Skin of the face and neck lose elasticity as one ages. Underlying muscles lose tone and overall volume decreases. Aging of the face and neck is magnified by sun exposure, weight gain or loss, gravity, and genetics. A face lift and neck lift help improve the most visible signs of aging through removing and redistributing excess fatty deposits, tightening underlying muscles, and removing sagging skin. These surgeries are often complemented with other procedures to restore volume and address cosmetic issues throughout the face and neck structures. Other facial procedures can be performed at the same time including forehead lift, eyelid lift (blepharoplasty), neck and cheek implants, nose reshaping (rhinoplasty), liposuction and free fat transfer.
Neck lift choices include a traditional neck lift incision or a limited incision neck lift or direct neck lift. The incision choice depends on how much change you’d like to see.
A traditional neck lift incision begins in the hairline, near the sideburn. It continues down and around the ear and ends in the posterior hair. Fat may be sculpted or even redistributed from the neck and jowls by excision or liposuction. The underlying neck skin tissue is repositioned and the muscle is tightened. The skin is then re-draped over the contours and excess skin is trimmed away. Sometimes liposuction is necessary under the neck, which may require another separate incision. Sutures and skin adhesives are used to close the incisions.
A limited neck lift incision involves incisions only around the ear, which are shorter, but may give limited results. A direct neck lift is a horizontal incision in the natural neck crease under the jaw. The excess skin and fat are than directly excised and sutured closed. This is best for someone with focal deposits and excess skin directly under the neck area, but not on to the lower neck.
A direct neck lift procedure takes 1 – 1.5 hours. Traditional neck lift procedures usually take 3 – 3.5 hours.
After neck lift surgery, incision lines are closed with sutures. Depending on which sutures are used, they will either dissolve or need to be removed after one week. Incision lines are concealed along the hairline and the natural contours of the ear or under the neck. A bandage might be placed around your face and neck to help minimize swelling and bruising. A thin tube might also be placed to drain any excess blood or fluid that may collect. Your plastic surgeon will give you specific instructions that will include how to care for your incisions, which medications to take orally and to apply to the incision lines, and when to follow up with your plastic surgeon. You will need to wear a compression band around the neck for 1-2 weeks to reduce swelling and fluid accumulation.
It is important to keep your head elevated to help minimize swelling. Excessive twisting or bending of the neck should be avoided as it can compromise blood flow and result in skin death. Recovery from a neck lift takes time and it is important that you’re patient with the process. Most people can return to work in one to two weeks. Physical activities and athletics should be avoided for at least three weeks.
The results of a neck lift procedure are visible almost immediately. But it is important to keep in mind that it can take several weeks to months for the swelling to dissipate and up to six months for the incision lines to mature. Once the swelling and bruising subside, the more visible improvements of your neck lift surgery will appear. You will be appear more youthful and rested and it will help you feel more confident about your neck and profile.