• 
  American Society
  of Plastic Surgery
• 
  American Society of
  Aesthetic Plastic Surgery
• 
  American Association for Accreditation
  of Ambulatory Surgery Facility

SELECT A PROCEDURE: Face Lift | Mid-Face Lift (Cheek Lift) | Cheek Augmentation | Endoscopic Brow Lift (Forehead Lift) | Neck Lift | Blepharoplasty (Eyelid Lift) | Lip Augmentation | Otoplasty | Rhinoplasty

Procedure: Neck Lift

A "neck lift" is a procedure that improves the overall contour of the upper neck. It helps to define the chin-neck angle providing a more definite demarcation between the two. In most instances there is a combination of excess fat along with relaxation of the superficial neck muscles giving rise to the "turkey gobbler neck". When neck skin is loose then the skin can be tightened by excising some of the excess. This is usually performed in conjunction with a facelift procedure to be able to remove the maximal amount possible. If a full facelift is not necessary then a mini-facelift can be combined with the neck lift to provide more tightening.

Surgery

Most neck lift procedures begin with liposuction to remove excess fat. Fat is removed through a small incision just below the chin. The muscle (platysma) is sutured together, if necessary, to tighten the upper neck muscles thus decreasing the sagging appearance. The incision is then sutured and the areas treated are covered by a bandage or garment to help redrape the skin and contain the swelling. In more limited situations two incisions are made, one in front, under and/or behind each ear. Sections of skin are trimmed and lifted into place and sutured. Tightening the platysma (neck muscle), requires an incision below the chin. These same incisions can be used for liposuction of the neck and tightening loose skin.

Anesthesia The procedure is usually performed as an outpatient under local anesthesia. If you have other procedures performed at the same time, then general anesthesia will be necessary. On occasion sedation can be performed using intravenous medications. The anesthesiologist and the surgical facility will bill separately for their services.

Duration of Surgery The operating time will vary depending on the patient and the extent of the procedure, and whether any additional procedures (face lift or mini-facelift) are performed. Generally, the operative time for a neck lift is approximately 1 ½-2 hours.

Before Surgery Do not take aspirin and ibuprofen or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from energy drinks or any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center. 

Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken.

After Surgery

A bulky dressing is applied after the procedure and this is changed to a light type dressing in 2-3 days. A small drain is usually placed and is removed in 3 days. Sometimes an elastic wrap or support is used to give gentle compression to the operated areas after the dressings are removed. Ice packs are applied to the sides of the face and neck to help reduce discomfort and swelling. There is usually a moderate amount of swelling and bruising after a neck lift. You should try to sleep with your head and shoulders elevated to help reduce the amount of swelling. You may bathe the day after surgery, but do not get the dressings wet. You may shower and shampoo your hair once your physician has removed the dressings. You may remove the elastic support to shower or bathe. Men should be able to shave after approximately 3 to 5 days.

Initial discomfort is controlled with oral medication but typically the pain is minimal. Stitches are usually removed in 5 to 7 days.

Return to Normal Activity Most people return to their usual activities and to work approximately 1 to 2 weeks after surgery. It is acceptable to apply make up after 3 to 5 days. Strenuous sports and other activities should not be performed for 3 to 4 weeks. You may drive when driving does not cause pain, or when you are no longer taking pain medication. This usually takes 3 to 6 weeks.

Swelling and Bruising Swelling of the neck and lower face or any site following surgery is normal. During the first 1 to 2 weeks your neck will feel firmer due to the swelling and scar formation. The skin may appear shiny due to the swelling. The swelling will start to subside after the 4th postoperative day. It may take as long as 2 months for the last bit of swelling to recede. You may expect about 50% of the final improvement at 2 weeks and about 75% at 1 month. You will continue to see improvement out to 6-9 months. The bruising will also take 1-2 weeks to subside. Taking the herbal medication, Arnica Montana, as well as fresh pineapple and/or papaya will help decrease the swelling and bruising.

Diminished Sensibility As with any surgical procedure, small sensory nerves near the surface of the skin are interrupted during a neck lift. Portions of your neck and face will feel numb or have less than full feeling. The sensibility in these areas gradually returns, usually within 2 to 3 months as the nerve endings spontaneously heal. During the healing process the skin of the face may become hypersensitive for a period of time. Sensibility returns over several months, but some diminished feelings may last indefinitely.

Scars You should expect a scar under your chin and possibly in front of each ear, with an extension upward into the hair of the temple region and downward around the earlobe and into the hair behind the ear. The location will vary slightly depending on the hairline. The scars are placed in natural skin creases and will fade with time. This usually takes 6 to 9 months. All scars are however permanent. The width, height and color of scars are unpredictable. Wear a sunscreen of at least SPF of 30 or greater when outside to protect the scars from sunlight during the healing process.

 

Complications

When neck surgery is performed complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

HEMATOMA A collection of blood under the neck skin may occur in 1 - 2% of patients. The body will absorb minimal bleeding. A larger collection may necessitate aspiration to drain the collection. Only on rare occasions will it require additional surgery. On very rare circumstances, bleeding could result in intense pain along the upper neck with a marked amount of swelling requiring surgical intervention.

EDEMA This is swelling, which is a normal consequence of surgery and is best treated simply by elevating the head of the bed. The application of ice packs or cold compresses is very helpful for the first 2 to 4 days.

ABNORMAL SCARS A small percentage of patients will develop scars that are unacceptable despite meticulous attention to detail, both during and after surgery. The scars may widen, remain red or raised. If the scars are problematic, a steroid ointment or injection may be used to improve their appearance. This usually corrects itself with time, massages and patience. In rare cases, the scars may need to be surgically revised.

WRINKLING As the neck skin heals there may be scar formation from beneath that result in wrinkling of the overlying skin. Occasionally the wrinkling may be pronounced enough that external massage or ultrasound therapy or steroid injections may be necessary. Most of the time the amount of wrinkling is very mild, if any, and should resolve on its own. These problems are usually mild and require no additional treatment.

NERVE INJURY In addition to the small sensory nerves to the skin noted above, the other main nerve that is at risk is the facial nerve. Injury to this nerve occurs in less than 1% of cases. When it does occur it results in weakness of the face when smiling. If the nerve or one of its branches is injured due to stretching it may take 2 to 6 months for recovery. If the nerve is cut there may be either partial or complete weakness of a certain area.

SKIN LOSS This is also a rare occurrence. It may be due to cigarette smoking in the days to weeks before and after surgery, or due to undo tension at the site of the incision, which could be compounded by swelling or hematoma. Usually this is managed without the need for additional surgery.

INFECTION This complication is also rare. Prevention is the key and antibiotics are given both before and for a period of time after surgery.

I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be.

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Telephone: (801) 743-0700
Fax: (801) 743-0701
for more information.

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