As we age and skin elasticity decreases, we begin to see the sagging of skin tissue.  This is evident everywhere from our eyebrows, eyelids, cheeks (causing nasolabial folds), jawline (jowls), and neck. With the graduated approach method, I am looking to address problems appropriate to their severity.  A small amount of sagging of neck tissue in a young patient may be differently managed than a larger amount of sagging in an older patient.

Weight loss and excess skin

With weight loss, and loss of skin fat, skin sagging can actually be more noticeable. I therefore recommended completing any weight loss programs prior to undergoing any surgical intervention for the best results.

Common face or neck problems

include jowling, neck sagging or neck “wattle”, hollowing of the cheeks, and platysmal banding.



The most effective way to address sagging of the lower face, this procedure is performed through incisions hidden around the ear.  Extra skin is removed and the lower face is lifting into its natural position.  I avoid “pulled” or “stretched” results by replacing tissues in their natural position.  This can be demonstrated by pulling the tissues “up” rather than “back”.  See the Facelift Page for more information about how I perform this procedure, expected downtime, and results.


The traditional necklift is typically combined with a facelift procedure to achieve the best results. This procedure can be done by itself for patients only interested in neckline and submental (chin) appearance. I typically perform a necklift in conjunction with liposuction of the neck and jowls. See the Necklift Page for more information about how I perform this procedure, expected downtime, and results.

Neck Liposuction

Done through a small pinhole under the chin (and sometimes additional sites), fat is suctioned from the deeper layer of the neck.  This fat usually produces the heavier look of the neck.  This procedure can be done along with a necklift or done on its own.

Platysmaplasty or Platysmal Myectomy

The muscles in the front of the neck, over time, separate to form vertical bands. These can be addressed by sewing the edges together or by excising a portion of the muscle so that it is less active and less prominent. This is typically done at the same time as a necklift procedure.

Mid-face lift

This procedure addresses an often overlooked part of the youthful face, the midface.  Through a combination of eyelid incisions or small incisions made in the hairline, a lift of the cheek area can be performed.  This can address the region of the tear-trough as well as the shadowing just below the cheek bone (known as malar mounds).  This procedure is often done in conjunction with a lower lid blepharoplasty (eyelid surgery) to remove extra skin or with a brow lift. See the Mid-Face lift page for more information about how I perform this procedure, expected downtime, and results.

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