Patients with neck fullness may not be candidates for a face lift because of medical conditions, high blood pressure, smoking, blood thinning medications, or patients may disqualify themselves because of cost, unavailable recovery time, or emotional resistance to “such a big procedure.” I have published a six-year study involving 132 patients who had neck liposuction without a facelift (published in Plastic and Reconstructive Surgery, 2003, p. 1393, “Submental Suction-Assisted Lipectomy without Platysmaplasty: Pushing the (Skin) Envelope to Avoid a Facelift for Unsuitable Candidates”). Neck liposuction without a facelift was observed to be a reasonable alternative for some cosmetic surgery patients in St. Paul or Minneapolis who were unable or unwilling to undergo a facelift.
Localized fullness in the middle of the neck was observed to be the best predictor of a good outcome. A crepe paper appearance of the skin preoperatively was the best predictor of failure. I still advise healthy older patients intent on reliable definitive changes to undergo a facelift. More about liposuction in general is discussed later in this book.