A long neck has always been considered a sign of elegance, especially to those of us who were fans of Audrey Hepburn. While the neck cannot truly be lengthened (except by the practice in some African cultures of using metal rings to stretch the neck from childhood), one can give the illusion of a longer neck by removing the excess fat or hanging skin.

Fat is often accumulated in the upper portion of the neck. One sometimes sees the problem in younger patients, both men and women; but usually it is as part of the aging process that people tend to accumulate fat there in the neck. This condition is sometimes referred to as a double chin; it destroys the youthful contour between the jaw and neck.

Years ago, the only method available was to make an incision under the chin to cut out the unwanted fat. This had been advocated by a well-known plastic surgeon so many others tried it. Unfortunately, when done as a single procedure, it was nearly impossible to produce a smooth transition to the rest of the neck that could not be reached through the incision. The result was an unsightly depression. Also, an attempt to pull up some excess skin using this incision caused visible lumps at the ends of the incision.

Fortunately, with the advent of liposuction, this operation is no longer done. It is quite simple to make a very small incision under the chin (or two small incisions just under the ear lobes), insert a thin liposuction cannula and suck out the fat. The skin almost always shrinks up completely. The result is a beautiful neck and jaw line, with the youthful contour being successfully restored.

When a receding chin is coupled with a fat neck, the chin may appear to run straight into the chest. In such a case, a defatting of the neck combined with a chin enlargement will solve the problem.