Aging of the neck is intimately related to aging of the face. Most patients who are concerned with submental laxity (a “waddle”) also have sagging jowls, wrinkles, sun damage, and other concerns. Neck lift patients, therefore, often need a facelift. Patients should find a surgeon who thoroughly understands the complexities of facial rejuvenation and can help you understand the best treatment plan for your needs.

Dr. Steven Goldman is a triple-board-certified facial plastic surgeon and plastic surgeon with extensive facelift and neck lift experience who can help you find the right treatment options for you, including neck lift, facelift, fat injection, laser treatments, injectables, and other options to get the ideal result for you.

What is a neck lift?

Most surgeons use the term neck lift to describe the tightening of the platysma muscles (the muscles that create the vertical bands in the neck) and the removal of deep fat in the neck below the chin, using an incision placed under the chin.

Because of this incision, this procedure can also be referred to as an open neck lift. Tightening of the platysma is also referred to as a platysmaplasty. An open neck lift can be combined with liposuction along the jaw-line and neck.

However, some surgeons use the term “neck lift” interchangeably with “lower facelift” or with “facelift.” Thus, it is important for patients to clarify their esthetic concerns and for surgeons to clearly explain their recommended treatment options for their patients.

Many patients desire lifting and smoothing of their jawline and treatment of jowls in addition to lifting and tightening of their submental area (waddle). These patients need a facelift; some need an open neck lift to remove excess fat and tighten the platysma muscles, also.

What does a neck lift achieve?

The open neck lift is used to remove excess fat under the chin and to tighten the platysma muscles. This helps deepen and sharpen the cervicomental angle, the angle formed where the front of the neck meets the jawline, to create a more defined, youthful, fit-looking neck.

So, patients who have a heavy neck with deep fat or patients who have vertical bands in the neck from the platysma muscles will benefit from an open neck lift with platysmaplasty.

It’s important to note that most patients who are bothered by submental fullness or looseness (the waddle) are also bothered by jowls, sagging cheeks, and other signs of facial aging. Such patients generally need a facelift.

Dr. Goldman performs the deep plane facelift, an aggressive but natural-looking facelift. (Some doctors or patients will still refer to this as a neck lift because they are treating their neck and jawline, but if the surgery involves treatment of the tissues in the face, the more accurate terminology is a facelift.)

As noted above, some patients who are bothered by their waddle benefit from the deep plane facelift and do not need to have the additional open neck lift. Dr. Goldman can help determine which procedures are best for you.

What contributes to aging in the neck?

Aging in the neck is caused by similar risk factors to those of aging in the face. Multiple factors influence facial aging, especially:

  • Sun damage.
  • Weight loss.
  • Smoking.
  • Hereditary factors.

Who is a candidate for a neck lift?

An open neck lift is a safe and effective option for individuals with excess fat in their necks or problematic platysmal bands (vertical muscle bands). A facelift is a better option for patients with jowls and loose, thin, deflated skin in the neck that needs to be redraped and lifted.

Patients undergoing facial rejuvenation surgery, or any elective surgery, should be in good health with no untreated medical problems. Smoking increases the risk of wound healing problems. Nicotine reduces blood flow to the skin, compromising healing. Interference with blood flow and vasculature lasts long after smoking stops, so most surgeons suggest no smoking for 6 weeks or more before surgery.

In addition to being in good health and quitting smoking, the ideal candidate should:

  • have realistic expectations of their anticipated results;
  • be compliant with before and after instructions; and
  • be prepared to go through the surgical procedure and the recovery process.

The procedure

A typical open neck lift takes an hour or less to complete. The patient can go home on the day of surgery, even when combined with other facial rejuvenation procedures.

  • General anesthesia is typically used in addition to local anesthetic. Dr. Goldman’s team minimizes narcotics and uses additional strategies to speed recovery and minimize nausea.
  • The open neck lift and platysmaplasty are performed using a short (approximately 1-inch) incision under the chin. If a deep plane facelift is used, well-hidden incisions in front of and behind the ear are also used.
  • The chin (submental) incision is used to identify the platysma muscles, remove fat from the central neck from underneath the muscles, and then bring the muscles together in the midline to tighten them. The muscles are cut in the lower neck to further release any bands.
  • Dr. Goldman often also uses liposuction to help contour the neck tissues.
  • If a facelift is needed to lift the neck skin and tighten the jawline (which is usually the case), then a layer called the SMAS in the face is elevated, lifted, and re-draped to lift the platysma and loose neck skin back up into the face, recreating a more youthful contour. This is referred to as an SMAS lift. The deep plane facelift involves an aggressive SMAS lift.
  • Excess skin is trimmed using the facelift incision, which is closed artfully and precisely in a well-hidden fashion. Skin is generally not removed from the submental/chin incision.
  • Dr. Goldman does not use drains for his open neck lift or deep plane facelift patients. Nor does he use bulky dressings, just a light, removable Velcro neck compression garment.

What to expect for recovery

Dr. Goldman uses rapid recovery techniques, which involve the use of light dressings, early ambulation (walking the night of surgery), and other techniques to minimize pain and speed recovery.

Patients may shower 2 days after surgery and exercise lightly 2 weeks after surgery. Walking begins immediately, as soon as patients get home on the day of surgery.

Swelling and mild to moderate bruising are common after a neck lift procedure. This varies greatly from patient to patient. Most bruising can be hidden with makeup and clothing a week or two after surgery.

Typical postoperative instructions are as follows:

  • Elevate your head on extra pillows when lying down for 3-4 days to minimize swelling.
  • Patients wear a compression garment (Lycra and Velcro) most of the day for 1 week, then while at home for another 3 weeks or so, and sometimes at night for another month or so.
  • Most patients take a few narcotic pills after surgery. Some only use Tylenol.
  • Walking begins immediately, light exercise at 14 days postop.; no neck straining for 6 weeks. Most patients work out hard but not at full capacity for 2-3 months.
  • Patients must be accompanied by a responsible adult for 24 hours after surgery.
  • Patients go home the same day. At home, patients move more and are more comfortable than in a hospital or hotel setting. Out-of-town patients can stay in hotels that work with our practice.

Are the scars visible?

Neck Lift and facelift incisions are well hidden. All incisions are noticeable for the first few days after surgery. Most patients feel these incisions are hard for others to see in 2-3 weeks. Any scar actually takes 1-2 years to fully fade. Dr. Goldman uses intense pulsed light and other modalities as needed to expedite scar healing.

Do neck lift surgeries have complications?

As with any surgical procedure, there are risks associated with a neck lift. Risks are low for healthy patients. Some of these include:

  • Infection: Cases are rare and usually treated with oral antibiotics.
  • Bleeding: Bleeding is also uncommon but can require return to the operating room.
  • Nerve damage: Weakness of a muscle that pulls down on the corner of the mouth is uncommon but is a risk of any neck surgery, even liposuction. Most cases will resolve in a few weeks, but weakness can be permanent.
  • Scarring: While scars are inevitable after surgery, excessive scarring may occur in some cases. Patients who have risk factors, like a history of keloids, may require steroid injections, laser, or other treatments.
  • Anesthesia risks: Medical complications associated with anesthesia are rare but can occur, even in healthy patients, including blood clots, allergic reactions, respiratory problems, and cardiovascular events.
  • Unsatisfactory results: All esthetic results depend in part upon how the body heals. Factors like scarring, tissue strength and elasticity, and vascularity affect healing. This causes some unpredictability with all surgery. Furthermore, patients should have realistic goals. Surgery can sculpt and tighten the neck and face, but it cannot truly make tissues 20 years younger.

It is important to discuss these risks with your surgeon and follow their instructions carefully before and after surgery to minimize the likelihood of complications. Additionally, choosing an experienced and board-certified plastic surgeon like Dr. Goldman can help reduce the risk of complications and optimize the potential for a successful outcome.

Complementary procedures

As noted, the open neck lift is most often combined with a facelift. Other procedures are often used to compliment the neck lift including facial fat injection (to restore youthful volume to the cheeks, jawline, neck, and other areas), laser resurfacing (to tighten and smooth skin texture, treat sun damage, and minimize wrinkles), medical grade skin care, injectable, radio frequency skin tightening, and other modalities.

Using additional treatments allows a more aggressive correction of facial aging while preserving a natural appearance, for a dramatic but natural correction.

Is neck lift surgery painful?

As with any surgical procedure, some pain and discomfort are expected. In general, pain varies greatly between patients. However, Dr. Goldman uses techniques that minimize pain. Local anesthesia is used during surgery, which also has benefits in the early postoperative period. The gentle compression from a light compression garment also reduces pain, as does early ambulation and movement immediately after surgery.

Why choose Dr. Goldman?

Choosing the right plastic surgeon is critical to achieving the best possible outcome. Dr. Goldman is one of only a handful of triple board-certified facial plastic surgeons nationally. He has a special interest in facial rejuvenation surgery and extensive experience in facelifts, neck lifts, blepharoplasty, laser resurfacing, fat injections, and related procedures. He is known for his dramatic and natural-looking results.

He and his team also have a comprehensive, holistic approach to facial rejuvenation (and plastic surgery in general), utilizing surgical and non-surgical techniques and technologies to optimize results and maintain them in the long term.

Perhaps most importantly, Dr. Goldman is committed to providing personalized care and attention to each patient. He takes the time to listen to his patient’s concerns and goals and works with them to develop a customized treatment plan that meets their unique needs.

To get a neck lift surgery consultation, email or call us at (216)514-8899.