• Introduction

• What Is a Neck Lift?

• Are You a Candidate for a Neck Lift?

• What to Expect at Your Consultation

• Your Preoperative Appointment

• Preparing for Your Surgery

• How a Neck Lift Is Performed

• The Road to Recovery

• Risks & Complications of a Neck Lift

• The Average Prices of a Neck Lift 

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Introduction
For some individuals, the neck begins to show age faster than whole face and many times patients only need a neck lift, rather than a full face lift.  However, when a face lift is chosen and a neck lift is included, these two together can complete the rejuvenation package.  Sometimes, it isn't age that determines the need for a neck lift, but rather having lost considerable weight or it may even be hereditary feature you'd like to remedy.  In fact, many younger people undergo platysmaplasty.  Many men and women who have undergone neck lift are often thought to have lost a lot of weight or toned up rather than having had surgery. 

Jowls can form from fatty deposits at the jaw line and laxity in the muscles, the neck muscles may begin to separate and hang, creating bands and the skin may hang more that we'd like creating the turkey waddle look.  If this is the case perhaps you'd like to further research the platysmaplasty procedure.

What Is a Neck Lift?
A Neck Lift, or platysmaplasty and even submental platysmaplasty, is a surgery designed to reduce the loose look of sagging skin in the neck area and under the jaw line.   Some patients who complain of having a fleshy neck, jowls, plastysma or neck banding, or a turkey waddle can benefit from this procedure.  Many times patients choose to have a neck lift with their face lift procedure.  You must realize that the neck lift or face lift procedure is not designed to rejuvenate the area above the brow or around the eyes.  If this is what you seek a brow (forehead) lift or blepharoplasty may benefit you.  These four procedures can be performed in conjunction with one another for a complete transformation.  You may even with to have laser resurfacing, if you are a candidate, for increased wrinkle ablation and facial rejuvenation.

Are You a Candidate for a Neck Lift?


First and foremost, an individual must be in good health, not have any active diseases or pre-existing medical conditions and must have realistic expectations of the outcome of their surgery.  Communication is crucial in reaching one's goals. You must be able to voice your desires to your surgeon if he/she is to understand what your desired results are.  Discuss you goals with your surgeon so that you may reach an understanding with what can realistically be achieved.

You must be mentally and emotionally stable to undergo an cosmetic procedure.  This is an operation which requires patience and stability in dealing with the healing period.  There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue.  Please consider this before committing to a procedure.  It the above describes you and you have the desire to rid yourself of loose sagging skin around the neck, you may be a good candidate for platysmaplasty (neck lift). 

What to Expect at Your Consultation
After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation. You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc. -- this is very important.  You really should consider smoking cessation as this can significantly decrease healing.  Visit the Medication & Supplements List for more information. 

You will also discuss the available anesthesia that will be used for your procedure.  Most neck lift procedures are performed under General Anesthesia, Light Sleep Sedation, Twilight, Regional or even an oral sedative (valium) and local anesthetic for less extensive plastysma work.  Either way, discuss this beforehand as many people are not aware of the risks of Anesthesia.   If you do go under Deep General, ascertain that the anesthesiologist is certified.  Please read the All About Anesthesia Page - the risks regarding anesthesia should be considered for a fully informed choice. 

If you would like more information on consultations or a list of questions to ask your surgeon please visit the Consultation Help Page.  If you should choose to book or reserve a surgery date you will usually give a deposit to hold your surgery date.  Most times if you cancel a few days beforehand, this amount is non-refundable.  After paying your deposit and scheduling a surgery date, you will also schedule a pre-operative appointment...

Your Preoperative Appointment
This appointment addresses more questions you may not have thought to ask at the initial consultation, such as more surgical details, concerns and even ascertaining that your surgeon is aware of what you desire from your procedure.  Just as your surgeon will make certain that you know what it realistically possible from this procedure.

You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead.  You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs and perhaps a box or directions for gaining a box of Arnica montana.  Would like to know more on the benefits of Arnica montana?   Perhaps you will be instructed to obtain Bromelain or other types of remedies, although many surgeons would rather have you not take ANYTHING other than your prescription medications, please do not go against your surgeon's wishes.  Remember, always ask your doctor before taking any of these products. 

Please do not hesitate to address any concerns that you may have during this time and even after your pre-operative appointment. If you remember something when you get home or the next day or even the day of surgery - don't be afraid to ask. 

Preparing for Your Surgery
You should be given a pre-operative information packet that explains everything you should do and know before your surgery date.  The packet should include a list of all the medications you should not take starting usually at 2 weeks before your surgery.   These medications will include, but are not limited to, aspirin containing products, stimulants, seratonin supplements, etc.  Would you like to view a typical Medication & Supplements List?  We have a printer-friendly version as well.  Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities.

It is quite possible that you will have preliminary blood work performed.  This is normally an extra out-of-pocket expense that the patient must participate in to check your white and red blood cell count (complete blood count, CBC) which ultimately alerts your surgeon to disease or disorders beforehand.  If you are a female they may take an extra vial for a pregnancy test.  Some surgeons ask that you have physical.  This can be yet another out of pocket expense so ask at your consultation what will be needed when you are quoted a price.

How a Neck Lift Is Performed
A neck lift procedure normally takes generally takes 2 to 3 hours to perform.  However, if you will be having other procedures performed with your neck lift -- this time will be increased and you will more than likely have General Anesthesia.

First, you will have monitoring pads attached to you so that the surgical team can properly monitor your vital statistics before, during and after your operation.  When you are brought to the operating room, electrodes will be plugged into these pads which are connected to the monitoring equipment.  

Once you are on the operating room table, you will then be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date.  If you had been given an oral sedative or valium prior you will have less anxiety.  They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway for anesthesia, antibiotics, and other medications.  If you haven't been given a sedative, it is more stressful for some patients.  If you feel that you may experience anxiety inquire beforehand regarding an oral sedative.  Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time.  It's the initial placement of the IV that may sting a bit.  Some people get heir IV placed in the crook of the elbow, some the hand - it all depends upon your veins though.  So if your veins are not very prominent this can be a problem. You are then brought to the O.R. if you aren't on the table yet.  After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein.  This is called a catheter.  The  catheter is taped to your skin so it is not accidentally knocked or pulled out and is ready to be used as a sort of entryway for anything the surgical team deems necessary for your body.  This is usually done before you get into the actual O.R., by a nurse, and you have a saline bag hooked up to you.  The medications will usually be given with a drip system with this saline. As said before, the saline will keep you hydrated both during and post-operatively.  

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body.  The the effects of the anesthesia are felt soon after injection or opening the stopper -- a few seconds in fact.  It may feel similar to a sensation of "heat" entering your arm or hand at the catheter site.  It then feels as though it is creeping up your arm - then it jumps from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.  The anesthesiologist or surgeon will then determine if you are sedated properly, your stats are stable and if you are ready for the surgery to begin.

You will then be marked with a magic marker type pen for the placement areas if your placement is to be performed intradermally.  You will then be scrubbed with Betadine, the surgical marker markings will remain, although not as dark.  You will be injected with a solution of Lidocaine, epinephrine and saline.  The epinephrine is a vasoconstrictor. This will impede your skin's ability to bleed excessively.  Lidocaine is an anesthetic.

The surgical team then performs a sponge and instrument count and your surgeon then closes your incision with, more than likely, a non-dissolvable type suture or tissue glue.  You will have a pressure dressing placed around your head.  If you are not familiar with this look it involves wrapping a dressing around the top of your head to underneath your chin, and covering your ears.  Of course there may be differences in surgical technique depending upon the preference of your surgeon.

You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released.  This is dependent upon the individual but may take up to two hours.  Your neck may feel tight and quite tender as the anesthesia wears off.  You may even feel emotional or upset -- this will depend upon your body's reaction to anesthesia.  You may also experience rigors or shivering.  This may feel uncontrollable and is usually from the medications -- more than likely epinephrine that is used as a vasoconstrictor.  The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable.

Some patients feel nothing different although if you have had General you may feel a little sick, hopefully your surgeon gave you something to lessen this.  Your prescribed medication should alleviate this pain and discomfort.  However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately.  You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home

The Road to Recovery
You may get sick on the ride home from the surgical center or hospital so have a bucket or can with a lid as well as water and some Ritz or Goldfish crackers.  Bring pillows and a blanket if need be.  If you hurt take your pain relievers.  There is simply no reason to suffer.  Besides studies have shown that patients with increased pain heal slower than patients who are not in pain.

You may be groggy from the anesthetic and or oral medications and probably won't remember much of the first day or two.  You will have to take it easy and sleep on two pillows to keep your head elevated for about 14 days - or however long your surgeon suggests.  A recliner is the best for this.  PLEASE KEEP YOUR HEAD & NECK STILL.  Do NOT turn your head from side to side.  MOVE YOUR WHOLE BODY, if you must move.  When you wake up you will notice that your lower face and neck will look even more swollen in the first 3 days.  You won't usually be extremely swollen until late that night or the next day and then the third is by far usually the worst.  But, as the days go on the swelling will dissipate.  There may be a lot of bruising, but this will go away, as well.  So make a mental note of this or you may be shocked into a depression.  Bruising and swelling are a normal occurrence in most surgeries.  Don't worry, it is all a part of the natural healing process.  You shouldn't really look at yourself in the mirror, but rather have your partner or nurse care for you instead (even take photos if you wish it). 

Although any discomfort should be alleviated by your prescribed pain medication if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon immediately!  Take your temperature regularly.  An elevated temperature could mean an infection.  Take those antibiotics on time.  Also, don't forget if you are a female taking birth control pills that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well.

Your back will more than likely cramp up from not being able to lie completely stretched out and flat on your back so some patients prefer heating pads or hot water bottles.  Remember not to sleep while using any of these devices.  This can result in severe burns -- especially if you are heavily medicated and don't feel the heat or pain.

You will more than likely go to your first post-operative visit in the next few days .  The surgeon MAY change your bandages or may wait until the end of the week, depending upon the seepage or the extent of work. Your sutures won't be removed until day 7 to 10 and your staples in your scalp (if applicable) not until around day 10.  Your scalp takes longer to heal.

Your skin will be numb, don't be afraid or worried, this is quiet normal, remember your nerves and all have been partially separated from their source.  Give them time to recuperate, just as you, yourself, need time to heal.  Please take it easy and try not to do too much, too soon.  You should be up and about in the first few days but don't feel guilty if you don't.  Listen to your body. 

Even though you may feel better, you must take it easy for the first 3 weeks.  Be careful not to bend over or lift heavy objects.  And be careful not to raise the blood pressure for at least 3 weeks as this could cause internal bleeding at your treatment area.  Your blood vessels dilate to allow increased blood flow when you raise your heart rate.  This may cause problems at internal wound sites.  Do not participate in contact sports for at least 6-8 weeks, although ask your surgeon what he recommends specifically.  Usually, you are instructed not to go into any steam rooms or use steam devices, saunas, face and neck masks or products containing Niacin, Niacinamide or Niacinamate (these products cause flushing and make your face and neck red); NO products of any kind to promote major flushing of the skin.  

You may notice a change in your smile, odd sensations of tightness, tingling, the sporadic sharp pain, or pulling, burning, and cold sensations.  These usually subside within the first few weeks.  Your swelling will subside, revealing a more defined, youthful version of your former self.  Although this may take some time so please prepare yourself emotionally.  Some patients experience a lull or down period where they become depressed or feel unattractive.  This is very normal.  Please print out our Emotional Preparation Sheet so that you will be able to remind yourself that you will get through your low period.

Risks & Complications of a Neck Lift
Unfortunately, all surgery has risks and complications. With platysmaplasty, these include an allergic reaction to the anesthetic used and infection.  For risks related to anesthesia -- please see our Introduction To Anesthesia section.  There could be asymmetry, general dissatisfaction, hematoma or seroma, lumpiness, and/or mottling of the skin.  Cording, laxity relapse of the platysma and skin of the neck. 

Numbness is possible, it usually subsides within the first few weeks but it may become a permanent issue.  Puckering of the skin may occur and deeper than desired depressions may result.  Excess scar tissue and lumps are possible as well.  Please go over all risks with your surgeon at your consultation and your pre-operative appointment.

The Average Prices of a Neck Lift
The approximate costs of a platysmaplasty, or neck lift, can vary greatly due to region and the surgeon chosen.  However, the average prices may be anywhere from $3,000. to $6,500.US in itself - and does not include other procedures such as face lift.  Some surgeons include submental lipectomy (fat removal under the chin) along with this procedure so determine this beforehand.

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This page was last updated: 04/06/2006