Why I Had Neck Liposuction

It was the holiday snapshot from hell. Leaning on the railing of a bridge over the Tiber River in Rome, a warm breeze blowing through my hair, I gave my boyfriend, Nelson, my best over-the-shoulder come-hither look as he aimed the camera at me. Ah, a memorable moment captured, I thought. But not in the way I'd hoped. Somehow an extra chin made it into the frame.

I've always hated my neck. The skin was mushy, saggy, squishy. Over the years, I'd look in the mirror, turn to the side, and pull my skin tight across my throat, just so I could see what I'd look like with a chiseled profile. Occasionally, I'd do facial exercises, like clenching my jaw, but to no avail. It made me feel deeply resentful of those perfectly sculpted beauties like Gwyneth Paltrow.

As I approached my late 30s, I became increasingly self-conscious — OK, neurotic — about my neck droop. I realized I was starting to look like my father from the side, but, unlike him, I couldn't cover my gullet with a beard. Instead, I spent a fortune on firming creams, massaging them in with careful upward strokes morning and night. When being photographed, I'd do my best to avoid unflattering angles. Eventually, I stopped wearing my hair up. When pashminas became all the rage, I pounced on the trend, wearing mine tucked under my chin in a stylish twist. I went through a silk-scarf phase, too, but the Nora Ephron solution just made me look like I was hiding a hickey.

Of course, summer was a problem, so I lost some weight. And yes, my face got skinny, but my neck stayed soft and slack.

The Roman Holiday photo was the final straw. There was no denying it: My chin was blending irreversibly into my gorge.

The opportunity for more extreme measures came when my boyfriend, prone to vanity himself, went to a plastic surgeon to talk about smoothing out the bags around his eyes. I tagged along with him to Manhattan's Upper East Side to ask the surgeon, Dr. Barry Goldenberg, a few questions about what would be right for me.

Immediately, Goldenberg sized me up as a perfect candidate for neck liposuction. A pinch test confirmed that my 42-year-old skin was still youthful and firm enough to snap tightly into place after the fat was extracted. The fact that I wasn't a sun worshipper or a smoker would help me get good results, he said. The only warnings he gave me were to avoid tanning before the procedure (because tans dry out the skin, which can result in more pronounced scarring) and to make sure I didn't gain weight afterward (because the remaining fat cells could expand and produce a fuller look again).

I was a plastic-surgery virgin with a visceral fear of anesthesia. Could I do this? Images of Tara Reid's bumpy, post-lipo torso flashed through my mind. Plus, the price tag was $3500.

Ultimately, narcissism won the day. I made an appointment for the following month. Something about Goldenberg's low-key, conservative approach was reassuring. He was no Dr. 90210, and that was fine with me.

There are other options for tightening the neck that are more cutting-edge than lipo, including injections of Botox or fillers to smooth out neck bands, and surface treatments, like Thermage, which heat the skin to help produce skin-tightening collagen. Other new procedures essentially insert a laser fiber under the skin via a tiny tube in order to heat up and melt the fat before removal. While there are no statistics on how many women are undergoing these various types of procedures, Dr. Neil Sadick, a New York City dermatologist who specializes in laser treatments, says the cornucopia of neck-fixing options is attracting a growing number of women. His practice sees about 40 cases a month.

Of course, there's always a risk of infection, and the surgery needs to be done by a pro; for instance, if too much fat is removed, it can create pouches of slack skin, like a turkey wattle. Also, in laser-assisted lipo, it's possible that the heat generated to melt the fat can burn the skin if it's not properly controlled. The key, says Sadick, is to find a surgeon who has done a high volume of procedures and knows how to handle the equipment. He suggests that patients look for surgeons who belong to the American Society for Laser Medicine and Surgery (aslms.org).

I decided to stick with the traditional procedure — good old-fashioned lipo. When I went in for my appointment, a cocktail of anesthesia and antianxiety meds from an IV drip sent me off into a pleasant stupor. I wasn't completely unconscious; at times I was aware of the whir of the lipo machine sucking out the fat. Goldenberg was also using a cannula to induce some irritation of the connective tissue under my skin; this helps produce collagen to tighten the area as it heals. I woke up at one point to a feeling of sharp jabs in my face — as promised, the doctor was injecting some of the extricated fat to smooth out the area under my eyes and to fill in my smile lines. But I was too zoned out to care much about the pain.

The recovery was the hardest part. For the two weeks following the procedure, I had to wear a compression bandage around my head and neck day and night, and the swelling made me look like a chipmunk in a turban. The bandages made my ears hurt, I had huge bruises along the sides of my sore neck, and for the first week I couldn't shower or wash my hair. It took a couple of weeks before I could venture out in public, and still longer without swathing my neck in a big scarf (thank God it was winter).

Now, eight months down the line, my neckline is positively angular, and I no longer hate Gwyneth. I feel better in my own skin. Friends comment on how good I look and assume it's due to weight loss. But I'm so pleased with myself for taking the plunge that I'm all too eager to tell them what I've done.

Of course, Nelson couldn't resist taking another portrait. But no worries. These days, the camera is my friend.