WHAT IS NECK LIFT SURGERY OR SUBMENTOPLASTY?
The elements that characterize a youthful neck include a distinct inferior mandibular border, visible sub-hyoid depression, noticeable thyroid cartilage bulge, visible anterior sternocleidomastoid line, and ninety_ angles with the submental line and cervical mental angle of 105 to 120.
These criteria are seen in glamour models. In evaluating the neck properly, the neck aging changes may be due to skin excess, fat accumulation, platysma laxity, digastric hypertrophy, submandibular gland abnormalities, or anatomic variants such as a low hyoid bone. Straightforward neck procedures include defatting superficial to the platysma, subplatysmal and inter-platysmal defatting, and medial platysmaplasty/platysma. Surgical approaches to neck rejuvenation include liposuction, anterior or submental incision, direct skin excision, and Z-plasty.
How Do I Prepare for Neck Lift Surgery?
- Your surgeon will supply thorough preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.
- I may also need you to obtain medical clearance from your family physician or internist.
- Preparation for surgery begins after the surgeon examines you and discusses the details of the procedure. If he recommends that you stabilize your weight before surgery or make other lifestyle suggestions, do your best to follow them to ensure the best results and minimize complications.
- Patients should also prepare for their surgery by mentally preparing for the downtime and planning for transportation and after-care. Most people should plan to take one to two weeks off from work, although specific times will vary depending on their selection procedure.
- Stop smoking six weeks before your surgery to promote good wound healing and reduce scarring. Smoking also increases your risk of serious complications.
- Avoid taking aspirin, nonsteroidal anti-inflammatory medications (NSAIDs: Advil, Motrin, Aleve), and vitamins/homeopathic regimens. These can increase bleeding.
- Regardless of the type of surgery to be performed, hydration is essential before and after surgery for safe recovery.
Your Neck Lift may be performed in a hospital or MSI outpatient surgical facility. If it is outpatient, arrange for someone to drive you home after surgery and stay with you for the first twenty-four to forty-eight hours unless you and your surgeon have decided on other postoperative recovery options. In advance of your procedure, your surgeon will ask you to:
What Can I Expect on the Day of Neck Lift Surgery?
Neck Lift surgery needs at least several hours to complete, though more extensive procedures may take longer. The goal of your aesthetic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results and to make your surgical experience as easy and comfortable as possible.
- You will receive medications to keep you comfortable during the surgical procedure.
- Local anesthesia combined with sedation is used during Neck Lift surgery, though general anesthesia can be used instead. An anesthesiologist or nurse anesthetist may be present to administer sedatives (or general anesthetic) and assist in monitoring.
- For your safety during the surgery, I will use various monitors to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
- Your plastic surgeon will follow the surgical plan discussed with you before surgery. Once the operation has begun, they may combine various techniques or change a technique to ensure the best result. It is vital that you feel comfortable and trust your doctor to make these decisions.
- After surgery, I will take you into a recovery area to closely monitor you.
- Your incisions will be covered with bulky bandages that provide gentle pressure to minimize swelling and bruising. A small tube might be placed under the skin behind one or both of your ears to drain any excess blood or fluid.
- Before leaving for home on the day of surgery, you or someone looking after you should feel comfortable emptying and resetting the drains.
- You may choose to go home on the day of surgery or spend the night with an official consultant or nurse unless you and your plastic surgeon have made other plans for your immediate postoperative recovery. Under no circumstances will you be permitted to go home alone.
How Do I Look Immediately After Neck Lift Surgery?
- You may be placed in a compression garment or wrap immediately after surgery. Wear this exactly as directed. Remove it only as directed for cleansing incisions or showering.
- To minimize swelling, recline rather than lie down. This will be more comfortable for you and can reduce swelling. Always keep your head elevated. Do not bend forward or over.
- You will have a mild to moderate amount of pain and discomfort. This should be easily controlled with oral medications. If it is not, call your surgeon.
- The discomfort and pain should begin to decrease within forty-eight hours after surgery. If you have a significant increase in pain after this period, call your plastic surgeon. Severe pain is rare; if you experience this, call the doctor at once.
- Expect bruising and swelling. These symptoms will peak within the first thirty-six to forty-eight hours after surgery and gradually subside over ten to fourteen days. Sleep with your head elevated for weeks after the surgery to minimize swelling.
- It is not unusual to have slight drainage for the first forty-eight hours. A bulky cotton compression dressing with drains will cover your scalp and face for one to two days to help prevent blood collection under the skin.
- Patients should attend all follow-up appointments with their surgeons in the weeks and months following a Neck Lift. They should also carefully check their progress and alert their doctors if they notice the signs of post-surgical complications. It may take several weeks for patients to see the results of their Neck Lifts. Nevertheless, as recovery progresses and swelling subsides, patients should begin to enjoy a younger, more alert appearance.
What Will I Look Like During Recovery from Neck Lift Surgery?
Your surgeon will discuss how long it will be before you can return to your average activity level and work. After surgery, you and your caregiver will receive detailed instructions about your post-surgical care, including information about:
- Drains, if they have been placed
- Typical symptoms you will experience
- Potential signs of complications
Postoperative Care after Neck Lift Surgery
Minimizing postoperative problems begins in the operating room. The control of bleeding should be meticulous. The anesthesiologist should raise the blood pressure to the preoperative level as hemostasis is gained.
- Relative hypotension will mask bleeding. Raising the pressure toward the end of the procedure will conversely minimize postoperative hematoma. The recovery from anesthesia should be smooth without coughing or retching.
- Except for liposuction, patients are seen in the morning following surgery. At that time, the operative dressing and drain are removed. Drains are used in all cases when there is significant neck dissection. However, if drainage is significant, i.e.,>30 cc in 24 h, the drain remains in place until the drainage has subsided. Drainage is likely to be significant in fat necks or if electrocautery is used to raise flaps. Therefore, scissor dissection is favored for skin flap elevation.
- A chinstrap is worn continuously for five days and at night for two weeks for those undergoing platysmaplasty and fat resection.
- Patients are instructed to sleep with their heads elevated, and necks gently extended. It would be best to avoid a single pillow positioned
- behind the head. Cervical flexion can increase edema through the venous obstruction, place excess tension on mastoid region closures, and diminish adherence of the skin to underlying structures.
- There should be no heavy lifting or bending in the immediate postoperative period. NSAIDs and anticoagulants are best avoided for at least one week after neck rejuvenation.
- Finally, effective communication between the surgeon and patient increases cooperation and helps achieve a better surgical outcome.
- How Long Will My Results Last?
Your genes, skin quality, and maintenance routine are essential factors in the longevity of your Neck Lift, but the Neck Lift technique is the number one factor in determining how long the result will last.
Limitations and Risks of Neck Only Lift Surgery
Fortunately, significant complications from Neck Lift surgery are infrequent. This surgery remains the gold standard for facial rejuvenation and is usually performed without significant problems. I should discuss the risks and potential complications of surgery during your consultation. The risks in most surgeries are similar such as:
- Poor reactions to anesthesia
- For most patients, anesthesia is extremely safe. However, there may be some risk for heart attack, stroke, and other severe complications for patients with underlying health conditions.
- All surgeries pose some risk of infection. However, this risk is shallow when doctors and surgical centers follow proper sanitation protocol.
- Hematoma is the most common post-Neck Lift complication, affecting 1 to 3 percent of women and 7 to 9 percent of men. While the risk is higher for males, other factors that may raise a patient’s chances of developing a hematoma include smoking, NSAIDs or aspirin, and high blood pressure. Patients who combine a facelift with a specialized neck lift procedure known as anterior platysmaplasty also have a higher risk of this complication. Bleeding under the skin can cause immense discomfort and swelling, and skin discoloration. Surgery is the only way to repair this problem.
- Nerve damage:
- Nerve damage, the most dreaded complication of Neck Lifts, is the second most common risk of this surgery. A nerve may be cut, nicked, or cauterized in rare cases, causing numbness or facial paralysis. Sensory-motor damage, which can cause reduced sensation in the face, is more common, occurring in up to 7 percent of all cases. Fortunately, when this does occur, the damage is not always permanent.
- Visible scarring:
- Although there will always be some scars still being after a Neck Lift, in most cases, they are hidden. Occasionally, some faint marks may not be concealed behind the ear or hair.
Before deciding whether to undergo rhytidectomy, patients must weigh the benefits of Neck Lift surgery against its risks and potential side effects.