Neck lift surgery aims to tighten the flaccid skin in the submandibular and upper neck region and also pull the deeper tissues of the area such as the cervical bands taut. It allows the patient to improve the cervical-mandibular angle and also remove the excess submental (under the chin) fat, sometimes in combination with a jowl liposuction.
WHO NEEDS IT?
A Neck Lift procedure is recommended for patients showing marked flaccidity, including the formation of cervical bands (‘turkey neck’), sagging skin and/or the accumulation of submandibular fat. Those usually appear at the age of 45 or older. It is easy to find relatively young people showing an aged appearance due to such factors.
Jowl liposuction is recommended, or a neck lift procedure, for those cases showing significant skin flaccidity.
Sometimes there is no fat component to those symptoms and flaccidity is solved in its entirety by the neck lift technique.
Neck Lift surgery can be done under local anaesthesia supplemented with sedation. General anaesthesia can be provided to patients who don’t wish to stay conscious during the intervention.
Incisions are made in front of the lobe and behind the ears. They can extend to the retroauricular scalp depending on the level of flaccidity of the neck’s skin. From there the submandibular skin is detached to allow access to the muscular-aponeurotic system which is then disected and strengthened.
Any excess skin is resected and stitched with delicate, tension-less suture in order to produce imperceptible scarring.
This procedure also provides, when necessary, a correction of the anterior edges of the Platisma muscle, which are the source of a very typical deformity in the aged neck consisting of two bands of skin along the neck. Usually access to this area is achieved through a 3 cm-wide incision under the chin.
DURATION OF THE PROCEDURE
It lasts about an hour and a half to two hours, requiring 24 hours of hospitalisation.
Recovery time is not painful, with patients alluding to discomfort and tightness at most. The bandages are removed 24-48 hours later and replaced with a compressive garment (an elastic band) to accommodate the tissues to the new position and contain the edema.. This band will be kept in place for a week. There will be ecchymosis (bruising) which will disappear between the 7th and 10th day after the procedure.
Infection is a risk associated to any surgical procedure and is prevented through the use of antibiotics.
Blood accumulations under the detached skin (haematoma) can appear. They must be evacuated to avoid the formation of fibrosis, hardness and skin retraction in the intervened area. Those accumulations should not be confused with bruising (ecchymosis), typical of any surgical intervention.
Nervous system alterations are not frequent. They can appear when dissection is performed on an incorrect plane. This usually happens when visibility is difficult due to profuse bleeding.
Heavy smoking patients can show loss of retroauricular skin due to alterations in blood microcirculation that make the wound healing process difficult.
Do not ingest Aspirin or derivatives a week before surgery. It is useful to supplement the patient’s diet with vitamin A, E and C for two weeks before the intervention. Smokers ought to stop smoking fifteen days before surgery or at least reduce their tobacco consumption a month before.
After surgery, applying cold to the intervened area and using compression garments can greatly diminish the edema.