Patients with neck fullness may not be candidates for a facial plastic surgery procedure, like a facelift, because of medical conditions, high blood pressure, smoking, or blood-thinning medications. 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 liposuction of the neck 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 pre-operatively was the best predictor of failure. I still advise healthy older patients intent on reliable definitive changes to undergo a facelift. More about facial liposuction can be discussed during a consultation.