We’re lucky we’re not turkeys.

Turkeys are born looking old. Just take a look at their necks. And it doesn’t get any better with time for turkeys.

Fortunately for us – humans – we have a more natural progression of ageing when it comes to our face and neck. We arrive into this world looking young (well, after the first few days, anyway – months of bathing in a wet womb can take its toll on the skin!). In essence, our youthful skin shines a smoother texture, consistent thickness, and a bouncy elasticity. Free of irregular blemishes and non-erasable “smile lines”. Many factors then enter in to influence how we age and the rate at which we progress along the the assembly line of life: nutrition, exercise, sleep, stress, smoking, and most importantly, our genetics, of which we cannot choose.

Why does a “turkey neck” develop?

We need to consider the ageing effect on the neck’s underlying anatomical structures. Each component from the skin to the underlying muscle and fat can contribute to its appearance. Let’s take a look at each one of these:

Skin. With time, our skin starts to diminish in elasticity. It also becomes thinner. It is more easily stretched and doesn’t bounce back quite as easily after been stretched. Together with the help of gravity, our necks begin to sag.

Muscle. The neck muscle – or platysma – is a vertically orientated, flat and thin muscle that forms a veil over the front of our neck. Think of it as a sling that holds the neck up. Its strength and integrity helps to define the neck angle – that transition between the bottom of the jaw with the neck. It starts off in life strong and sturdy, joined at the midline, but with time, it’s fibres begin to pull apart, most commonly at the centre, but also at any point along its span. These “gaps” that develop in the muscle are analogous to a fishing net with large holes in it – the contents are no longer held tightly within it’s confines. The neck looses its sharpness.

Fat. There’s fat in the neck that exists both in front of the muscle (pre-platysmal) and also behind the muscle (post-platysmal). Each on their own or together can cause increased fullness in the front of the neck. Liposuction or removal of fat is sometimes necessary to help deflate the neck.

It is far less common for me to perform rejuvenation surgery on the neck in isolation. Certainly in some younger patients, liposuction alone may be all that’s required to improve the neck’s definition. More commonly however, I need to address both the lower face in conjunction with the neck in order to achieve a coherent and harmonious rejuvenation of the face. The lower face, notably the cheeks, tend to sag in rhythm with the neck. To fix the lower face without addressing the neck (or vice versa), when ageing features are present in both areas, doesn’t quite complete the job. I view the lower face and the neck as a zone. A zone that contributes consistently and noticeably to the suggestion an ageing face. An improvement to this zone in the appropriate patient can often be achieved through a lower face and neck lift. The neck component of this procedure addresses each of the contributing factors to a loose neck, as mentioned above. Fat content is reduced, muscle is restored, and skin is tightened.