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What conditions can a facelift and necklift target?

As we age, our skin loses its elasticity, the underlying tissues lose their volume and the bones lose their structure. Facelifts and neck lifts are both straightforward procedures which can help problems caused by the ageing process, including double chin, sagging neck and jowls.

A facelift works by repositioning the soft tissues and skin to its former level and plumping out the soft tissues to give the refreshed look of natural youth. A neck lift tightens the skin around the chin and jowls.

Here we will look at the problem of a double chin, sagging neck and jowls and how a facelift and necklift can help.

Double chin

A double chin is exactly as it sounds - extra fat under the skin gives the illusion of a person having two chins.

The condition occurs when an extra layer of fat is formed beneath the chin and this can be caused by a number of different things. The most common cause of a double chin is massive weight gain and it is often associated with obesity. The condition is also caused by ageing, where the skin loses its elasticity, and genetics. Another equally important factor is the anatomical level of the insertion of the muscles of the floor of the mouth into the hyoid bone, which supports the windpipe (trachea) at the level of the vocal cords. If this level is high, there is a sharp angle between the chin and the neck. If it is low, then the angle disappears and however much fat is removed, there will never be the desired definition.

Having a double chin can have a huge impact on a person’s self-esteem, making them feel self-conscious and anxious about their appearance.

However a facelift and neck lift at the Cadogan Clinic can help to tackle this problem area.

During a facelift the surgeon will remove excess fat and loose skin around the chin and neck region, causing the double chin to disappear. In the case of a neck lift, extra skin around the chin is removed and the neck muscles are tightened, resulting in a better facial appearance and eliminating the double chin.

Liposuction can also be used to remove fat under the skin and sculpt the chin.

Sagging neck

Loose, sagging skin in the neck area can be caused by a number of common factors, including genetics, ageing, dramatic weight loss and lifestyle factors, such as smoking and excessive sun exposure.

People who do not have a defined angle between the chin and the neck (also known as mento-cervical angle) and significant submental fat are at greatest risk. The mento-cervical angle is determined by the level of the hyoid bone above the windpipe. If the hyoid is low, there is no angle and skin of the chin slopes directly into the neck.

Ageing, sunshine and smoking are the main causes of sagging skin of the neck, causing the skin to thin and reducing elasticity. This allows the vertical bands of the platysma (neck cords and neck bands) to show through. Sometimes these gather together with the surplus skin in the middles, resulting in a so-called turkey neck.

There are nonsurgical treatments available, but these are not as effective at tackling a saggy neck as the standard neck lift, where the skin is drawn upwards and backwards towards the ear. This is by far the best option when the jawline (jowls) are also an issue. This procedure is combined with fat grafting around the chin and face.

Turkey neck

A turkey neck, also known as a wattle, refers to the loose surplus skin which hangs down in the midline from the chin to the neck. It takes its name from the farmyard bird which has a noticeable flap of skin hanging from underneath the chin.

Once again, a turkey neck is a side effect of the aging process. When the skin in this area loses its elasticity, it takes the shortest route from the chin to the neck. It occurs when the neck muscles begin to weaken and the skin loses the ability to stretch and stay tight.

A turkey neck is typically worse when a person has experienced significant weight loss.

There are a number of facial exercises which purport to help lessen the appearance of a turkey neck. There is no evidence that any of these work. Surgical procedures, such as a neck lift, are the only way to get rid of a bothersome turkey neck.


Everyone develops jowls along the jawline as they age. The soft tissues naturally lose elasticity and descend. They are held up by deep ligaments to the eyes, nose, ears, mouth, chin and mandible behind the chin. The wider, triangular upper face and narrow chin become inverted, resulting in a sunken, narrow upper face and wide jawline. The outer angle of the eyes slip down and there is a downturn of the mouth. The deep attachments force the skin to fold at the nasolabial (smile) lines and the hitch at the jawline behind the chin forms the jowls behind it.

As part of the ageing process, the appearance of jowls happens to all of us, but it is more of a problem for some people than others as it can be inherited. A person’s nationality and their skin type can have an affect on the severity of jowls. For example, a person with Celtic skin, who has been exposed to sunshine, can find the problem more acute. Strong cheekbones and jawbones delay the onset of jowls.

The onset of jowls can also be delayed with the use of sunblock and quality skin care, but eventually the condition will require surgical intervention. This will recreate the triangular shape of a youthful face, with strong cheekbones and a defined jawline.

Our expert surgeons here at the Cadogan Clinic will lift the soft tissues away from the mandible to restore the volume to the upper part of the face, tightening the floppy skin. A facelift is one of the most effective treatments we offer to tackle the appearance of jowls.

If you have developed a double chin, sagging neck or jowls and would like us to help, please book in for a consultation with one of our expert surgeons here at the Cadogan Clinic to discuss the available options.

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