Neck Lift/iGuide

A neck lift is a good procedure for women and men who have advanced facial aging that is most prominent in the neck area, with loose, sagging skin and extra folds (a condition known as a wattle or “turkey neck”). The iGuide procedure has replaced the less reliable “G Stitch” as a minimally invasive neck lift. Instead of a single suspension suture (G-stitch) the iGuide creates a mesh of sutures to naturally elevate the skin of the neck improving the tension and the angle of the neck.

Frequently the neck is the most obvious part of a pattern of overall aging of the face. In many cases an isolated neck lift can emphasize the aging of the lower face. In others, especially men, both the surgical corrections and the use of absorbable sutures can provide an excellent improvement.

About the Procedure

Surgical Neck Lifts

This procedure is performed on an outpatient basis under general or local anesthesia, either in a free-standing surgical center or in the office. Dr. Kress begins the incision at the earlobe and curves in a gentle arc behind the ear. A second incision is necessary in the groove under the chin for access to the front of the neck. Through these incisions the underlying tissue is tightened for a more natural appearance. A repair of the muscle separation in the front of the neck and/or liposuction in the area beneath the chin may also complement the neck lift. The excess skin is tightened and removed. Drains are seldom necessary, but may be used overnight at most. In many cases, the neck lift is performed along with a facelift procedure.

A milder version of the Neck Lift

T to Z lift

Used mostly in men with their thicker neck skin. This is an excellent procedure for men who only want to be rid of the turkey neck with less concern about the face. Usually done under general anesthesia it is a fairly quick fix to the anterior neck waddle. Excess skin and fat is directly removed from the front of the neck and crisscrossing Z flaps prevent a band from forming. While the skin is elevated the fat and muscles of the neck can be improved. A drain is rarely required.

The trampoline or iGuide lift

The trampoline lift or iGuide 2.0 is a less invasive procedure done on an outpatient basis, usually under local anesthesia, at either in a free-standing surgical center or in the office. The lift involves precise weaving of a suture through the loose skin of the neck similar to the effect of a corset in order to achieve a smoothing effect. Small incisions are placed in strategic locations along the jaw line, the neck, and just beneath the chin in the middle of the neck. Liposuction is performed in the neck area to help mobilize the neck skin. The suspension materials are passed from incision to incision crisscrossing and creating a lifting mesh (trampoline) of suspension. The overall effect is a lifting and smoothing of the neck to a new and more esthetic angle.

Recovery Time

There is virtually no pain involved with neck lift plastic surgery. Full surgical neck lift patients will have their sutures are removed within 7 to 10 days. Any bruising or swelling is gone within 10 to 12 days. Many people can return to work even before all of the sutures are removed. Persistent bruising can be addressed by our staff estheticians.

The trampoline or iguide lift has no sutures to remove. Temporary bruising, swelling and difficulty swallowing can still occur.


Neck lift patients see relief from the heaviness and excess skin that had accumulated on their neck and lower face. Softening of the wrinkles of the neck and elimination of the “turkey neck” also are possible, creating a healthier, more youthful appearance in the neck and lower face area.

NeckLift FAQs

How can I tell whether I need a neck lift or a iGuide?

The appropriateness of the procedure depends on the skin. If there is excess skin, then a neck lift would be necessary to remove the excess skin. The iGuide can be used when the skin is not excessive or to add to the effect of the neck lift.

I spoke with another plastic surgeon and he never told me anything about this stitch. Is this something new?

The iGuide is an improvement of the “G” suture.Dr. Giampapa originally described this procedure in seminars over ten years ago. It has not, however, been written up in a lot of the plastic surgery literature. Because of this, it’s possible that the other plastic surgeon may not be familiar with it.

How can I tell if my gag reflex is too sensitive to have this procedure?

A good approximation of the iGuide sling can be achieved by holding your finger in what is going to be the sharpest part of the angle of the neck while swallowing against it. Take note of how uncomfortable this is, because after the procedure, this same sensation will occur for at least the first three to five days. NOTE: There is no danger of choking because of the iGuide suture. There is only the psychological aspect of mild discomfort.

“The loose, hanging skin of my neck was so embarrassing that I never wore anything except turtleneck shirts and blouses to hide it. After my neck lift I could wear any neckline. I still wear turtlenecks sometimes, but now I’m comfortable in anything!”

T.W. (Age 56)


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