People tend to concentrate on signs of aging in their face first—considering a facelift—but overlook their necks. Many also focus most of their attention on their faces when applying skincare while the neck goes unaddressed, even though this delicate skin is just as vulnerable as that of the face.
At Pearlman Aesthetic Surgery, we help you notice these seemingly little things—no detail is too small. Often, Dr. Pearlman recommends combining a facelift with a neck lift (or platysmaplasty) in NYC to achieve the most natural-looking, comprehensive results. Otherwise, correcting only one area can create a stark contrast against the other.
Dr. Pearlman leads the leaders of plastic surgery, educating the next generation of surgeons on his effective facial rejuvenation techniques, including the mastoid crevasse technique for neck lifts. Here’s how this technique works, and how Dr. Pearlman’s synergistic approach to anti-aging goes beyond a facelift alone.
The Anatomy of the Neck
The neck is a complex structure composed of about 30 muscles that allow you to breathe, speak, eat, and move your head properly. Over time, those muscles grow thinner and weaker—a natural process known as muscular atrophy.
The skin on your neck is much thinner and more delicate than that of the rest of your body, making it more prone to show signs of aging before other areas. As muscles shift and shrink and fat deposits change, the skin on your neck struggles to adjust and mold to its new shape without ample collagen and elastin proteins, which also decline with age.
Together, these changes can leave you with an older, less defined appearance, resulting in:
- Deep creases or banding in the neck
- Excess fat beneath the chin, causing a “double chin” or “jowls”
- Skin laxity or sagging, creating a “turkey neck”
At Pearlman Aesthetic Surgery, we may recommend a neck lift to address these symptoms if you are in overall good health and do not smoke, or are willing to stop smoking before and after surgery.
Understanding Neck Lift Techniques
A neck lift, also known as a lower rhytidectomy, is a cosmetic procedure that removes excess tissue to create a tighter, more youthful appearance to the neck. However, different techniques provide different results.
Platysmaplasty
In NYC, many surgeons recommend a platysmaplasty when the neck muscles are responsible for aging, as this technique targets the platysma—the thin, sheet-like muscle that extends from the chin to the collarbone. Typically, a surgeon creates a small incision behind the ear and beneath the chin to reposition this muscle to address vertical neck bands and define the jawline.
The Mastoid Crevasse Technique: A Deep Plane Neck Lift
Dr. Pearlman recognizes that while every patient is different, often a combination of skin and muscle changes is responsible for neck aging. This means that a traditional cervicoplasty or platysmaplasty in NYC may not deliver the youthful results you desire, as your surgeon needs to simultaneously reposition the neck muscles while removing excess skin and fat for a more comprehensive, natural-looking, and longer-lasting transformation.
This topic is at the forefront of many of Dr. Pearlman’s medical lectures, where he educates surgeons on how the mastoid crevasse technique can deliver superior results. The mastoid crevasse technique is a unique, advanced approach to neck rejuvenation that removes and reattaches ligaments deep on the mastoid bone—behind the ear—creating a permanent ligament beneath the jawline.
By strategically repositioning the neck’s underlying structures rather than solely focusing on removing excess skin, Dr. Pearlman relieves deeper tension and removes deeper fat deposits to reset the neck and lower face. This technique will help create a more defined angle of the jaw.
Complementary Procedures for a Neck Lift
In older patients with advanced skin laxity, Dr. Pearlman does not typically recommend any form of neck lift procedure without a facelift, as a synergistic approach provides more seamless, longer-lasting results. Beyond a facelift, he may recommend pairing a neck lift with other procedures to target your specific concerns and deliver the results you envision. This maintains the natural harmony between your features, helping you look like yourself—only younger and more refreshed, rather than “overdone.”
Facelift
A facelift is one of the most sought after anti-aging procedures, but like neck lifts, there are different facelift techniques that deliver different results. While Dr. Pearlman may recommend a traditional or “mini” facelift for younger patients with mild skin laxity, a deep plane facelift offers more dramatic, longer-lasting improvements—without appearing unnatural—for patients with moderate-to-severe skin laxity.
Similar to his mastoid crevasse technique with platysmaplasty in NYC, Dr. Pearlman’s approach to a deep plane facelift goes beyond removing excess skin to reposition the underlying muscles, in this case the superficial musculoaponeurotic system (SMAS). The term “deep plane” refers to the anatomical plane between the SMAS and the other facial muscles that allow you to create expressions. By repositioning these muscles while removing excess skin, Dr. Pearlman places all the tension on the SMAS muscle to avoid the “pulled” look of a traditional facelift.
The term “deep plane” refers to the anatomic plane between the SMAS and the muscles that create our facial expressions. Unlike a traditional facelift, the deep plane facelift is focused on the repositioning of the muscles at the same time as the skin. Patients get a superior result that looks less “pulled” by placing all the tension on the SMAS muscle.
→ How to Plan for a Facelift (Rhytidectomy) in NYC
Neck Liposuction
While a neck lift focuses on removing excess skin and repositioning the underlying muscles, neck liposuction solely removes fat. The aging process may cause you to lose fat in some areas and gain it in others, such as the submental area. Submental fat, also known as a “double chin,” can be resistant to diet and exercise, requiring manual removal.
Dr. Pearlman may recommend pairing a neck lift with neck fat removal in NYC if you are looking to address submental fat and skin laxity to provide the best results, including a more defined jawline.
→ Learn More: Neck Lift vs Liposuction
Buccal Fat Removal
While liposuction can be transformational, it is not effective for removing buccal fat—the fat pads between your cheek and jaw bones. Liposuction can only remove subcutaneous fat near the surface, but buccal fat lies deeper, requiring a specialized procedure.
Dr. Pearlman’s approach to buccal fat removal is more strategic and conservative than that of many other surgeons, as he accounts for your age and how your face will continue to lose “baby fat” over the years. Performing buccal fat removal too early may result in a “gaunt” appearance down the road, but when paired at the appropriate time with a platysmaplasty in NYC, it can define your cheekbones to complement your newly established jawline definition.
→ What to Expect From Buccal Fat Removal: Before and After
Chin Implant
A weak or recessed chin can emphasize the appearance of jowls, in which case combining a chin implant with a neck lift can provide the best results.
By adding definition to the chin, Dr. Pearlman can improve the overall balance between your face and neck, further enhancing jawline definition to deliver the most cohesive outcomes.
Brow Lift
When sagging occurs above the eyes—in some cases, obstructing vision—Dr. Pearlman may recommend a brow lift to return the brow to its natural, youthful position.
Pairing a brow lift with a platysmaplasty in NYC targets both the upper and lower face, while a facelift targets the middle of the face.
→ Learn More About the Benefits of a Lateral Brow Lift in New York City
Eyelid Lift/ Blepharoplasty
If the issue lies in the eyelids themselves rather than the skin surrounding them, Dr. Pearlman may recommend eyelid surgery, also known as a blepharoplasty.
An upper blepharoplasty removes excess tissue in the upper eyelid, while a lower blepharoplasty reduces the appearance of “bags” beneath the eye, which can occur at any age but often develop over time.
Non-Surgical Treatments
While there is no true alternative to a platysmaplasty in NYC, we offer a range of non-surgical treatments that can alleviate some concerns associated with facial aging, including:
- Dermal fillers
- RF microneedling
- MyEllevate
- SofWave
However, it’s important that you set realistic expectations for these alternatives, as they will not provide as dramatic of improvements as surgery and require more maintenance.
→ Learn More About Your Options for a Non-Surgical Neck Lift in NYC
Step Back Into a More Youthful, Confident You
If you’re ready to learn more about our personalized approach to anti-aging, book your consultation with Dr. Steven Pearlman.
Dr. Pearlman is uniquely dual board-certified in both facial plastic and reconstructive surgery and in otolaryngology—head and neck surgery (ENT)—and has performed thousands of successful procedures. He leads the leaders, traveling across the world as a visiting professor to educate future surgeons on his proven facial aging solutions while serving as a clinical professor at Columbia University College of Physicians and Surgeons.
Consistently recognized over the past decade, Dr. Pearlman has been honored among the top 5% of doctors.
→ Read More About Dr. Pearlman’s Awards From Castle Connolly
Not quite ready for an in-person visit? While nothing can replace an in-person consultation, especially for a platysmaplasty in NYC, you can use our virtual procedure match tool to explore our available techniques. Answer a few questions about your goals, and we’ll send you customized recommendations right to your inbox!
