandibular gland.  It may just make the large gland stand out even more.

thick neck, submandibular gland, streamlining neck lift, Inland Empire

Head and Neck Surgeons, who sometime become Facial Plastic Surgeons like me, have been performing surgical procedures on the submandibular gland for years.  If it’s blocked or cancerous, they often have to remove it completely.  According to Dr. David Eisle at Johns Hopkins Medicine:

When one salivary gland is removed, the others can provide adequate saliva to help you talk, eat, and swallow. Dry mouth after submandibular gland excision is very rare.

However, we’re not looking to remove the gland, just reduce its size and bulkiness.  One study found 0 instances of chronic dry mouth among those who had a procedure to shave the submandibular gland down to normal size.  Your surgeon will use a hot instrument to slowly reduce its bulk by 50%, avoiding the salivary duct at the bottom and the facial nerve on top.

The result will be that your submandibular salivary gland will no longer make your neck bulge.  In combination with the other steps outlined above, this will streamline your thick neck.  Your healthy elastic skin will cling to your neck’s new desirable shape.

Reducing the size of the submandibular gland can cause it to leak saliva under your neck skin for 5-7 days.  If left untreated, this leak can continue up to a month.  Then you’d need several treatments a week for several weeks to alleviate it.  To prevent all that, your surgeon will insert a drain that must remain in place for 5-7 days.  He or she can suggest foods to eat and to avoid so you don’t produce more saliva than necessary during that time.  Then your surgeon will remove the drain.

And while 99% of patients have no problem, one patient in a hundred will experience bleeding a week or so after the procedure.  If that happens, your surgeon will be able to take care of the problem.

Tailoring your treatment to the reason for your thick neck or tech neck

It’s important to work with a highly experienced, board-certified facial plastic surgeon or plastic surgeon that specializes in the face and neck.  The reason for one person’s thick neck may be different than another’s.  For instance, tech neck can cause bulging neck muscles.  In that case, the Streamlining Neck Lift may work well.  But if your skin has also become loose, a neck lift that removes excess skin could be needed.

Older patients with sagging skin would usually need a traditional neck lift, which eliminates a turkey neck or a double chin.  But if they also have deepening nasolabial folds, jowls, or marionette lines, a deep plane facelift could give them all the face and neck rejuvenation they could want in one procedure.  A veteran of many surgeries has performed enough successful neck lifts to recommend the right option.

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Before and After deep plane facelift without neck lift by Dr. Brian Machida

The ideal solution to your thick neck or tech neck is to work with a highly experienced surgeon who can perform all these procedures well.  They will be able to recognize the exact reasons for your thick neck and recommend a solution that will give you the results you want – often at a cost you can afford.  If you’re in Inland Empire, California and want to streamline your neck, you can find me at STC Plastic Surgery in Ontario.

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About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

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