NECK LIFT SURGERY

Although the neck lift is commonly performed in conjunction with a complete face lift, a neck lift alone may be sufficient to reverse the signs of aging, or to reduce the appearance of sagging in the neck as a result of weight loss or just excess skin. Some patients may not be ready for a complete facelift and may only be bothered by the infamous “turkey neck.” In these cases, the neck lift alone is sufficient to rejuvenate the aging face and neck.

A neck lift is a procedure to lift, tighten and smooth the appearance of the neck. Often performed in conjunction with a facelift as part of a facial rejuvenation procedure, the neck lift can reverse the appearance of sagging, jowls, loose skin, and fat deposits that are part of the aging process.

The appearance of aging in the neck area is attributable to several factors:

• Laxity of the platysma muscles – the neck muscles on either side of the throat, which extend from the base of the neck to the jaw line. The platysma muscles are part of the muscle structure that creates facial expressions, and as they become lax, they can contribute significantly to an aged appearance.
• Aging effects on the SMAS (submuscular aponeurotic system). As we age, the underlying structures of the face and neck become looser and suffer from the effects of gravity, resulting in sagging and drooping.
• Loss of skin elasticity and fatty deposits. As with the rest of the body, the neck suffers from the aging effects of loose skin and deposits of fatty tissue.
• A neck lift can address all of these issues, tightening and joining the platysma muscles, to create a firm, taut muscular base, tightening and trimming the SMAS, removing excess fat deposits, and trimming and tightening the skin of the neck.

There are two parts to the neck lift procedure: the skin lift part, and then the tightening of the muscles (called the platysmaplasty.) For the skin lifting part, an incision is made behind each ear, from which Dr. Blackledge is able to pull the skin taut and trim away excess, thus eliminating drooping, sagging and wrinkling and leaving the patient with a firm new neck. The muscle-tightening portion is done underneath the skin. The muscles are pulled tight which allows for a much longer lasting process.

Following surgery, the face is wrapped in a dressing that is left in place overnight and then removed the following morning.   We prefer to use this type of dressing instead of drains.

Absorbable sutures are then used to close all of the incisions, and no drains are used. Instead a dressing is placed around the patient’s head that will be removed the following morning.

Even though the recovery period technically starts immediately after surgery, there are several things that you can do before your surgery day to make the recovery period smoother. During your consultation, we will talk to you about the importance of being physically and mentally prepared for surgery to ensure that we get the best results possible.   Now back to the recovery period. Immediately after surgery, compression dressing is placed around your face and head to reduce swelling and removed the following morning. You have the option of either staying over night or going home. This decision will be discussed with you at the time of consultation. Most patients sleep the remainder of the day and night after surgery. The following morning the dressing will be removed and at this point you will be taught how to keep the incisions around your ears clean with peroxide swabs and then moist with ointments. All of these measurers allow for a more pleasing scar.   The first day after surgery is strictly a “bed rest” day. Most patients feel better than expected, so the temptation is to “over do” it on this first day. However, patients have less bruising and swelling if they rest with their head elevated on the first day. Swelling is typically mild to moderate reaching its maximum on the third postoperative day, and then it starts to decline. We allow you to resume limited activities and also apply makeup by day four. Stitches are removed on day seven, and most people are presentable to the general public (with camouflage makeup) by day ten. Of course, this varies with the individual healing process. All of the “do’s and don’ts” for facelift surgery will be given to you separately.

Bruising

Bruising is expected after any kind of surgery. The amount that you bruise is extremely individualized – some people will bruise more than others. However, with every patient, we can expect a reduction in the amount that you bruise by taking Bromelain during the preoperative and postoperative period. We encourage you to drink at least 8 glasses of water each day during your recovery period to flush the bruising out of your system. Our experience with neck lift surgery is that the combination of Bromelain and water intake will reduce the amount of bruising that you normally would have had.

During the recovery period, you will notice that your bruising changes colors. All bruises initially appear red and change to a purplish hue. By day five, the majority of your bruises will have changed to a green and then yellow color. Once you have reached the yellow stage, you are almost “bruise free.”

Swelling

Just like bruising, expect swelling. The day after surgery, once the dressing is removed, swelling will actually increase over the next day. Typically, swelling begins to decrease on the third day after surgery. We often get the question, “what can I do to reduce swelling?” You will be scheduled during the recovery process for a procedure called lymphatic massage, which works to reduce swelling. Our aestheticians are trained to manually massage the swelling out of your face and into the neck area. Lymphatic massage has been proven to significantly reduce postoperative swelling. I usually do not recommend ice packs. Remember that there will be areas on your face that are numb initially after surgery. You can actually “freezer-burn” your skin if you have an ice pack over an area that is numb.

Sleeping

It is best to sleep in an upright position with your head at least above the level of your heart for the first two weeks after surgery. This helps to reduce swelling and also bruising. The best beds are usually either a recliner or an incline pillow. Both of these keep the head and shoulders in a natural position. If you try to sleep with your head elevated with pillows, you wind up sleeping in an unnatural position and develop muscle spasms in your shoulders.

 Exercise

You may begin light walking on the fourth day after surgery. In fact, we usually encourage this because it helps to improve your circulation, which in turn gets rid of bruising and swelling quicker. You can gradually increase the intensity of your walking over the next few days as your body tolerates it. Your body will tell you how much exercise is enough. We usually recommend that you refrain from any competitive sports such as tennis or golf for at least two weeks. When it comes to exercise, don’t pull against any tight sensations that you may have.

Pain

A popular question is “how much pain will I have after a neck lift?” Most patients will tell you that they had little to no pain after surgery. The common response is that everything felt “tight.” This is usually due to swelling and the tight sensation begins to subside after about 2 – 3 weeks. Patients are given prescriptions prior to surgery for pain medicine and are encouraged to take theme as directed for discomfort. However, most patients switch to Tylenol soon after surgery.

Eating

Because of the tight sensation in the cheek and neck after surgery, you will be advised to stay on a soft diet for at least the first week after surgery. Any foods that do not require aggressive chewing (such as soups) will make the first week a comfortable experience.

Obviously, this is a very individualized answer. The average patient is able to go back in public without being obviously swollen or bruised by about 5 – 10 days.