Neck Lift Surgery - Platysmaplasty
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
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
must be mentally and emotionally stable to undergo an cosmetic procedure.
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
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.
really should consider smoking cessation as this can significantly decrease
healing. Visit the Medication
& Supplements List for more information.
You will discuss your complaints
and concerns and discuss the various looks one can achieve, the amount that can
be removed and tightened, etc. Your surgeon will explain the technique
(Corset platysmaplasty, Hammock platysmaplasty, mini-platysmaplasty, etc.)
and incision placements that may be most appropriate for you. He or
she should discuss the risks associated with neck lift with you, as well.
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.
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...
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
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.
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
So many things to do... so little
time. Surgery will be here before you know it so visit the Preparing
For Surgery page and relax. This section contains, printer-friendly
pre-op lists, tips and advice as well as things you must do to prepare for your
How a Neck Lift Is
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.
For a Neck Lift Only:
The skin only lift can
be done with two incisions under or behind the ear, the platysmaplasty with the
additional skin lift can be accomplished with a small incision under the chin
and the behind or under the ear. With the skin only procedure sections of
skin are trimmed and lifted into place and sutured or fixed with tissue glue.
With the platysmaplasty, a section fat muscle
is removed if need be and the ends are sutured to bring them together at the
mid-anterior (front) section of the neck. The skin can be brought together
under or behind the ear to further firm up appearance of the the neck.
Some surgeons may use suture,
mesh or even AlloDerm suspension as a sort of hammock to keep the
neck tight and waddle-free. Whatever the case, please know
that surgeons may have different techniques so please discuss this at your
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
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
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
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).
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
-- especially if you are heavily medicated and don't feel the heat
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
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.
Please continue to
avoid alcohol and aspirin containing products for a few days to weeks (or until
your surgeon tells you) as this has anti-platelet properties and could cause
bleeding. Also you are going to be bruised and swollen for quite some
time. If you quit smoking before the procedure you REALLY should not start
back up. Smoking greatly increases lack of vascularity promoting necrosis
(death) of skin, improper healing and excessive scarring. Quit beforehand
and stay such.
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
Complications of a
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.
Prices of a Neck
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.