Neck Lift

A neck lift is a restorative surgery that helps reduce ageing signs on the neck by tightening the sagging skin and removing extra fat deposits from under the chin. The surgery is also known as lower rhytidectomy, platysmaplasty, chin lift, or submental lipectomy.

Neck is the pedestal for face. The ageing process affects not only the skin of the face but also the muscles, fats, and bones. However, unlike the face, neck lacks supporting bones. This may be the reason the latter usually ages before the face. With age, the skin of the neck tends to loosen or the excess fat or skin on the neck starts to sag under the chin. These effects may be caused not only by ageing but also due to stress, hereditary, or environmental factors.

A cosmetic surgeon may suggest a neck lift to remove any visible signs of ageing in your neck and jawline. It is a suitable option for individuals who are unhappy with the appearance of their neck area. The surgery may be performed along with other rejuvenation procedures such as eyelid surgery (to improve the appearance of ageing eyes), a brow lift (to correct sagging eyebrows), or fat transfer (to reduce wrinkles and add fullness to the cheeks or lips). If the effects of ageing are seen evenly in the face and neck, the surgery will be performed along with facelift (to remove wrinkles, loose skin, and fat from the face). A neck lift usually involves incisions (cuts) behind the ears and under the chin to remove the excess sagging skin and tighten the muscles and underlying tissues of the neck.

The surgery is recommended in individuals with the following:

• Excessively loose or wrinkled neck skin
• Bands of muscles around the neck
• Double chin or excess deposits of fats under the chin
• Saggy skin in the lower face (jawline)

The surgery is generally not done in people below 50 years or above 75 years of age. It may not be performed in pregnant women, in individuals with serious medical conditions, including heart, lung, or kidney disease or in individuals who smoke regularly as it might make the use of general anaesthesia unsafe.

You will need to visit the hospital a few days prior to the surgery for a preoperative consultation. The surgeon will measure and examine your face and take a few pictures for your record. You will be asked to share the following details with the surgeon:

• Medical history
• Coexisting medical conditions
• Any allergies you may have 
• History of anaesthesia
• List of medicines that you take, including herbs, vitamins, and over-the-counter medications
• Whether you are pregnant

Additionally, you will have to do the following preparations before the procedure:

• Stop taking blood-thinning medicines (such as warfarin, aspirin, and ibuprofen) a week prior to the surgery.
• If you are a regular smoker, the surgeon will advise you to stop smoking immediately. This will help reduce the risk of complications associated with the surgery.
• Take a shower and remove nail polish, body piercings, and make-up before you arrive at the hospital on the scheduled day of the surgery.
• Arrange a friend or family member to drive you home following the procedure.
• You will need to fast from midnight of the night prior to the surgery. Fasting is recommended to prevent vomiting (a risk of general anaesthesia) during the surgery.
• You will have to sign an approval form to grant permission for the surgery.

After you arrive at the hospital, the hospital staff will provide you with a hospital gown. They will also insert catheter in a vein in your arm or hand (IV) to supply you with essential fluids and medicines during the surgery. The surgery usually involves the following steps:

• An anesthesiologist will administer general anaesthesia to put you into a deep sleep. In some cases, IV sedation along with local anaesthesia (numbing medicine) is administered to help the patient relax.
• The surgeon will make a cut within your hairline on either side of your head. The incision will extend down from the front of your ear to around your ear to the back of your head.
• With the help of these incisions, he/she will:
  • Redistribute or sculpt the excess fat from under your chin and neck
  • Reposition tissues under your neck skin
  • Tighten your platysma muscle (the broad, thin muscle in the front and sides of the neck)
  • Trim excess neck skin
  • Tightly pull the skin over the uplifted area
• The surgeon will make another small, inconspicuous incision under your chin to repair muscles and perform liposuction. During liposuction, excess fat is loosened, dislodged, and suctioned out using a syringe or surgical vacuum.
• He/she will close the incisions either with absorbable or non-absorbable stitches.
• Finally, the surgeon will cover your neck and face with bandages to reduce the bruising and swelling after surgery.

If limited results are required from the surgery, the surgeon may make small incisions around your ear (instead of a large one) to remove excess fat from your neck. After the surgery, the surgeon will insert a drainage tube in the operated site to remove any accumulated fluids in the area.

The entire surgery may last for about two to three hours. You may feel restless or groggy, have a dry mouth, sore throat, and other symptoms after you regain consciousness. These are the side effects of general anaesthesia that fade within a few hours. The surgeon will remove the drainage tube before you are discharged from the hospital, i.e., on the same day.

The results from neck lift will not be immediately visible after surgery as bruising and swelling will obscure the operated area. You may experience tightness around the surgical site for several months. Once you reach home, you will need to take the following care:

• Keep your head in an elevated position (above your heart) to reduce swelling in the operated area.
• Avoid excessive bending, twisting, and other movements of the neck.
• Avoid clothes that are required to be worn from over the head.
• Do not subject the operated region to excessive abrasion or force during the healing period.
• Your surgeon may prescribe some medications to provide relief from the discomfort that you may experience after surgery. Take them as directed
• Avoid vigorous physical activities for around four to six weeks.
• Avoid application of ice over the neck as it can affect the flow of blood in that area and cause skin death.
• You can resume work and other daily chores in about two weeks after the surgery.
• Following a healthy lifestyle and using proper sun protection can help achieve long-term results from this surgery.

The swelling may require several weeks to months to completely subside, and incisions may take about six months to heal. The results of the surgery will be noticed once the bruising and swelling subside. Neck lift not only restores a youthful appearance of the neck but also helps boost your self-confidence.

When to see the doctor?

Contact the surgeon if you experience any of the following after the surgery:

• High body temperature
• Increased swelling, redness, and warmth in the operated site
• Bleeding or discharge from the incision
• Increased numbness and tiredness
• Poor pain relief
• Nausea or vomiting
• Stitches poking out of the skin
• Severe diarrhoea or constipation

The potential complications associated with the surgery include:

• Infection
• Thick, wide, red, or painful scars
• Breaking apart of wounds
• Changes in the colour of the skin over the operated area
• Loss of blood supply to the surgical site
• Damage to internal tissues or structures
• Nerve damage and numbness in the operated area 
• Allergic reaction to anaesthesia or stitches
• Unsatisfactory results from the surgery
• Risks of general anaesthesia such as confusion, lung infection, or stroke

The surgeon will provide you with a schedule for follow-up appointments before you are discharged from the hospital. If non-absorbable stitches are used to close the incisions, the stitches will be removed during the follow-up scheduled one week after surgery.

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.