Patients who have loose neck muscles and/or loose neck skin undergo different types of neck lift procedures. The first one is called an open necklift, which consists of an incision which begins at the earlobe and extends to the back of the ear. This is performed for patients who have loose neck skin and muscles. If the patients have excess fat, some liposuction is performed before the incisions are made. The skin is then separated and pulled away from the underlying muscles and the muscles are pulled back and tightened. In some cases the muscles are also separated in the middle. In those instances, I also bring the muscles together in the middle and tighten them. The excess skin is then removed and the wound is closed. There is also another type of necklift which is a closed necklift. This is performed on patients who have loose muscles but tight skin. This procedure is performed with an inch long incision under the chin and one inch long incision behind each ear. If there is excess fat deposits, liposuction in performed first. Next, the loose neck muscles from the middle are anchored by stitches and carried from under the skin to the opposite side of the neck, behind the ear and anchored to the tissue behind the ear, therefore tightening up the muscles and redefining the jaws. This procedure, which is also called Platysmal Banding, is performed in a surgery center under general anesthesia or sedation, and is two to two and a half hours in length. In all necklift procedures the sutures are removed after one week, and a neck strap is worn for one to two weeks. Short term recovery is one week. Risks and complications include infection and bleeding which are extremely rare.