Neck Lift FAQs Columbus OH
Frequently Asked Questions Regarding Neck Lifts
1. What is a neck lift?
If you ask this question to ten different plastic surgeons, you may get ten different answers. One of the reasons for this is that a well-done formal neck lift requires quite a bit of work, takes a good amount of time, and can be somewhat difficult to perform because the surgeon must work through a small incision but reach a considerable distance.
A good neck lift removes excess fat in the neck (primarily from under the chin), removes excess skin (taken from behind the ears), and tightens the neck muscles (the platysma) both in the midline of the neck and laterally on the sides.
2. Where are the scars from a neck lift?
There is a short scar under the chin that is about 2-2.5 inches long that the surgeon uses to get to the central portion of the neck. The resulting scar is rarely visible. There are also scars starting around the earlobes, extending up the crease behind the ears and then turning ninety degrees backwards to either go into the scalp or down along the hair line, depending on how much skin is to be removed.
3. Are the scars from a neck lift visible after they heal?
As previously mentioned, the short scar under the chin is rarely visible. Those that fall in the fold behind the ear are usually well hidden as are the ones that extend into the scalp. When a considerable amount of skin must be removed, and the scars are positioned down along the hair line, they will be visible in those with short hair or when one puts their hair up in a ponytail or bun. This is why bald men or those with very thin or short hair must weigh the risk of visible scars in tradeoff for an improved neck. Unfortunately, men also tend to scar worse than women.
Hypertrophic scars (thick, pink-raised scars), can be painful, require a long time to heal, and sometimes occur around the ears. They may require steroid injections, scar revision, or both. The eventual scar can be rather wide as opposed to a desired fine line. These are also more common in men. Actual keloid scars can occur on or around the ears but are relatively rare from facelift or neck lift incisions. These are much more common in African Americans.
4. Can I have a neck lift if I smoke?
No. You absolutely must refrain from smoking for at least one month before and after a facelift or neck lift. This includes any form of nicotine such as secondary smoke, nicotine gum, patches or vaping. Nicotine causes narrowing of the blood vessels which limits the blood supply to the skin (vasoconstriction). When the skin has been undermined and pulled tight as in a facelift, neck lift, arm lift, thigh lift, breast lift, breast reduction or tummy tuck, even a very small amount of nicotine can reduce the blood supply to the skin enough to cause it to die (necrosis). This can result in severe scarring that may be permanent.
5. Is liposuction done on the neck at the time of a lift?
Fat removal is an important part of most neck lifts. This can be done with liposuction or direct fat removal with a scissors. Most neck lift procedures include a combination of both.
6. Is a neck lift part of a facelift?
The word ‘facelift’ is a bit of a misnomer. Most people think of their face as being from the top of their forehead to the bottom of their chin. But a facelift does nothing for the forehead, eyebrows, or eyelids. The biggest changes that occur with a facelift include improvement of the jawline by eliminating the jowls and correcting a sagging neck. A mini-facelift corrects the jowls without much change in the neck.
7. What other procedures can be done at the same time as a neck lift?
Eyelid surgery (blepharoplasty) is the most common surgery done at the same time as a neck lift. Others include rhinoplasty (nose surgery), dermabrasion around the mouth, brow lifts, and mini-facelifts. It is also possible to perform non-facial procedures at the same time as a neck lift such as breast augmentation, breast lift, liposuction or a tummy tuck.
8. What is a platysmaplasty?
The platysma muscle is the paired sheet-like muscle that envelopes the major structures of the neck on each side. The medial edge is what causes the vertical bands that hang down the central portion of an aged neck. A platysmaplasty involves suturing the central edges of the right and left platysma muscles together in the midline and then suspending the lateral portion with sutures on each side of the neck. This, in effect, sinches up the deep tissues of the neck allowing the skin to be redraped leaving a smoother contour. It is also referred to as a ‘corset platysmaplasty’ as tightening of the platysma muscles functionally acts as a corset for the neck. Virtually all good neck lifts include a platysmaplasty.
9. Is it common for drains to be put in with a neck lift?
As a large raw surface area is created during the neck dissection when the skin is elevated off the muscle and the fact that the neck is quite vascular in nature, it is normal to place at least one if not two drains in the neck which are brought out through small hidden incisions behind the ears. These are typically removed the next day.
10. Is there much pain with a neck lift?
Most patients have surprisingly little discomfort with a neck lift. Some will complain of a tight feeling in their neck which is a result of the platysmaplasty. This relaxes over a few days and that tight sensation goes away quickly. Dr. McMahan uses tumescent fluid injections in the neck during a neck lift which dramatically reduces pain and bleeding. Very few patients take pain medication past the first day or two.
11. Will a neck lift help my jaw line?
A neck lift helps the contour of the neck below the jaw line and therefore will have no effect on sagging jowls. This area is effectively treated with a facelift or a mini-facelift.
12. Will the skin on my neck feel numb after surgery?
It is normal for the neck skin to feel very numb after a neck lift; much like the lateral cheek skin after a facelift. The sensation usually returns to normal after a few months, though it is possible to have small areas remain permanently numb such as an earlobe. It is not typically a problem for women; however, men tend to gouge themselves while shaving as they can’t feel the blade on their skin. Therefore, we recommend that they switch to an electric razor until most of the sensation returns.
13. What kind of dressing is used after a neck lift?
An antibiotic-impregnated gauze is commonly placed over the incisions which is then covered with sterile gauze which is held on by four-inch gauze wrapped around the head and neck, similar to a facelift dressing. This is generally removed the next day and replaced with a supporting garment.
14. How soon can I shower and wash my hair after a neck lift?
The same as a facelift, you can shower and gently wash your hair 24 hours after the drains are removed.
15. What type of anesthesia is use for a neck lift?
Most neck lifts are done under general anesthesia as an outpatient. Tumescent fluid injections are commonly also done to reduce bleeding and pain after surgery.
16. I am old with a bad ‘turkey-neck’ and I don’t want a big surgery. Can’t you just cut the skin out under my chin?
It is possible to perform a direct excision neck lift. It is generally combined with a series of Z-plasties or a W-plasty to make the resulting scars run in a zigzag fashion in an effort to allow them to heal better and run closer to the natural skin lines of the neck. There is no muscle tightening and very little fat removed with a direct excision neck lift. Just cutting out the skin as a vertical ellipse and sewing the skin edges back together would leave an unsightly vertical scar that would contract and limit the amount one could extend their neck. /p>
The answers to the above questions are my personal opinions based on years of legitimate general surgery and plastic surgery training and extensive experience in plastic surgery private practice. They are intended to give you, the patient, as much knowledge as possible in making your decision about plastic surgery and who performs that surgery. They are not intended to be derogatory or demeaning towards any individual physician or group of physicians. I firmly believe that physicians should only practice within their field of training and expertise, except in lifesaving, emergency situations.