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Neck Lift

In some patients, the onset of aging is seen primarily in sagging of the neck. It can precede some of the other aging changes that occur in the cheeks and in the folds around the mouth. Since the face will remain unchanged after a neck lift, it is important to consider if a neck lift alone is indicated. Dr. Forley, with an expertise developed over more than 20 years in private practice, will perform a careful assessment during your consultation to determine if a balanced result is possible when surgery is limited only to the neck. His skill in both planning of the incisions and the attention to detail he places on the repair of the wound ensures the best possible healing of the surgical scars.

A neck lift does not stop the clock. It simply "resets" it. How long a neck lift lasts depends on many factors including the characteristics of your tissues. You’ll notice some loosening with the passage of time following a neck lift, but you may never regain the degree of your original concerns with the aging changes in your neck. Dr. Forley will recommend a maintenance program of skin care and minimally invasive procedures, such as Fraxel® laser or Ultherapy®, to prolong the duration of benefits you attain following surgery.

A neck lift is often combined with other procedures to simultaneously correct other areas of the face, such as the forehead or eyelids, to give you a more youthful appearance.

50 year old female 1 month following neck lift*Results may vary.

Is This For Me?

You should consider a neck lift if:

  • You have loose, sagging skin on your neck.
  • You feel the need to wear a turtleneck or a scarf to cover up loose skin.
  • You feel as if you look older than you really are because of your neck.

The Consultation

During your consultation, Dr. Forley will first ask about your medical history and to describe what concerns you most about your appearance. He will examine you to assess your skin quality and laxity, fat excess, and the presence of muscle bands or cords. Since the face will remain unchanged after a neck lift, it is important to consider if a neck lift alone is indicated. Dr. Forley performs a careful assessment during your consultation to determine if a balanced result is possible when surgery is limited only to the neck.

Preparation

Your pre-operative appointment will be scheduled 2 weeks prior to your surgery date. A complete review of the surgical plan as well as instructions for you to follow before and after surgery will be discussed. Medical clearance, including blood tests and cardiac testing as needed, will be obtained from your primary care doctor in preparation for your surgery. A program of vitamins and supplements to optimize your healing and recovery will be provided to you during your pre-op visit. Dr. Forley advocates a customized skin care regimen prior to and following surgery for all his patients and this will also be discussed. Photographs will be taken and kept strictly confidential.

The Procedure

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The contour and appearance of a youthful neck is restored with a neck lift by the removal of excess fat under the chin in addition to tightening of the muscle and loose skin that is present. Dr. Forley will carefully mark the incision sites and answer any last minute questions. The anesthesiologist will then review with you the twilight/sedation technique that is utilized exclusively in the Joint Commission accredited office surgical suite. Incisions placed behind the ear are used to carefully mobilize the skin and deeper layers of the neck. Prominent fat deposits are sculpted using very fine liposuction cannulas to precisely remove the desired amount of unwanted, bulging fat. The appearance of cords below the chin is due to thickening of the platysma muscle that lines the neck and can become more evident with age. These cords are treated by use of a row of stitches under the skin to create a supportive muscle sling that produces optimal definition of the neck. The excess skin that results from gravity, elasticity damage as a result of cumulative sun exposure, and weight fluctuation is removed via the incisions behind the ears which are then carefully closed to enable minimally apparent scars to form with healing.

What to Expect After Your Procedure

Although there may be some mild discomfort at first, pain is not usually experienced following a neck lift. You’ll feel some tightness in the neck area following surgery. This assures that you’ll have the best possible long-term result. Most of the tight feeling resolves in the first few weeks.

A protective turban-style head wrap is used for 1-2 days. Compression is not used as it actually increases the amount of swelling you might experience. In most cases, a drain is used overnight to remove any post-operative oozing of blood so that there will be less bruising. Dr. Forley will remove the drain the following day when he changes your dressing. You will be able to wash your hair within 2 days. Sutures are removed at about 8-10 days.

The Stages of Recovery

  • Day of surgery: May be performed as an outpatient procedure in our accredited office surgery facility. A nurse can be booked to monitor you overnight.
  • Bruising and swelling resolve: 5-10 days with continued softening of any firmness under the chin occurring for several months.
  • Return to work, social activity: Average is 2 weeks.
  • Aerobic or strenuous activity: 14-21 days.

We encourage a return to activity in the early post-operative period. Just don’t do any type of strenuous exercise that would push your pulse over 100 for about two to three weeks. Any aerobic activity that increases your pulse over 100 also increases your blood pressure, and could make you bleed.

Potential Risks and Complications

Risks common to all surgical procedures such as bleeding, infection and thickened scar tissue occur in a very small percentage of cases. There is a rarely occurring risk of affecting nerves that control facial movement. Dr. Forley will discuss the risks of neck lift surgery in more detail with you during your consultation.

We encourage you to discuss any concerns you may have during your consultation. If you have high blood pressure, it must be properly controlled prior to surgery to reduce the risk of bleeding. We will coordinate this with your primary care physician.

Neck lift procedures involve more risk in smokers. Nicotine causes constriction of blood vessels that supply the skin, reducing blood flow, and increasing the risk of skin loss. If you are a smoker, Dr. Forley will make specific recommendations to you to reduce those risks.

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1. A neck lift rejuvenates the entire face. A sagging neck is often what bothers people the most about facial aging. However, the impact of the loss of a youthful neck contour should not be viewed in isolation when accompanied by changes in the face such as jowls and loss of cheek volume. Dr. Forley will discuss the benefits of a neck lift with you and also whether you would achieve greater improvement by including the face in the surgical plan. 2. A neck lift causes noticeable scars. The scars are hidden behind the ear and in the scalp. Usually a 1 inch incision under the chin is used for additional fat contouring of the neck and to treat the muscle bands or cords by suturing the muscle edges together. Scars evolve over time but usually become minimally apparent at the conclusion of the healing process. Laser treatments can be utilized to blend the scars should they become raised or thickened in appearance. 3. A neck lift is permanent. The benefits of a neck lift will always keep you looking better than if you never had it done. However, the surgery doesn’t stop the clock and the outcome of the surgery will change over time. In some cases a maintenance procedure in the future may be desired to keep your neck looking its best. A non-invasive tightening procedure such as Ultherapy is an excellent way to maintain the results of a neck lift without surgery. 4. A neck lift will get rid of the horizontal creases in my lower neck. The etched lines that some people have in the skin of their neck have often been present from an early age. They develop from the interaction of underlying neck anatomy with thinning of the dermis and sun exposure. A neck lift does not change the quality of skin nor does it remove etched lines. However, it my make them less visible when they are accompanied by skin redundancy that will be treated by a neck lift. Techniques to smooth the lines using hyaluronic fillers such as BELOTERO BALANCE® have been very beneficial. 5. Anyone can get a neck lift and get great results. In some cases, a more extensive degree of facial aging has occurred that is not limited to the neck. The risk of only treating the neck in such patients is that a lack of harmony between the neck and the face is created. Although the neck appears more youthful, the contrast with the untreated face can make the face appear even worse in comparison. Dr. Forley performs a careful assessment during your consultation to determine what options for facial rejuvenation would serve you best.
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