Neck Suture Contouring

This treatment is ideal for individuals who have been unable to eliminate excess neck fat and sagging skin through diet, exercise, and skincare routines, often due to genetic factors or the effects of aging. This treatment elevates the loose skin under the chin and along the jawline, improving the overall appearance of the neck. It even helps when the neck is flexed, at which point the so-called “double chin,” “selfie chin,” or “tech chin” is exacerbated. The large vertical neck bands (“platysmal bands”) and bulging/prominence of the submandibular glands can also be improved.

No, threads are dissolving sutures that typically feature small barbs or cones to assist in lifting tissues, though their effects are more limited. These threads can be effective in facial tissues, but the neck has a greater range of motion, resulting in threads lasting only a few months for neck enhancement compared to 12 to 24 months in the face. The duration depends on the technique, the number of threads used, and the type of thread material.

Dr. Burroughs employs a neck suture suspension technique that utilizes permanent suture material, which has been employed in surgery for decades, resulting in longer-lasting outcomes of several years. The original Suture Neck suspension technique used a 4-0 polyester thread, while Dr. Burroughs’ current method uses a 3-0 polyester for improved contouring and better support of sagging tissues.

One advantage of this technique is that it creates a space between the neck skin and the underlying platysma muscle, allowing loose skin to glide upward and heal in a tightened position. In contrast, threads are placed within the subdermal layer of the skin without separating the skin from the muscle, which leads to a less dramatic and shorter-lasting lift.

The suture suspension is also positioned behind each ear and extends across the submental area of the upper neck twice to provide broader support. This technique works similarly to a hammock, effectively supporting the neck tissues.

Dr. Burroughs found that while the techniques were quite similar, he preferred a stronger and broader support, opting for a 3-0 caliber suture, which is larger than the Suture Neck suspension 4-0 suture. Although the placement pattern remained generally the same, he tailored the approach to fit each patient more effectively, as he discovered that the Suture Neck suspension measuring templates were not ideal for everyone. For example, some patients possess larger, taller, or broader necks than others. Dr. Burroughs’ customized technique allowed for more optimized results across a diverse group of patients, both male and female.

By making a few small incisions —typically 1 to 3 cm—one below the chin and one at each earlobe—his neck suture suspension technique achieved a significantly improved lift and contour. This method also effectively addressed vertical bands, horizontal lines, and skin redraping. It’s akin to a minimally invasive “open neck” technique with very discreet incisions. The small incision under the chin allows direct severing and suturing of neck bands, which may be more beneficial for certain candidates. Additionally, it provides reliable access for removing excess fat under the chin.

No. As with all plastic surgeries or procedures, results can vary from person to person due to factors that may not always be predicted. Skin quality plays a significant role, and other factors, such as weight loss or compromised health, can also affect the outcome. Dr. Burroughs has performed Suture Neck suspension and his customized neck suture suspensions on hundreds of patients, with the vast majority experiencing significant improvements. However, some individuals may not be candidates for the procedure, including those with excess skin or fat, smokers, individuals with a history of neck surgery, and those with poor skin quality (such as a lack of elasticity).

Given Dr. Burroughs’s extensive experience with this technique, he can generally predict who will benefit from it. An in-person consultation is necessary for him to assess the tissues and identify the specific needs of an individual’s neck. Some patients may require a lower facelift in addition to neck suture suspension, as well as lateral platysmal work and skin excisions. When more extensive skin removal is required, Dr. Burroughs typically performs the incisions behind the ears to make them less noticeable.

Dr. Burroughs often combines treatments for initial sessions, focusing on energy tightening and improving skin quality. His preferred energy-based device is the NeckTite, which utilizes bipolar radiofrequency. This device carefully measures the treatment temperature both on the surface of the skin and beneath it, enhancing results while prioritizing safety.

For patients with a small amount of fat under their chin, NeckTite can effectively address this issue on its own by providing lipocontouring and creating a sharper jawline. The skin-tightening effects take a few months to reach their full potential, with many patients experiencing 30-40% skin contraction and tightening.

Dr. Burroughs has been using bipolar radiofrequency on neck tissues since 2018 and has incorporated neck suture suspension and contouring since 2020. Other effective treatment options that complement neck suture suspensions include laser skin resurfacing and additional tightening with radiofrequency microneedling devices such as Morpheus or Pixel8.

Some patients may also benefit from chin fat grafting, and those with very thin neck skin might see improvements with volumization injections using hypermixed (hyperdiluted) Radiesse (Calcium Hydroxylapatite) or Sculptra.

It is extremely safe with a very low incidence of serious complications (e.g., significant blood loss or poor scarring). If a suture breaks or loosens, it may be necessary to place a new one, which is usually determined at 6 months. The original suture can remain in the neck permanently, but if it is easily visualized, it can be removed if one prefers. Complications are very low with this technique, but may include suboptimal improvement, infection, and, very rarely, scarring or contour irregularities of the neck skin that may need to be addressed; these are typically self-limited and improve with time or treatments that Dr. Burroughs can recommend. Dr. Burroughs has seen results lasting over 5 years, but maintaining stable weight and an optimized skin care regimen is critical.

Yes. Suture neck suspension can be performed alone for sagging neck skin but provides additive results to neck liposuction and energy-based skin tightening procedures. Dr. Burroughs was an early adopter and remains one of the most experienced surgeons of the technologically advanced and safe Inmode FaceTite/NeckTite radio-frequency assisted lipolysis (RFAL) treatments. The NeckTite tightens the skin tissue by up to 35% in many patients and can address mild amounts of unwanted fat. For larger amounts of fat then suction-assisted liposuction can also be performed all while you’re awake but relaxed and comfortable. It is optimal to perform these procedures together as you are already anesthetized and the improvements occur synergistically.

Skin quality improvements for fine lines, sun damage caused pigment dyschromias can further be addressed with intense pulse light, chemical peels, and laser resurfacing. Suture platysmaplasty can also be performed with non-surgical FaceTite or surgical face lifting. Rarely, patients that have lost their skin elasticity and/or have significantly excessive amounts of sagging skin will benefit from some behind the ear skin removal to avoid pleating of the skin as it is lifted.

Dr. Burroughs performs all of these procedures under either oral or light IV sedation in his office procedure-operating room. Once you are relaxed, dilute anesthetic solution (tumescent) is injected into the superficial neck tissues. This provides the comfort needed and makes the procedure most commonly bloodless. Sterile skin prep and draping is performed followed by dissection between the skin and underlying platysma muscle, application of radiofrequency energy skin tightening (NeckTite) that provides skin quality improvement and an up to 30-35% additional skin tightening. Thus, the neck tissues are not only lifted but they are tightened. The neck bands can then be released, if needed, utilizing the suture in novel-technique in which it is passed above then below the muscle bands, so they can be released. Any needed liposuction can be performed at this point followed by the placement of the suture through the small skin holes. The suture is placed in a hammock-like pattern with strong anchoring behind the ears followed by the final suture knot placement under the chin area in the midline. It is amazing to see the lift occur immediately upon tightening and tying the suture.

No. A dressing wrap is placed for 48 hours, and a foam neck collar is worn for 10 days while awake to avoid flexing of the neck. We want the newly released and raised neck skin/tissues to heal at the new higher position created by the dissection-provided sliding envelope. Most activities that are non-strenuous can be resumed nearly immediately and all activities including intense workouts after 10 days.

No. It is completely different as the suture is a permanent type that has been used and well tolerated in other surgeries for decades. Threads are slowly dissolving and even the longest-lasting threads that can provide up to 18 months improvement in the face only typically last 6 months or so in the neck as the range of motion of the neck is much more extensive than the face thereby reducing the result longevity as compared to the strong support and lift provided by the “net” or “hammock-like” support of the precisely placed suture material. The suture is also much more robust than the threads in thickness and anchored strongly to the fascia behind the ears. Threads are also placed very superficially in the skin as compared to the more deeply placed suture. The initial and elegant dissection to gently allow the skin envelope to freely move upward is not performed with thread lifts. Dr. Burroughs devotes considerable procedure time and has mastered this dissection technique portion of the suture platysmaplasty. The value proposition given the significant number of threads that would need to be placed that still only yields lower results and longevity compared to the suture technique is simply not comparable.

Absolutely yes. This in-office procedure performed under light sedation is very safe with extremely low infection or other risks. The training for this procedure is only provided to surgeons or experienced liposuction physicians. Dr. Burroughs has had no severe complications, has performed this procedure for several years, and has taught his technique at numerous national and international cosmetic meetings. Monitoring is performed during the procedure and very detailed post-procedure instructions are provided. Dr. Burroughs always either carefully modifies his current techniques to optimize safety, comfort, and results or researches new techniques and technologies before bringing them to his surgical practice and Springs Aesthetics. Dr. Burroughs travels and speaks extensively at Aesthetic conferences across the world and has a network of colleagues that freely exchange ideas to improve their surgery techniques and other rejuvenative technologies. Dr. Burroughs also provides his personal mobile number if concerns arise outside of normal business hours for his post-surgical and procedural patients.

The percutaneous approach to improving the neck is one of Dr. Burroughs’ most sought neck treatments and has predominantly replaced the need for surgical neck lifting in his practice. It has long-lasting (typically 5+ year) results, is very safe, minimally invasive, quickly and comfortably performed without general anesthesia, and carries very high patient satisfaction. Typical patients that seek this procedure either have a neck contour they have never liked as it is too full/sloped without a beautifully defined angle or aging has caused additional sagging in conjunction with the development of neck bands, prominent horizontal neck lines folds, and a fat “double chin” appearance. These improvements can restore public image-related confidence and comfort in person or virtually while performing work or personal video calls (e.g., FaceTime, Zoom, others). This is why it has been called by many as the “Zoom Lift.” If you’re concerned with the appearance of your neck then call for a consult to get all your questions answered and to find out if you are a great candidate for this amazing procedure.

Suture neck suspension is fantastic for anyone who is relatively healthy, has good skin elasticity, and unhappy with the fullness and poor definition in their neck and submental chin area. If your skin is very non-elastic with considerable excess saggy skin, then you are not an optimal candidate for suture neck suspension. However, improvements in skin elasticity can be obtained through customized skin care, external energy-based skin tightening procedures, and PRP injections.

There may be some bruising and swelling for 2-3 days, but there is minimal discomfort. Some tightness for a few weeks can be felt but there is minimal discomfort. You will be sent home with a chin strap supportive dressing, but recovery is generally only about 4 days. You can be minimally active, but downward activities with your neck are discouraged in the early phases.

No, there can be some minimal discomfort during injections, but most patients will not find the actual procedure to be painful. We include Pro-Nox, our popular nitrous oxide laughing gas, for those patients that wish or need additional comfort during injections.

No. Suture neck suspension uses a permanent suture material placed in a mesh-like pattern to provide very long-term results that mimic surgery for optimal candidates. Thread lifts, on the other hand, are more temporary as they slowly dissolve over time and need repeating every 1-2 years. Suture neck suspension has been used successfully for many years, with many patients having multiple years of results. Suture neck suspension can be repeated, but is not necessary for several years. In the rare circumstance of a suboptimal result, it can be repeated at 6 months. Suture neck suspension is definitely a “game-changer” for minimally invasive neck rejuvenation.