What is a neck lift?
Neck lift surgery, also known as platysmaplasty or submental rhytidectomy, aims to refine the contour of your jaw and neck, delivering a renewed youthful appearance.
A neck lift usually focuses on the following aspects:
- Lifting and tightening saggy skin
- Eliminating surplus fat and skin tissue
- Strengthening the platysma muscle, which helps shape the neck
A well-executed neck lift addresses specific issues such as skin looseness, fine lines, a double chin, neck banding, and the infamous ‘turkey neck,’ enhancing the overall aesthetics of your neck and jawline.
Certain surgeons, including those specializing in facial plastic surgery, are skilled in an advanced technique known as the deep plane neck lift. This intricate technique sculpts the neck's deeper anatomical features that could still contribute to a bulky appearance, despite the tightening of the skin and muscle.
The deep plane neck lift offers an exceptional revitalising effect and goes a step further than the conventional methods by targeting:
- Fat deposits residing behind the platysma muscle
- Protruding submandibular and parotid salivary glands
- Digastric muscles located beneath the platysma muscle
For those looking for a less extensive procedure, a mini neck lift might be the solution. This approach involves the removal of extra fat and skin, followed by a skin-tightening process. However, muscle tightening, or platysmaplasty, is typically not part of this scaled-down operation. A mini neck lift is often performed with local anesthesia, accompanied by intravenous sedation.
Melon Hint: In contrast to non-surgical neck lifts, which usually necessitate numerous skin-tightening sessions, a surgical neck lift provides a comprehensive, enduring transformation. Performed on an outpatient basis, neck lift surgery presents a more effective solution for significant neck rejuvenation.
What are the pros & cons of a neck lift?
- A neck lift addresses multiple issues such as excess fat, lax muscles, and saggy, surplus skin, all in one operation.
- The procedure delivers remarkable, enduring results that can last a decade or even longer, outperforming any non-surgical alternatives.
- Neck lifts generally result in minimal, well-positioned scars that gradually become less noticeable.
- Anticipate a recovery period of 1 to 2 weeks, contingent on the scope of the operation and your body's natural healing ability.
- The cost can be prohibitive, Medicare and private health insurance generally do not extend coverage to aesthetic treatments like neck lifts.
- As is the case with any surgical intervention, potential risks include infection, hematoma, and seroma.
- In rare instances, facial nerve damage can occur, resulting in temporary facial muscle weakness that may require up to half a year to fully recover.
- Although the treated neck area will still age naturally, it will still appear more youthful than if you had opted for no treatment at all.
How much does a neck lift cost?
Average Cost: $16,100
Range: $7,300 - $23,000
The cost of your neck lift will be influenced by several variables, including your surgeon's expertise, their professional standing, the geographical location of their practice, and anesthesia choices.
Medicare and private health cover usually do not include cosmetic procedures like this one. To make the process more financially accessible, many practitioners offer buy now pay later services and also accept 3rd party financing solutions.
What are the potential risks and side effects of getting a neck lift
A neck lift is generally considered a safe cosmetic procedure, especially when conducted with the patient awake and under local anesthesia. This approach removes the dangers associated with both IV sedation and general anesthesia, making it an attractive option for older individuals or those with stable pre-existing health conditions.
During your initial consultation, your doctor should go over these associated risks in detail.
- The most frequently observed complications post-neck lift is minor asymmetry or insufficient correction, which can often be fixed in a subsequent minor procedure using local anesthesia.
- There is also the possibility of fluid or blood accumulation under the skin; known as hematoma and seroma. Surgeons may use tiny drains or compression to mitigate these risks.
- In rare cases, facial nerves may sustain damage during the procedure, leading to a temporary weakening of the lower face. Such issues usually improve on their own within a few months but can cause emotional stress during that period.
- In isolated cases, patients report experiencing a 'cobra neck deformity,' which manifests as a sag in the neck's midline, usually caused by excessive fat removal that results in the skin scarring down to the muscle layer. Correcting this issue requires revision surgery.
To reduce the potential risks related to a neck lift, it's crucial to choose a seasoned, board-certified plastic or facial plastic surgeon to perform your surgery.
What to look for in neck lift before & after photos
When selecting your plastic surgeon, search for images of neck lifts that feature individuals close to your age and with similar preoperative conditions like lax skin, necklines, or other issues you may have. Focus on before & after pictures that maintain consistent facial expressions, posing, and lighting conditions.
Pay extra attention to side profile images where the chin is held level, as these are the most revealing. Take note of any discernible shadowing beneath the jawline and chin area. Ideally, you'll want to observe not just a well-defined neck but also a sculpted jawline. Should you spot any scarring, it should be small and barely noticeable, conveniently concealed either beneath the jawline or behind the ears.
Who can get neck lift surgery?
The ideal candidate for a neck lift is generally a healthy individual who does not smoke and is dealing with surplus skin around the neck area as well as looseness in the platysma muscles, accompanied by additional neck fat (or not).
Sometimes, neck bulging could be attributed to enlarged glands and muscles, issues that can also be corrected with neck lift surgery.
When should you consider a mini neck lift?
A mini neck lift might be for you if you meet the following criteria:
- Exhibit minor excess skin and/or fat at the bottom of your jawline
- Only experience moderate to light skin drooping
- Does not have noticeable neckbands
Typically performed under local anesthesia complemented by intravenous sedation, a mini neck lift involves the surgeon excising extra fat and skin and then firming up the remaining skin. Platysmaplasty, or muscle tightening, is generally not included in this scaled-down procedure.
In terms of cost, a mini neck lift is usually thousands of dollars cheaper than its full-scale counterpart. It also has a faster recovery time.
While lower expenses and quicker recovery can be tempting, it's crucial to note that a mini neck lift is most effective for individuals showing only mild symptoms of skin laxity, banding, or sagging.
What happens during neck lift surgery?
This same-day procedure can be carried out using either local anesthesia coupled with IV sedation or under full general anesthesia, subject to both the surgeon's advice and the patient's selection. Some plastic surgeons even conduct both traditional and deep plane neck lifts with the patient fully conscious, relying solely on local anesthesia. If this method is in your comfort zone, it can be a cost-effective alternative while also reducing the risks linked to general anesthesia.
Depending on the complexity of your surgery, the operation lasts between 1 to 3 hours.
The procedure typically targets three main concerns: surplus fat, slackness in the platysma muscles, and drooping skin in the neck region. Because surgical techniques can vary, it's crucial to discuss your specific goals and your surgeon's approach during your preliminary consultation.
Additionally, inquire about the placement of your incisions to have a clear idea of the type of scarring that may result. Experienced surgeons can often conceal these incisions either behind your ears or along your hairline, thereby minimizing any visible scarring post-procedure.
For those with limited extra skin, the neck's anatomical structures can frequently be reached via a minor incision discreetly located beneath the chin, also known as the submental region.
However, if a significant amount of skin requires removal, surgeons normally create incisions around the ear area, and sometimes these are complemented by a submental incision. When a neck lift is conducted independently of a facelift, the incisions are generally restricted to the back of the ears, making the resulting scars less conspicuous.
Here’s an overview of how a neck lift procedure is executed after incisions are made.
Different approaches are available to surgeons to remove the excess fat that causes a bulky neck, double chin, or sagging jowls.
If the fat is localized above the platysma muscle and adheres to the skin, liposuction is often employed. This involves three tiny incisions, one beneath the chin and one behind each ear, before extracting the unwanted fat.
For those who have fat both above and below the platysma muscle, the surgical approach is slightly different. Surgeons typically excise the deeper fat through direct visualization, often utilizing a lighted retractor for precision. Liposuction then handles the remaining superficial fat above the platysma.
The platysma muscle tends to deteriorate and slacken over time, resulting in visible thin, vertical bands; usually a pair of them. The muscle stretches and presses against the skin over time, making these stringy neck bands increasingly noticeable that also soften the jawline. This is also a contributing factor to what’s commonly called ‘turkey neck.’
To rectify these issues, surgeons perform a platysmaplasty that includes:
- Stitching both sides of that platysma muscle together, beneath the chin and along the neck, much like lacing a corset.
- Optionally excising surplus platysma tissue for added tightening.
- Securing the platysma to neighbouring neck muscles for enhanced support.
Skin Tightening: Cervicoplasty
Factors like aging or significant weight fluctuations can result in saggy skin, often necessitating a cervicoplasty as part of most neck lift procedures. This involves:
- Excision of the surplus saggy skin.
- Firming up the remaining skin to iron out wrinkles and create a tighter silhouette.
Some plastic surgeons also employ a ‘short scar neck lift’ technique that enhances the neck’s shape without the need to remove additional skin. In this approach, a small incision is made beneath the chin to adjust the neck’s underlying structure, thereby increasing the skin's surface area. This yields a smoother neck and a more defined jawline.
Upon completing the surgery, the incisions are sealed using dissolvable stitches.
How long does it take to recover from a neck lift?
Expect to take between one and two weeks off to heal after undergoing a neck lift, Recovery time is also impacted by the complexity of the surgery and your body's natural healing ability.
Some individuals opt for a brief one-week hiatus before returning to work, using makeup, scarves, or collared shirts to disguise any incisions or remaining swelling. Others may prefer more time away, particularly if their procedure included a facelift, allowing more time for bruising and swelling to subside.
Adhering to your healthcare provider's postoperative guidelines can alleviate discomfort and ensure a safer recovery. Your surgeon will give you tailored advice on how to maintain incision cleanliness and general neck care.
What to Anticipate During Neck Lift Recovery:
- A chin strap or pressure bandage that goes over the head and loops under the chin is commonly worn for the first 24 hours post-surgery. This assists in controlling swelling and bruising.
- For those who undergo more comprehensive neck lifts, small surgical drains may be utilized. These are generally left in place for a day or two to prevent fluid and blood accumulation.
- A follow-up consultation is usually scheduled for the day after the surgery to confirm that the healing process is on the right track.
- If non-dissolvable stitches were used, an appointment for their removal will be arranged around seven days post-surgery.
- Refrain from heavy lifting and bending over for the first week.
- High-intensity physical activities should also be avoided for the first 2 weeks.
- After around 2 weeks, the majority of bruising and swelling should subside, and any scarring should begin to lighten and heal.
If you are worried about potential scars, consult your healthcare provider about various scar treatments, such as silicone scar creams that can be applied during your recovery period.
Melon Hint: Some surgeons advocate for post-surgical lymphatic drainage massages to expedite healing. These specialized massages, performed by certified therapists, can significantly enhance the postoperative recovery experience after a neck lift.
Is a neck lift painful?
Contrary to what you might expect, neck lift surgery is generally pain-free, courtesy of anesthesia. However, more expansive procedures like the deep-plane neck lift may cause some level of discomfort.
As the effects of anesthesia diminish, you'll likely experience tightness and soreness in the neck area. You can anticipate minor discomfort lasting for about a day or two post-procedure. Prescription medications are effective for pain management during this period.
It is also not uncommon to experience numbness following the surgery, a result of temporary nerve-ending disruption. According to some patients, this numbness may persist for several months, or in some instances, extend beyond a year.
Delicate massage can assist in the "reawakening" of nerve endings during the recovery period. It is normal to feel sensations like tingling, itchiness, or brief episodes of minor pain as your nerves gradually recover their usual functions.
When will you see results after a neck lift?
Immediate changes in your neck outline will be visible, although the presence of swelling and bruising will obscure the complete outcome for a few weeks until such symptoms pass.
Generally, you can expect to see the majority of your final results within 4 weeks post-procedure, with the results looking better and better over the subsequent months.
How long does neck lift results last?
The effects of a neck lift generally last for a decade or even up to 15 years. However, it's essential to remember that the aging process will continue to affect your neck.
While you can't halt aging entirely, your neck usually won't sag as severely as it did before the surgical intervention.
To extend the lifespan of your neck lift results, focus on maintaining a stable weight, abstaining from smoking, and diligently applying sunscreen to fend off UV-induced skin damage, which accelerates aging.
Non-invasive skin tightening treatments like radiofrequency or ultrasound therapies can also contribute to longer-lasting outcomes by encouraging the production of collagen.
What are some other procedures instead of a neck lift?
A mini facelift is designed to target loose skin and jowls on the lower face and jawline. While it doesn't offer the transformative changes that a complete facelift does, the benefits include less scarring and quicker recovery times. The procedure is effective in repairing the area between your lower face and neck.
If you're open to less dramatic and shorter-lasting improvements, you might want to explore non-surgical neck lift options. Various physicians specialize in different techniques for this, commonly utilizing a blend of rejuvenating procedures such as:
- Anti-wrinkle injections in the platysma muscle are effective for relaxing the downward pull of the neck and mouth muscles. A 2017 study on this "Nefertiti lift" found that a whopping 96.6% of patients were happy with the outcomes.
- Dermal fillers can address horizontal neckbands, offering a more youthful appearance, lasting around a year.
- Therapies like laser resurfacing and radiofrequency (RF) microneedling are suited for those aiming to minimize fine lines and improve skin texture on the neck. These methods stimulate the body's natural healing by causing microscopic damage to skin layers.
- If you’re only worried about a double chin, fat-freezing might be a good choice. However, chin liposuction offers more immediate results. Both options focus on eliminating superficial fat rather than deep fat deposits.
- Ultherapy, Sofwave, and other energy-based therapies work by heating subdermal tissues to induce collagen production, and also offer a tightened appearance.
- FaceTite and NeckTite are minimally intrusive approaches that utilize radio frequency waves to dissolve fat and moderately firm the skin of the lower face and neck.
Neck thread lifts using PDO threads are generally not recommended for neck rejuvenation as they are unable to support deeper tissue layers. The threads can often be seen or felt under the skin, and there's a risk of complications like extrusion, puckering, and scarring.
Another option worth considering for some candidates, particularly those with minor skin sagging and surplus fat, is the MyEllevate procedure. It employs an internal stitching design to support deeper neck tissues and is noted for its low complication rate.
Sources & Studies
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Dibbs, RP, Chamata, E, Ferry, AM & Friedman, JD 2021, ‘Revision Facelift and Neck Lift’, Seminars in Plastic Surgery, vol. 35, no. 2, pp. 088–097, viewed 31 August 2023, <https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0041-1727208>.
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