GENERAL INFORMATION
   A neck-lift is considered a less extensive operative procedure than a traditional face-lift.  
Contrary to some non-medical reports, it is not possible to remove all the folds and eliminate all of the sags of the neck.  The appropriate amount of skin will be removed depending on your facial contour.  The age, lifestyle, and skin type of the patient will all play an important factor in the final result.  In addition, the neck-lift is really a “neck/jaw line” lift and does not improve the lip-cheek grooves, temple, mouth, or eyelid region.  It also will not improve the texture or wrinkles of the skin.  All patients need to understand that a neck-lift is done to remove excess skin, not wrinkles.  (For information on wrinkles, see our laser brochure).

Before

After

  Along with the development of better surgical methods, there has been a
significant change in opinion concerning the optimum age for facial surgery.
  There is no need to wait until you are in your sixties and seventies to have
a neck-lift.  While correction is perfectly possible at this age, there is a lack
of tone to the muscles, making it more difficult to repair.  Preference has
shifted to the early forties, when tone and healing are achieved more rapidly.

Before

After

   Frequently, in combination with a neck-lift, liposuction is done to remove the excess fat in the neck area.  A small incision is made under the chin, and the scar will be barely noticeably.
Generally, the entire operative procedure has been extremely successful and has provided significant satisfaction to many individuals.  Please remember that the patient must follow postoperative instructions carefully in order to achieve the very best results. 
However you must remember that no matter how tight the neck is immediately after surgery, some relaxation of the neck tissue will occur.

PREOPERATIVE
   You will have an appointment approximately one week prior to surgery.  This will allow you to ask questions before your procedure.  All instructions and prescriptions will be given.
1.      Discontinue aspirin products one week prior to surgery.
2.      Some pre-op testing may be required (blood work, EKG, etc.) depending on medical history.
3.      Wash hair the night before surgery. Your head will be wrapped like a mummy for 2-3 days.
4.      No make-up should be worn.
5.      Nothing to eat or drink past midnight the night prior to surgery.
6.      Please do not wear jewelry to surgery.
7.      Shorts are a good idea to wear.
8.      Please arrange for transportation after surgery.
9.      Fees for the surgery are to be paid in full prior to the procedure.
Please purchase Aquaphor ointment (over the counter) for sutured areas, and a tennis sweatband.

PROCEDURE
   The operation is usually performed in the office setting, after which the patient returns home.  The surgery is approximately four hours.  The following is a general description of the procedure:  Incisions are within the temple area, in front of the ear, behind the ear, and into the scalp behind the ear.  After the incisions are made, the skin is released from the underlying tissues, pulled on the proper lines of tension, and the excess skin is removed.  In extreme cases, there will be small tubes coming out through the skin.  This is a drain used to help prevent blood and fluid from collecting.  Sutures are often placed in the deeper structures to assist in maintaining stability.  The incisions are then closed with surgical stitches and staples.  A tight feeling lasting from six to twelve months may occur due to the tension put on the skin.

ANESTHESIA
   General anesthesia or local anesthesia plus IV sedation helps the patient to be completely relaxed.  The operation itself should not be painful.  The operation can be done under general anesthesia, with the patient totally asleep.  This would necessitate the surgery being done in a hospital setting.

DISCOLORATION
   The patient can expect some swelling of the face and eyelids and discoloration is common with any type of facial surgery.  This is usually most noticeable on the second and third day and diminishes in approximately two to three weeks, depending on the patient’s type of skin, age, and healing ability.

SCARS
   The surgical scars are permanent; however, they are barely discernible to normal visual observation after a reasonable amount of time.  However, if you are prone to scarring, you should notify me prior to surgery.

COMPLICATIONS
   Even in a well-performed and controlled operation, there may still be some limited blood collection under the skin.  This can be treated during the follow-up office examination, and will not affect the overall results.  Larger collections require early and more vigorous treatment and possibly the re-opening of part of the surgical incision to remove clotted blood or to stop small bleeding points.  This complication is very rare.  There may be some temporary lag in normal motion of the facial muscles, but rarely is this permanent.  Most often, this delay is due to swelling, and will gradually subside without permanent change.  There will be some slight change in the normal hair pattern just in front of and slightly behind the ears.
    A number of other complications must also be anticipated in the early postoperative period.  There will be a feeling of numbness and tension in the neck and cheek areas, as well as around the ear.  This is the result of separating the skin from the underlying tissue, which disappears during the first four to six weeks after surgery.  Swelling and bruising of the skin (particularly in the lower face and neck) varies, but usually lasts approximately two to three weeks.
    It subsides gradually during the early postoperative period, leaving no ill effects.  Temporary swelling around the eyes is also not uncommon shortly after the neck-lift operation.  Other complications include infection, wound edge separation, persistent numbness, skin necrosis, permanent weakness of the lower lip, loss of hair follicles of beard in men, and widened scars.  Most complications are rare, and can be repaired or treated.  This list is to inform you and is not limited to the above.

MAKE-UP
   Usually, make-up can be applied over the skin and face up to the edge of the surgical scar approximately one week following surgery.  The scars themselves may be covered with make-up after three weeks, unless advised differently.

SHAMPOO AND SHOWERS
   You may wash your hair normally after the bandages come off.  Do not permit any beautician to pull on your hair or roughly massage the scalp.  A hair dryer should be set at medium to cool heat.  This is of utmost importance if any areas of numbness are present.  Keep incisions dry until the sutures are removed.

SOCIAL ACTIVITIES
   Social activities should be limited for approximately two weeks.  Strenuous exercise should be avoided for four weeks.  Earlobes may be numb, so be extra careful when placing earrings in lobes.