The most common signs of an aging neck are the development of vertical muscle bands, sagging skin and excess fat deposits. Muscle bands (platysmal bands) occur due to the regular use of the platysma muscle, with the vertical lines representing the muscle edges. Excess fat is also a common issue, and can be considered age-related or due to weight problems, because in many cases the development of these fat deposits is the result of hormonal changes in the body.
A neck lift, addresses wrinkles and sagging skin on the neck caused by aging or weight loss. The objective of neck lift is to remove excess skin, tighten underlying muscles, and improve the contour of the jawline. Neck lift is typically performed in conjunction with a facelift, but it can be done as a stand-alone treatment. A neck lift could also be called neck rejuvenation that comprises of variety of invasive or non-invasive procedures to improve the visible signs of aging in the jawline and neck. The best way to treat the signs of aging in the neck is through a custom-tailored, individualized treatment plan depending upon the presenting problems and desirable outcome. These procedures include:
1. Cervicoplasty is the cosmetic surgical procedure used to removes excess skin and subcutaneous fat tissue to redefine the neck and jaw for more taut appearance; the skin is then re-draped over neck muscles. The suture line is hidden in the hair-bearing skin and natural folds of the face.
2. Platysmaplasty is a surgical procedure that removes or alters neck muscles (platysma muscles) by bringing the muscle edges toward each other, and suturing them together.
3. Liposuction can be performed either on a standalone basis, or as part of a neck lift. During neck liposuction, the excess fat is physically removed from the area with the use of a cannula and tumescent fluid. If vertical muscle bands are not an issue and if the skin is sufficiently elastic, a neck lift may not be needed during this procedure.
4. Thread lift is gaining popular as a “minimally invasive procedure” for the face, neck, or jowls. Patient who seeks improvement in the contour of the neck without undergoing invasive surgery may opt for thread lift. These threads, which have small cones/hooks on them, are passed under the skin via a large needle. The cones/hooks then anchor the skin from the under surface and pull to re-suspend the skin in a lifted, more youthful position.
5. Botox injection is a non-invasive procedure to relax parts of the platysma muscle that are responsible for the “band” appearance or fullness look around the neck.
6. Kybella injection is the first FDA approved injectable for removing a double chin. The active ingredient in Kybella is synthetic deoxycholic acid that will destroy fat cells once injected into the fat beneath the chin. Once these fats cells are destroyed, they will be removed by the lymphatic system.
IDEAL CANDIDATES
- Patient who has a positive outlook and realistic expectations in mind for the improvement of appearance
- Physically healthy
- Non-smoker
PRE-OPERATIVE EVALUATION
Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
The preoperative assessment for neck lift may involve:
- Discussion about patients’ expectations and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Examination of the face and its soft tissues
- Discuss the options available for facelift and facial rejuvenation
- Preoperative evaluation for types of anaesthesia
- Photography for preoperative and postoperative evaluation
PREPARATION
- Preoperative medical evaluation including blood investigations
- Avoid certain medications or adjust your current medications
- Stop smoking or alcohol for about 2-3 weeks prior to the scheduled surgery
- Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding and bruises
RISKS AND SAFETY
It is important for patients to understand that every surgical procedure has its own complications and down time. However, if a patient is assessed properly before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced. The risks involved in facelift surgery may vary depending upon the nature of the surgical procedure.
Some of the risks of neck lift include:
- Wound infection
- Poor wound healing (higher risks in chronic smokers)
- Unfavorable scarring
- Bleeding (hematoma)
- Anaesthesia risks
- Facial nerve injury particularly mandibular branch resulting in lower facial muscle weakness
- Asymmetry
- Numbness or other changes in skin sensation
- Fat necrosis
- Fluid accumulation
- Skin contour irregularities
- Skin discoloration, sensitivity or swelling
- Possibility of revision surgery
POST-OPERATIVE EXPECTATIONS
During the initial healing phase, patient may experience swelling, numbness, discomfort, bruises and discoloration around the lower face and neck regions. These symptoms vary from each patient and they usually last for about 2-3 weeks. A compressive bandage and ice compression are usually placed around the lower face or neck regions for 3-5 days to minimize swelling and bruises. Drains to remove any excess blood or fluid from the operative field will be removed 1-2 days after the surgery. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed after 7-10 days.
POST-OPERATIVE CARE
- Follow the postoperative instructions given carefully
- Head elevation especially when sleeping for 1-2 weeks
- Take the prescribed medications as instructed
- Compressive bandage may be applied for 3-5 days
- Ice compression on the lower face or neck regions for 3-5 days
- Regular wound cleaning with antiseptic solution and antibiotic ointment
- Avoid strenuous physical activities for 3-4 weeks
- Regular use of sunblock for 3-6 months after the surgery
