If a person’s neck does not appear youthful, the face – no matter how limited the effects of aging are – will often not be perceived as youthful either, unless the aging neck is concealed.

Even in the absence of other signs of facial aging, a poorly-defined or sagging neck can add years to a patient’s overall facial appearance. When performed properly and with great attention to detail, a necklift surgery can dramatically restore a natural and youthful neck profile, with no outward evidence that any surgery has been performed.

Over the past 17 years many cosmetic neck lift operations have been designed to restore the loss of the youthful neck and jaw line. None have been as successful and long-lasting as the Suture Suspension Technique in both men and women.

Recent modifications of this operation have further increased its utility and effectiveness to a wider range of patients. With the availability of the new Contour Thread™ suture, the possibility for total neck rejuvenation in an office setting, without intravenous or general anesthesia has now become a reality.

Necklift surgery can consist of a variety of surgical techniques that are carefully selected to meet each individual patient’s particular needs. It is therefore important to select a qualified physician with a great deal of experience in numerous necklift procedures.

Who is a candidate?

While it is impossible to tell you definitively whether a neck lift is the right solution for your concerns, here are some general questions that suggest you may be a suitable candidate for a neck lift:

  • Is your facial skin and tissue healthy?
  • Are you realistic about your expectations for the outcome of the neck lift procedure?
  • Are you in reasonably good physical and psychological health?

In younger patients with good skin tone, submandibular liposuction alone may produce a dramatic improvement. For some patients with good skin tone but poor definition at the angle of the neck, we add a suture-suspension necklift to sharpen the angle between the jawline and neck. This procedure is minimally invasive and has a very quick recovery. It will not, however, improve the situation if a true excess of skin is present.

Patients with more advanced aging changes in the neck generally require tightening of their neck skin as well. The neck is the one area in facial rejuvenation where a tighter and more toned surgical result looks natural and aesthetically ideal (as opposed to the face where ‘tight’ and ‘tighter’ just looks like surgery). Neck skin removal is accomplished through incisions around the ears which can be extended a short distance into the scalp if necessary.

If the incisions are created and closed correctly and without undue tension, a very natural looking result can be obtained with no obvious signs that a necklift has been performed. A great deal of experience and expertise is required to avoid distortion of the ear and surrounding skin.

The ideal patient for the “G String” neck lift technique is the Class 1 or 2 neck deformity previously described. In summary, these neck classes include those patients with just loose platysma muscle with small amounts of submental and submandibular fat. Both patient types have naturally deep submental angles and strong mandibular bony outlines.

How is the procedure performed?

Both the original formal Suture Suspension Technique and the Contour Thread “G String” Technique utilize permanent sutures that create a new “supporting ligament”, that holds the platysma muscle in an internal and superior “vector” which restores both the cervicomental angle and mandibular borders. This creates a youthful neck and jaw line.

The “G String” neck lift Technique now allows the “appropriate patient” to obtain optimal neck and jaw line improvement in an office setting under local anesthesia. This involves the careful evaluation of six key anatomic points:

  1. Cervicomental angle depth
  2. Mandibular border definition
  3. Mandibular angle definition
  4. Labiomandibular fold prominence (jowling)
  5. Chin Prominence
  6. Neck width

By carefully assessing each one of these points during the consultation, the aesthetic surgeon can choose the neck lift procedure that will give the patient the best aesthetic result desired.

If both you and the physician decide a “G String” Neck Lift is the best choice for you, expect to receive instructions about how to prepare for surgery, as well as information about local anesthesia, sedation, pain control options, and post-surgical care.


The skin is dressed with strips of brown surgical tape or Steri-strips over the cervicomental angle and suction sites at the submandibular borders. A mild compressive rubber dressing or Ace wrap are used for 24-48 hours post-operatively along with oral Tylenol or Tylenol with Codeine as needed for pain.

The dressing is removed in the office along with the skin tape by the surgical staff after 24-48 hours. New small pieces of Steri-strips are placed on the submental incision site. The patient is instructed to limit their activity for an additional 48 hours when they can remove the residual Steri-strips described above. Sutures in the submental area are removed in one week and in the postauricular area in two weeks if they have not dissolved at that time. Full activity including heavy exercise is limited to four weeks. Activities of daily living can be resumed as early as when the dressing is removed in 12-24 hours.

            Most patients report minor post-surgical swelling and/or mild bruising that lasts about a week. Your stitches are removed 7 to 10 days after surgery.

In the long term, around the 12 month post-op period, the results have continued to improve with no relapse in neck or jaw line contours present. The incisions are virtually unnoticeable and recovery is limited to 3-5 days on average.

The Result:

The “G String” technique for neck rejuvenation using Contour Threads has resulted in excellent youthful contours of the neck and jaw line when used for the correct category of surgical candidates. The patients have been limited to Class 1 and 2 neck categories and have all had their procedures done under local anesthesia with or without oral sedation in the office setting as an outpatient.

The “G String” Neck Lift procedure involves a small incision underneath the chin, through which excess fat in the triangle below the chin and jaw line is suctioned with a very thin cannula. Then, through small incisions inconspicuously placed in the creases behind each ear, a permanent nylon suture is drawn underneath the chin and neck muscle situated on either side of the neck and an artificial ligament is created.

Once the suture is anchored in place, the muscle is tightened and held in a more youthful position. Additionally, because the technique is performed below the jaw line, the chance of damaging facial nerves, which is always a risk with a facelift, is minimal.

This approach for neck rejuvenation should result in an excellent long-term result, since it is based on identical procedural concepts as the original suture suspension technique of the neck, which has stood the test of time over the past 13 years.