Aging of the neck results in sagging and heaviness of the skin and soft tissues under the chin and the upper part of the neck. The neck muscles may also separate, producing visible vertical bands that run down the neck. Some patients may also have excess fat under the chin, creating the proverbial double chin or turkey neck appearance.
A neck lift addresses these issues by tightening the neck muscles, repairing separated muscle bands, and removing excess fat and skin. It is usually performed in conjunction with a lower facelift as previously described.
If there is excess fat under the chin, it is first removed by Vaser Liposelection (see Body Contouring section for a description of this technique). The lower facelift incision previously described is extended around the earlobe, along the back of the ear and into the hairline behind the ear. The skin is elevated from the neck muscles. Separated muscle bands are repaired with sutures, and loose muscles are tightened with sutures in an upward direction. Bleeding is meticulously controlled and excess skin is trimmed off before the wounds are carefully and accurately closed with fine sutures. The surgical wounds in the scalp behind the ears are closed with skin staples.
This procedure takes about three to four hours to complete under local anesthesia or intravenous sedation as a day surgery procedure.
Postoperative pain is mild and well controlled with oral pain medication. There is a moderate degree of swelling and bruising. The neck feels tight. The skin sutures are removed after one week. The scalp staples are removed after ten to twelve days. A compressive recovery garment is worn continuously for the first two weeks. Thereafter, it is worn at night for the next two weeks. It takes two to three weeks for enough swelling and bruising to subside for the neck to look presentable. The downtime is therefore about two to three weeks.
By about one month, the neck is usually looking fairly natural. Exercise can be resumed at this time.
The results typically last for five to ten years.
Overall this is a safe technique as the plane of surgical dissection and the method of tightening the facial muscles avoids the branches of the facial nerve. The risk of injuring this nerve is therefore very low. Optimal healing of the wounds requires adequate blood supply to the skin. Risk factors that compromise the skin’s blood supply include diabetes and smoking. Diabetes must therefore be well controlled and smoking must be discontinued at least one month before and after the surgery. General surgical risks such as blood loss and infection are also very low.