All Patients Are Not Created Equal
We all have different sizes and shapes and some patients are better candidates than others based upon their anatomy. The position of the structures of the voice box (larynx), hyoid bone and muscles of the floor of the mouth may determine the relative appearance of a facelift result. Patients that have these anatomic structures located higher and further back in the neck (top images) are better candidates for the “90 degree neck” as there is room to move the excess skin back into an acute angle.
Patients that have these anatomic structures located low and forward in the neck (bottom images) do not have the space to pull the skin back into and even with face and neck lift, may still exhibit a more obtuse (curved) neck. The bottom line here is that some patients will get a more angled neck from facelift surgery than others and must realize this before surgery.
Patients with the more rounded necks can enhance their results by having a procedure called submentoplasty which can in some cases reduce the roundness. A chin implant can also extend the front of the lower jaw so that result is more angular.
The picture above shows the difference between neck anatomy and possible facelift outcome. The top images show a normal neck with the structures lying high and rearward. This allows the skin to be pulled back at almost a 90 degree angle. The bottom images show neck anatomy that is lower and more forward. Even when pulled tight, the neck will be less angled than the normal neck. Submentoplasty and or chin implant surgery can help this type of anatomy to have a more angular result.