Neck Lift

While we age, our neck shows several changes like wrinkles, abnormal contours, jowl lines, etc. If you want to improve these signs of ageing and have a youthful and confident look, a neck lift or contouring might be something you would want to get done. Here is a complete guide on the neck lift or contouring procedure.

 

1. Remove any unwanted skin
2. Reduce the appearance of wrinkles and fine lines
3. Tighten the muscles underneath
4. Reduce the appearance of Platypus bands 
5. Contour and reshape the chin and jawline 

Factors like genetics, stress and environmental factors can cause a loss in the youthful appearance of your face and neck. These changes can be seen as fat pads under your cheeks and eyes, skin thinning, development of wrinkles, loss of volume of your lips, and drooping of your eyebrows. These signs of ageing usually appear in your late or mid-twenties.

Neck contouring, also known as a neck lift, chin lift, or lower rhytidectomy, is a cosmetic procedure that improves signs of ageing present on the neck and jawline. This surgery repositions the fat and tightens the skin and muscles, thereby giving a toned appearance. This procedure helps to treat skin problems like:

1. The appearance of the neck is not matching with your face
2. Skin that has lost elasticity or excess fat on your lower face or neck
3. Abnormal contours (irregular shape) on your neck due to muscle banding
4. Excess wrinkling and jowl lines (lower part of your cheek)

This procedure is more common in patients aged between 30-70 and is most suited if you are between 45-55 years of age. Neck contouring procedure will only alter your appearance, but it will not stop the ageing process.

Non-surgical procedures are also available for neck contouring, such as:

1. Botox
2. Dermal fillers
3. Kybella
4. Radiofrequency with micro-needling
5. Fractionated laser treatment
6. Ultrasound technology

However, non-surgical approaches will not provide similar results and will only delay the time for conducting a surgical process.

 

During neck contouring surgery, the surgeon:

1. Makes a cut at various locations depending on the type of surgery. The surgeon can make a cut:
   1. Starting from the hairline, around the ear, and down to your posterior hairline (traditional neck lift)
   2. Only around the ear (limited incision neck lift)
   3. Behind the ear
   4. In front of the ear
   5. Under the chin. This method is more common in elderly patients so that the complexity of the surgery is reduced.
2. Redistributes the fat from the neck and jowls 
3. Repositions the tissues beneath the neck skin and tightens a muscle called platysma muscle
4. Redrapes and trims the excess skin
5. Close the cuts using a skin adhesive, skin glue, or sutures. These sutures may dissolve with time or will need to be removed.

The surgeon usually takes two to three hours to complete the surgery.

 

Before undergoing neck contouring surgery, your plastic surgeon will schedule a pre-surgical appointment. During the pre-surgical visit, the surgeon will:

1. Ask about your existing health problems and lifestyle
2. Check your overall health and risk factors
3. Have a look at your face and take pictures
4. Ask you to undergo medical evaluation and laboratory tests
5. Discuss several types of neck contouring procedures and outcomes expected from this surgery
6. Discuss the possible risks and complications
7. Suggest a course of new medications or alter your current medications
8. Ask you to stop medications that increase bleeding, e.g., aspirin, herbal agents, and anti-inflammatory medications
9. Ask you to cease smoking at least four weeks before surgery
10. Ask you to sign a written consent which states that you are fully aware of the potential risks and complications of this procedure
11. Inform you about things to do at night and morning before the procedure

Your surgeon will consider neck contouring only if you:

1. Are a non-smoker
2. Are young or middle-aged
3. Have mild or moderate saggy skin
4. Have mild to moderate subplatysmal fat (fat layer below your platysma muscles)
5. Do not have any health problems that can delay your healing process.
6. Have a realistic goal and positive outlook

You will also meet your anesthesiologist, who will suggest a suitable anaesthetic medication. For this surgery, an anesthesiologist might recommend general anaesthesia (a medication that makes you unconscious) and intravenous sedation (a medication that relaxes your body).

 

Anaesthesia administration (Intravenous sedation)

The anesthesiologist will administer the sedative medication by using an intravenous line.

Cleaning and draping of surgical site

Other than your surgical site, the rest of your body will be draped (covered with a sterile material) to reduce the risk of infection due to surgery.

The recovery process in the hospital

Right after the surgery, you will have the following experience in the hospital:

1. The surgeon will place a bandage around your face and neck. This is done to reduce swelling and bruising due to surgery.
2. You will also have a thin tube placed at the site of surgery, so that excess fluid and blood collected under the skin is removed
3. Your surgeon will:
   1. Recommend methods for caring for your surgical site
   2. Suggest you look for signs of complications
   3. Suggest medications to reduce the chances of infection
4. Since the neck contouring procedure is performed on an outpatient basis, you will be discharged on the same day
5. You should arrange for someone who can drive you home and stay with you for a day after surgery

The recovery process after hospital discharge

While you are at home recovering from the surgery, you should:

1. Avoid excessive neck bending or twisting
2. Wear a compression bandage and keep your head in an elevated position while sleeping or lying down to reduce swelling. You should constantly wear the compression bandage for seven days post-surgery and only during nighttime after that.
3. Avoid ice pack as it can alter the blood flow reaching the surgical site
4. Avoid clothes that go over your head, as your surgical site must stay protected from excessive abrasion, motion, or force.

Work and activity restrictions:

1. You should wait for at least two to four weeks before you can resume your physical activity or sports
2. You can bath after three days post-surgery; however, avoid rubbing, washing, or massaging the neck until your surgeon recommends
3. You can return to work within one or four weeks after the surgery
4. You will be able to drive seven to 14 days post-surgery

Result expectations from the surgery:

1. The cuts or incisions made during the surgery are concealed in the ear and natural hairline. Scars are hard to detect after some time and become cosmetically invisible.
2. It will take a few weeks to months before the swelling and bruising at your surgical site fully reduces, and you begin to see the results. After your body is completely healed from the surgery, you will have a more rested and youthful look, feel confident, and have a long-lasting result.
3. To maintain this youthful look, your surgeon will suggest protecting your skin from sun damage and eating a healthy diet
4. Rarely you may not be satisfied with the results obtained from this procedure. In this case, your surgeon might suggest another surgery.

First Follow up Appointment

You may have a follow up after five to ten days post-surgery, during which your surgeon will remove sutures and staples.

 

It is expected if you experience some side effects after neck contouring. However, these effects last temporarily:

1. Mild to moderate pain
2. Bruising and swelling
3. Tingling, burning, pulling, or tightening sensation
4. Skin numbness
5. A delayed healing process if you are a smoker

Occasionally, you might experience the side effects listed below for neck contouring.

1. Prolonged swelling and pain
2. Poor healing of wound
3. Bleeding
4. The asymmetrical appearance of your face
5. Accumulation of blood under the skin at your surgical site
6. Infection
7. Nerves that control the movements of facial muscles can get damaged. This can cause effects such as weakening of your lips (rarely, the effect nerve damage can be permanent)
8. Blood clot formation in one or more veins, also known as deep vein thrombosis
9. Skin loss, discolouration, or irregularities
10. Hair loss from the surgical site (temporary or permanent)
11. Sutures become visible on your skin and irritate. This will require the removal of the sutures.
12. Scarring
13. Risks due to the anaesthetic medication or allergies due to medications used during the surgery
14. Not satisfied with the results (in this case, you may require a revision surgery)

Consult your operating surgeon if you experience any of the above changes.