Is a Neck Lift Right for You?

What You Need to Know About Platysmaplasty

Portrait of woman with lines on her face
Neck Lift Surgery. Robert Daly / Getty Images

If the eyes are the first place we show our age, then the neck is arguably the second. As we get older, vertical banding and horizontal creases may appear in the skin of the neck. Some of us may get a little more fat in the jowls or that dreaded “turkey-wattle.”

Things like this can be corrected with plastic surgery through a procedure called platysmaplasty. Quite simply, it's a "neck lift."

What Is a Platysmaplasty?

A neck lift (or platysmaplasty) is named for the platysma muscles which run along the front of the neck.

The surgery tightens the skin and underlying muscles to lift the neck. It also improves and sharpens the contour of the jawline.

Platysmaplasty is often performed in conjunction with a facelift. It may also be a stand-alone procedure.

Who Is a Good Candidate?

The best candidates for a neck lift are non-smokers who are in generally good health and who have a positive outlook and realistic expectations about the outcome. Sagging of the neck may be due to age, but may also be a result of significant weight loss or simple heredity.

Those who have sagging and/or wrinkling of the neck and a loss of separation between the neck and the chin or jaw can benefit from a neck lift procedure.

Pre-Operative Considerations

Your surgeon will almost certainly order some type of lab tests to confirm your health status before operating. She may also require that you adjust, cease, or begin taking certain medications a week or two before your surgery.

It is very important that you avoid aspirin, many anti-inflammatory drugs, and herbal supplements in the two weeks prior to surgery. All of these can increase bleeding. Talk to your surgeon about everything you may be taking.

Post-Operative Care

Most neck lifts are performed on an out-patient basis. After surgery, your surgeon will place a pressure dressing that will wrap around your head and underneath your chin.

Your neck will feel tight and sore as the anesthesia wears off. It may show even more swelling and possible bruising over the next 3 days. Dressings may be removed after just a few days, but your sutures will remain in place for 7 to 10 days.

Recovery & Downtime

Most patients can return to non-strenuous work after 5 to 10 days. However, for the first several weeks after surgery, you should avoid bending over, lifting heavy objects, and even turning your head from side to side. You will also have to sleep with your head elevated for one or two weeks.

These guidelines can vary widely based on the patient’s personal health, the techniques used, and other variables. Always follow your surgeon’s recommendations.

Risks & Complications

Risks and possible complications include excessive bleeding or hematoma, skin loss (tissue death), blood clots, and persistent edema (swelling). There is also the possibility of skin contour irregularities, discoloration and swelling, recurrent looseness of skin, and unfavorable scarring. You may experience numbness or other changes in sensation or intense itching.

As with all surgical procedures, there are risks associated with anesthesia. Additionally, the effects of plastic surgery may not be exactly what you thought and unsatisfactory aesthetic results are a reality.

In some cases, there may be a need for additional surgery as well.

After surgery, call your surgeon immediately if any of the following occur: chest pain, shortness of breath, unusual heartbeats, or excessive bleeding.

Complementary Procedures

Neck lift surgery is often done in conjunction with other surgeries to enhance the patient’s results. These procedures can include:

  • A facelift to correct sagging of the mid and lower face.
  • A brow lift or eyelid lift to correct "tired" looking eyes.
  • A chin or jaw implant or liposuction under the chin to improve the contour of the jawline.
  • Skin resurfacing procedures (e.g., laser resurfacing or chemical peels) to improve the overall look and feel of the skin.

    Results may also be enhanced through the use of Botox injections or non-surgical skin tightening using lasers or radio-frequency technology.

    How Is a Neck Lift Done?

    1. Anesthesia is administered. Neck lift surgery can be performed either under IV sedation or general anesthesia. For a very minimal lift, your surgeon may even determine that regional anesthesia or a combination of an oral sedative and local anesthetic link may be sufficient.

    2. Incisions are made. The traditional neck lift incision begins in front of the ear lobe and loops under and behind the ear ending in the scalp towards the back of the neck. If the platysma muscles will also be tightened, there may be an additional small incision under the chin. However, more specialized procedures may involve an incision only inside the hairline at the back of the neck (known as a posterior neck lift), or behind the ear only (for some suspension techniques). This depends on the techniques used and the degree of lifting required.

    3. Platysma muscles are tightened. In an aging face, the platysma muscles often separate. This creates a loss of support for the skin as well as a tendency toward a vertical “banded” appearance of the neck. Using sutures, these muscles are sewn back together in the center with a technique that looks similar to lacing up a corset. It is also possible that a small piece of this muscle will be removed or that some laser-assisted tightening is used on the underside of the deeper layers of the skin.
    4. Excess skin is removed. Excess skin is carefully trimmed away.
    5. Tissue and skin are repositioned and secured. In the case of a suspension lift, the surgeon will use some sort of sutures, mesh, or other materials in the deeper layers of the skin and muscles. This creates a sort of “hammock” to suspend and hold the tissues in their new, higher position.
    6. Incisions are closed and bandaged. Using a multi-layer suturing technique, the surgeon closes the incisions. If needed, drains will be placed at this time before bandaging the wounds.

    Sources:

     American Society of Plastic Surgeons. Facelift (Rhytidectomy), Consumer Information Sheet.

    Cook WR Jr. Laser Neck And Jowl Liposculpture Including Platysma Laser Resurfacing, Dermal Laser Resurfacing, And Vaporization Of Subcutaneous Fat. Dermatologic Surgery. 1997;23(12):1143-8.

    Schreiner C, Bailey B, Quinn FB Jr. The Aging Neck, Grand Rounds. Dept Of Otolaryngology UTMB. 1997.

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