An unattractive neck might be a result of excess fat, excess skin, or a combination of both, or from microgenia (a word for a small chin). Excess fat can be present genetically in a relatively thin person. A look at a person’s parents usually verifies this.

Or excess weight gain can contribute to this problem. However, if excess fat is the prime problem, the solution is simple.

A liposuction can be performed under local anesthesia in about 20 to 30 minutes. There will be mild swelling and bruising for 7 to 10 days.

Although the patient will look better than his preoperative appearance in a week or so, the final result is usually seen at about six months.

If the patient who is older, generally meaning 45 years old or older, surgery might be necessary. This is particularly true if the patient has had lots of sun damage and-or has been a smoker.

In such a patient, the face is usually a bit saggy as well. These patients need at least surgical neck lifts, lower facelifts or even full facelifts, according to the patient’s goals and expectations.

These procedures can be performed under local anesthesia, but most plastic surgeons and patients prefer general anesthesia, as there is no discomfort and the procedure time is usually shorter.

Recovery from the facelift usually takes from 10 to 14 days before patients want to be seen in public without at least a scarf and dark glasses. Patients don’t really start looking great until about the third week.

During the recovery time, there is usually swelling and bruising. If surgery of the eyelids and brow, chin injections or implant and-or fat grafts (transfer) are included, of course the swelling and bruising will take longer to subside.

Microgenia can be treated with fillers, which might last for one to two years, or a permanent chin implant can be inserted. The results can be dramatic.

Non-surgically, the Fraxel lasers are the gold standard for tightening the skin. For people over 50 years old, the Fraxel Restore (a CO2 laser) might be necessary.

It can be combined with a liposuction, although not at the same time. Although non-surgical, a week of recovery might be necessary.

The excess fat can also be reduced and skin tightened with ThermiSmooth radio wave treatments. This is indicated if the skin is only mildly loose.

It does require three to four treatments, but it is totally painless and there is no recovery time. Patients say that it feels like a hot stone massage.

A face-to-face discussion with a physician should take place to review the different aspects of both the surgical and non-surgical options. Choosing the right procedure option should be the physician’s goal.

  1. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand