The brilliant author and screenwriter Nora Ephron wrote publicly about IT. The exquisite and talented actress Katharine Hepburn covered IT up. My statuesque and Southern former boss had IT “fixed.”

IT is their necks.

                                          Kate & Nora

Hepburn hid her aging neck beneath turtlenecks. Ephron publicly discussed hers in the book I Feel Bad About My Neck: And Other Thoughts on Being a Woman,  a blunt and entertaining look at aging women who are dealing with everything from menopause to maintenance.  My ex-employer promptly hired a plastic surgeon to banish the telltale signs of aging from her neck—and face–soon after they appeared. She had her first facelift at 50!

I don’t feel bad about my neck. I hate it!  And although I like turtlenecks, I’m not about to wear them in 90 degree heat. That leaves me with three choices: Stop peeking at my neck in the mirror, accept it, or have a neck lift.  It’s unlikely I’m going to stop looking and start accepting. So I decided to find out what’s involved with a neck lift from Dr. David Sieber, a cosmetic and reconstructive surgeon in San Francisco. While I was at it, I  asked him about my (droopy) jowls and the rest of my (decades-old) face.

First, I’d love to share what I learned about the changes in most of our necks and faces as we age, and what we can do about them. It’s strictly a personal choice, of course, but the more you know, the more you can decide what’s best for you.


Neck Lift. This 66 year old woman underwent a neck lift and limited brow lift for facial rejuvenation.

SIEBER  “Most people will lose 30 percent of the fat in their faces, starting in their late 30s and early 40s. We also lose collagen, a large component of our skin, which diminishes the elastic properties it had when we were in our 20s. Our skin simply can’t recoil as it once did, and since it has nowhere to go—and less fat to fill it in—it  re-drapes over other things on our faces.

“Loss of fat and collagen, plus gravity, can create drooping skin around the eyes, sunken cheeks, pooching jowls, sagging neck, pronounced folds between our nostrils and the sides of our mouth (nasolabial folds), not to mention wrinkles and creases.

“Jowling is caused when your facial skin starts to fall and gets stuck on the ligaments that attach jawbone to skin on each side of your face. Known as mandibular retaining ligaments, they prevent our faces from totally falling down. The drooping skin also creates the two vertical lines that extend from the outer corners of the mouth down to the jawline on either side of the chin. We call these marionette lines.”


“Injectable fillers can make a face look really good. But when injectables are overdone on a face that has lost a great deal of fat and collagen, it will look worse and worse, like a balloon.  No one needs that much volume. The only option in that case is to surgically remove and reposition the fat where it should be on the face.”

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