Neck Lift Surgery by Jan Stanek at Surgical Aesthetics

Aging causes deterioration in the face and neck, although not in parallel in most individuals. Some have sagging of the face and some of the neck. In some cases, sagging involves both the face and the neck.

Minor sagging of skin and platysma muscle can often be corrected during a face-lifting procedure. However, if the sagging is significant and there is accumulation of fat underneath the platysma muscle under the chin, it may be necessary to carry out a neck lift operation. Those who have inherited poorly defined necks also need neck surgery. Liposuction is not the answer for any of these problems and is more likely to make any further surgery difficult, or even impossible.

The basis of neck lifting is separation of skin from the underlying muscle (the platysma), reshaping the neck under the platysma muscle and, finally, tightening the muscle and re-draping the skin.

Access to the neck is obtained through a 3cm incision, just below the chin crease and facelift scars. In some cases, especially in younger patients with elastic skins, the whole procedure can be carried out through the incision under the chin. In neck only procedures, where some access is needed around the ears, the incisions may need to be short, unlike full facelift incisions.

To reshape the neck, apart from removing excess fat under the platysma muscle, it may also be necessary to shave some muscles (diagastric) to obtain a sharper under the chin angle. In some cases, where the submandibular gland causes fullness below the jawline, it may be necessary to shave part of the gland to achieve a better definition.

After the neck reshaping the platysma muscle is tightened like a corset and, if there are muscle bands, part of the muscle is divided to prevent the banding.

To prevent accumulation of blood and serum after surgery which can lead to excessive and abnormal scarring, particularly in patients with thin skins, the entire surface of the muscle is sprayed with tissue glue and the neck skin firmly glued back. The glue also significantly reduces the degree of swelling and bruising.

There are no medical or surgical procedures that can reproduce the effects of a neck lift surgical procedure as described above.

Neck Lift: Possible Complications

As with all surgical procedures there are risks involved and these are described below:=

  1. Infection: It is rare for major infection to occur; more commonly the wound may develop superficial infection. The risk of any infection occurring is less than 1% and is treated with appropriate antibiotics and wound care.
  2. Bleeding/haematoma: most prone to this infection are males and those with high blood pressure. If you have taken Aspirin or vitamin E you are also at risk. Bleeding usually occurs shortly after surgery and is treated immediately with no long-term side effects, except perhaps, marked bruising. This complication occurs in less than 0.5% of patients.
  3. Poor scarring: all surgeons aim at producing the best possible scarring, but some patients may have a tendency to form thickened scars, so-called hypertrophic scars. Very rarely, particularly in dark-skinned patients, the scar may grow (keloid scar).These scars require treatment with steroid injections and, sometimes, they may have to be revised. These scars may continue to be problematic despite treatment.
  4. Hair loss: it is uncommon to lose hair and it usually happens in the vicinity of the temple scar. In most cases the hair re-grows after several months.
  5. Bruising: is common and in some individuals, such as redheads, may be quite marked. Aspirin and Vitamin E make you bruise more easily and it is important to stop taking these preparations at least one week prior to surgery. Most bruising subsides after three weeks or so.
  6. Numbness: it is normal to experience numbness in the neck area after surgery. In time it subsides completely. Sometimes, a patch of numbness may persist permanently.
  7. Injury to the facial nerve: this is a complication due to injury to a small branch of the facial nerve which may make one of the small muscles of the face paralysed temporarily, or permanently. It is extremely rare. However, most cases recover completely.
  8. Skin necrosis: in some cases skin may heal poorly because of poor blood supply. This is particularly the case in smokers who are advised to stop smoking at least four weeks prior to surgery. Even if they stop smoking, smokers will always have a higher incidence of this complication because of permanent damage to blood vessels and circulation.
  9. Sialoma: if partial resection of the submandibular gland has been carried out during neck lifting some fluid may accumulate in the vicinity of the gland and may require aspiration. It is uncommon and should lead to no further problems.
  10. Unfavourable result: dissatisfaction with the outcome of surgery can be the result of many factors, such as unattainable expectations. Neck lifting generally achieves good results but it cannot make you young again.

It is important to discuss these points with your surgeon at the initial consultation. He/she should be able to answer all your questions, as well as alternative forms of treatment, so that you can decide whether you want to go ahead with surgery.

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