Regardless of the type of necklift, the crepey (thin) skin on the neck doesn’t change with surgery

Q: I am researching options for revitalizing my neck. My neck is quite crepey but I don’t have jowls (yet). I am 58 years old and petite. I have been recently reading about the “simplicity lift” and would like to know if the results are comparable to a traditional neck lift.

A: Trademarked Lift vs. Traditional Necklift

All the other surgeons make excellent points regarding the comparison of a traditional necklift versus a name branded facelift or mini-facelift.

In general, the less work that is performed under the skin on the deeper fatty and muscle tissues “the SMAS” the less strength the lift can support over time. If too much skin is removed with too little support, then poor scarring can occur.

Mini-lifts can still have nice incisions and scars, but the surgeon needs to be very conservative with the skin removal, in order to prevent poor scarring. Yet at the same time the results from the mini-lift will also be “mini” after the “Honeymoon swelling” goes away after the first 3-6 months after surgery.

Crepey Neck skin … Tough problem

The additional point that I wanted to make was in regards to your “crepey skin” comment, because I think the before and after photos of our face and necklift patients don’t show the whole picture.

Crepey skin, for those of you who are reading along, is very thin tissue paper like skin, which tends to crinkle when pinched, and usually has significant sun damage to go along with it. This type of skin does not look young. The elasticity is significantly decreased, and non-surgical skin tightening procedures rarely “tighten” the skin enough to smooth out the crepiness.

Lasers, light based treatments and chemical peels have limited improvement for crepiness, and does not treat excess fat or muscle bands. Lasers and chemical peels can be performed more aggressively on the face than the neck, since the skin on the face is thicker and can tolerate higher laser settings or more concentrated chemical peels.

Plastic surgery can stretch the crepey skin over a wider area by excising or removing the extra skin. It is like restretching the leather over the top of a drum that has become loosened. By stretching the crepey skin this produces some “tension” which makes the skin appear more elastic. Over the subsequent months to years, the skin elasticity continues to decrease, and much of the crepiness will return. I think a conservative estimate is the first 6 months after face and necklifts, the neck skin will look and appear younger, but with additional time the crepiness will return.
Another observation which is not visible on the Before and After photos is when the patient lowers their chin or squeezes their decolletage area together, even a nice before and after result will reveal the crepiness of the neck skin and decolletage skin. The reason for this is that the skin is not fully stretched over the neck and chest, when the person is flexing their neck down, and their shoulders together.

Illusion of youth

I believe that these facial rejuvenations procedures are good at producing a result that makes the person appear younger by repositioning the skin, fat and muscle. But the key point is that the skin, fat, and muscle doesn’t actually become younger. Certain positioning of the face and neck will reveal the “smoke and mirrors” but for most normal positions the results look very good. In general, most patients with realistic expectations are happy with the improvement, but for those patients who expect to be miraculously transformed back to their younger selves may be disappointed.

I hope that makes some sense. I think realistic expectations prior to these types of surgeries results in more satisfied patients.


Dr. Yang