Neck Lift

Sagging jowls, loose neck skin and fat accumulation (commonly known as the ‘turkey gobbler’) under the chin may be corrected with a neck lift.  Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin. This is a procedure that is often done in conjunction with a facelift. An effective Neck Lift can emphasise your lower face, as well as providing your profile with more elegant definition.

Rejuvenating Procedures

Other rejuvenating procedures typically performed in conjunction with a neck lift are:

• Facelift, to correct sagging of the mid and lower face
• Chin augmentation, to increase projection and definition of chin

The Procedure – What happens in a Neck Lift?

Anaesthesia
Dr Vrtik performs all her neck lift procedures under General Anaesthesia. This ensures your comfort during the procedure and allows optimal blood pressure control. This is important as high blood pressure is associated with increased risk of bleeding.

Incisions
The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp behind the ear.

An additional incision is also made in the crease between the under-surface of the chin and the neck. This incision is usually less than 5cm in length and well hidden within the crease once healed.

Correction of neck contour
The Fat from under the chin and in the upper neck is removed in front and behind the muscle. The neck skin is then degloved from the underlying muscle (platysma muscle). This muscle is then sutured together in the midline to give the neck more definition vertically. The outer part of the muscle is also sutured and hitched up behind the ear to create a horizontal sling, to produce the tightening at the uppermost part of the neck under the chin.

Closing the incisions
The skin then re-draped and tightened around the incision, and behind the ear. Any excess loose skin is trimmed. The wounds are closed with in layers, with dissolvable sutures behind the ear and under the chin, and non-dissolvable sutures in front of the ear.

Specific risks of neck lift surgery

The decision to have a neck lift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Dr Vrtik and our staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

• Unfavourable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anaesthesia risks
• Temporary or permanent hair loss at the incisions
• Skin loss (skin necrosis)
• Numbness or other changes in skin sensation in the ear and on the face
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation (seroma)
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Deep sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions
• Possibility of revision surgery - It may be necessary to perform additional surgery to improve your results or correct any unsatisfactory areas
• Deep vein thrombosis, cardiac and pulmonary complications

Most of the above-mentioned risks are very uncommon, and some people (with particular health problems or skin types), may be at higher risk for specific complications. Dr Vrtik will discuss this with you during your consultation if any of these risks are specifically pertinent to you.

Although neck lift is an effective procedure where the benefits significantly outweigh the risks, the degree of surgical success can be altered by how each individual’s body responds to surgery and healing. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure; revision surgery may be necessary.

Be sure to ask questions: It’s very important to ask questions about your neck lift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings or concerns with Dr Vrtik or any of our staff members.

Use of fibrin sealants or tissue glue (Tissel®)

 Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising, bleeding and fluid accumulation following surgery.

This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing complications and promote healing by adhering layers of tissue together.

Postoperative recovery

When your procedure is completed, a bandage is gently placed around your face and under chin to minimize swelling and bruising. You will be encouraged to sleep in a semi up-right position and icepacks may be applied to your neck immediately after your operation.

A thin tube on each side may be present behind your ears to drain any excess blood or fluid that may collect under the skin. These tubes and the bandages are usually removed before you go home. Once removed, you will be able to wash your face and hair in the shower; then a neck garment is placed on your head and neck, providing firm pressure and support on the suture lines and around your neck to prevent bleeding, fluid collection and provide protection to your wounds.

For more information on postoperative instructions, please click here. (here is linked to Patient Resources – postoperative care page)

Expectation and results

The visible improvements of a neck lift appear when the swelling and bruising settle. The bruising may extend down into the chest wall as it follows gravity. The bruising often dissipate within 2-3 weeks, but it may take several months for swelling to fully subside and up to 6 months for incision lines to mature. Significant change in the contour of your neck is noticeable at approximately 2 months.

Slight discomfort and tightness in the neck around the throat is a common feeling described. This usually eases when the worst of the swelling settles at 7-10 days. Movement of the neck may feel restricted secondary to discomfort, this will also settle with time.

You can expect your neck lift result to be long-lasting. It should provide you with a youthful appearance of the neck with better and more elegant definition of the jaw line and neck line.

Enhancing your neck lift

A variety of other procedures can further enhance the outcome of a neck lift. They include:

• Resurfacing techniques (such as chemical peel and microdermabrasion) to improve the tone and texture of neck skin
• Botox® injection to treat visible neck bands and improve a smoother look to the neck lift

Please check with Dr Vrtik or our Practice Nurse if you would like to consider these options, as adequate time for recovery from your surgery is essential before any complimentary treatment. Check out our non-surgical services at Creare Clinic for more information on resurfacing and Botox®.

Vocabulary to know

• General anaesthesia: Drugs and/or gases are used during an operation to relieve pain and put you in a deep sleep.
• Haematoma: Blood pooling beneath the skin, usually due to bleeding under the skin.
• Seroma: fluid collection under the skin
• Platysma: a broad sheet of superficial muscle from lower lip and jaw, to the clavicle. It coats the anterior surface of the neck, responsible for the visible bands of the neck and holding the fat and deep tissues of the neck in.
• Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.
• Cervicoplasty: also known as neck lift or tightening of the neck 
• Platysmoplasty: manipulation and plication of platysma muscle during a neck lift

(Some Information & Illustrations are courtesy of the American Society of Plastic Surgeons).