The operation is usually performed under general anaesthetic and depending on the technique may require an over-night stay in hospital.
As with most aesthetic procedures the neck lift technique must be tailored to each patient individually. The following three techniques are used most commonly.
Mini Neck Lift
This technique is suitable to correct platysmal bands and when there is only a small amount of excess skin. A short skin incision (approx. 4 cm) is placed in a crease below the chin through which any excess fat in the frontal neck area can be removed and the platysma muscle tightened with sutures. Additional liposuction can be useful to improve the contour in areas that cannot be reached through the incision.
Anterior Neck Lift
When there is a significant amount of skin laxity, the contour of the neck can only be improved if the excess skin is removed. If only the neck is to be treated this is done by removing a vertical ellipse of skin along the midline of the neck. The length of the resulting scar depends on the amount of excess tissue, but usually ranges from approximately 3cm below the chin down to the thyroid cartilage.
Combined neck lift and facelift
The skin incision for the face lift follows an S-shape which starts within the hair at the temple, then continues down along in front of the ear, around the earlobe and then back upwards along the crease behind the ear. Depending on how much tissue needs to be removed the incision sometimes needs to be extended in to the hair behind the ear. In most facelift techniques the skin is then freed from the underlying soft tissue along a fine layer of connective tissue called the SMAS (Superficial Musculo-Aponeurotic System) which surrounds the facial muscles and fat compartments. The areas of soft tissue that have descended can be elevated into the desired position and retained with deep sutures. After re-drapeding the skin over the repositioned deep tissue and the excess skin is removed and the wound edges are sutured together.
The skin incisions are closed with fine non-absorbing sutures, which are removed after approximately 7 days. Sometimes skin staples are used to close the wounds within the hair bearing scalp.
Frequently combined procedures
Although certain areas of the neck are automatically corrected with a facelift alone, extensive laxity of the neck area may require additional tightening through a small incision underneath the chin, as it is done for a neck lift alone. Both upper and eyelid blepharoplasties are also often combined with a facelift procedure. Also autologous fat grafting can also help achieve optimal results, especially around the eyes.
What to expect after the operation
The skin around the eye is very thin and prone to swelling and discoloration. As hematomas and swelling follow gravity, it is therefore very common for the entire eyelid and cheek area, to swell up and turn blue, even if the area was not directly accessed during surgery. This can be reduced by cooling the area immediately after surgery for 24-48 h and keeping the head slightly elevated. It is therefore advisable not to schedule the surgery within 2-3 weeks before a public event.
Until the swelling has subsided the entire face and perhaps also neck area will feel extremely tight and distorted. The final result can usually be appreciated after about 6-8 weeks.
Numbness of the skin and also earlobe are quite common, but should subside after 1-2 months.
At the end of surgery a fairly large, well-padded head dressing will be applied, which will be removed after 24h and replaced with either light dressings or even just antibiotic ointment.
If drains were inserted during surgery they will also be removed at the same time.
In some cases a compression garment is recommended to reduce swelling for the first few weeks after surgery.
You will be instructed to keep the head slightly elevated (at least 30 deg) and cool the face (not with ice as it can cause thermal damage) for at least 48 h after surgery
The sutures will be removed approximately 7 days after surgery and the dressings can be left intact until then.
Showering and washing your hair is usually allowed after 48h, however rubbing the eyelids should be avoided until the wounds have healed completely.
Makeup can be applied anywhere more than 1cm away from the wounds after 48h.
Everyday activities are usually possible immediately after surgery, however strenuous activities, including exercise should be avoided until the swelling has gone down.
Regular follow-up appointments with your surgeon will be scheduled at 1 week, 2 weeks, 6 weeks, 3 months and 1 year after surgery.
As with every surgical procedure a face lift is associated with both anaesthetic and surgical risks. Preexisting conditions such as Diabetes, obesity, heart and blood vessel diseases, immune diseases and smoking significantly increase the risk of complications.
The most common surgical complications after neck lift include:
- postoperative bleeding, hematoma
- under- or overcorrection
- visible and/or asymmetrical scars
- persistent swelling
- permanent numbness of the skin or earlobes
- distortion of the earlobe
Rare complications after a neck lift include:
- delayed wound healing, wound breakdown or skin slough
- injury to the facial nerve
Do I need to stop my own medication prior to surgery?
Most medication can be continued normally. Some drugs such as blood thinners (e.g. Aspirin or Warfarin/Marcoumar) can increase the risk of postoperative bleeding and may need to be stopped or replaced before the procedure. We ask you to bring a complete list of all your medication and their dosages to your first consultation.
Does my GP need to perform or organize any special investigations or tests before surgery?
Usually not. We ask you to provide as much detailed information on your past medical history as possible when you come for your preoperative consultation so we can coordinate any necessary tests with your GP.
Do I need to stop smoking before surgery?
We seriously recommend stopping all nicotine consumption, including smoking at least 6 weeks before any surgical procedure. One of the most common complications following any type of surgery is delayed wound healing or wound breakdown. The main cause of this is usually bad blood circulation to the skin and tissues in the operated area. Nicotine is a chemical substance, which causes blood vessels in the body to constrict (narrow). This lowers the blood circulation to the wound and significantly increases the risk of complications.
How long before I can go back to work after surgery?
This depends on your work. Light duties, such as office jobs can usually be resumed a few days after surgery. However, your neck will be quite swollen and discoloured for at least a week after the procedure, so it is advisable not to schedule your surgery immediately before any public events.
Which is the ideal age to have a neck lift?
There is no real “ideal age” for any aesthetic procedure, especially as each individual ages differently and has a different perception of their appearance. Most importantly the expectations of what changes can be achieved must be realistic and the potential physical and psychological benefits of any aesthetic procedure must outweigh both the surgical and anaesthetic risks.
How long does a neck lift last?
This is highly individual. No aesthetic procedure can stop the ageing process, as both the changes of the tissues themselves and the effects of gravity remain ongoing. On average the lifting/tightening effect lasts for 5 to 10 years.
I already had a neck lift in the past. Can the procedure be repeated?
Technically yes, lifting procedures can be repeated, however the risk of complications are higher as the anatomy becomes distorted through scarring and the quality of the skin and soft tissue suffer with each re-do procedure. The expectations of the aesthetic outcome cannot be the same as for the first operation.
Can I wear make-up after the operation?
Once the wounds have healed completely (approximately 1 week after surgery) you can apply make-up freely. Before this time the wound itself should be kept clean and dry. You may apply make-up to the surrounding areas though.
Will I get a sick certificate for the time I am off work?
No. Sick certificates cannot be issued for cosmetic procedures. You will need to take leave for the entire period that you are absent from work.
Will my health insurance cover the costs for the surgery?
No. A neck lift lift is a purely aesthetic procedure which is not covered by health insurance.
Will my health insurance cover the costs of treatment if I develop any complications requiring medical treatment, hospitalization or even further surgery?
Yes, provided the complication is purely medical, e.g. an infection. Corrections of aesthetic complications (e.g. asymmetry, scarring, under- or overcorrection etc. ) are not covered.