Necklift

Over the course of a lifetime, our necks are subject to sun exposure and the effects of gravity, both of which naturally lead to the signs of ageing. The common signs of ageing in and around the neckline are a loss of structure, sagging skin, and occasionally neck thickening or band-link neck muscles which only plastic surgery can resolve. Necks, like arms and hands, often show the signs of ageing more prominently compared to other areas of our bodies, such as thighs and tummies, and while a sufficient and daily skincare routine can help, the signs of ageing on the neck are often impossible to avoid.

When the signs of ageing referred to as ‘turkey neck’ appear they can cause many people to feel self-conscious, and in serious cases can result in conditions such as anxiety and depression. What’s more, the neck often ages faster than the face (as do the eyelids), which can cause disparity between the two, with the aged neck giving a patient’s age away. Signs of an aging neck can begin in the late thirties and are often the reason for a patient to see a plastic surgeon. A necklift (platysmaplasty) cosmetic procedure can tackle the signs on ageing on the neck, resulting in a younger, healthier looking neckline.

Dr Dirk Kremer is renowned for his expertise in facial rejuvenation surgeries with healthy natural outcomes. A necklift procedure may be an excellent option to correct excess skin on the neck, any excess neck fat, and/or muscle banding. Necklifts are often performed in conjunction with a facelift, although they can be effectively performed as a standalone plastic surgery procedure. Based on your individual needs, Dr Kremer will perform a personalised necklift procedure to specifically address your anatomy, as well as your desired changes.

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The necklift surgery

If you are unhappy with the appearance of your neck, and are considering a plastic surgery procedure, before any operation is performed, you will meet with Dr Kremer in his office on Harley Street in London. During the consultation, Dr Kremer will discuss with you why you are seeking the cosmetic procedure, and what the surgery can achieve for you.

A ‘necklift’ is commonly performed under sedation, or general anaesthesia, by making an incision around the earlobes, behind both ears. In extreme neck rejuvenation, the incision ends in the hair behind the ears. First, the skin of the neck is undermined and the flat neck muscle (Platysma) with the overlying fat exposed. The muscle, or platysma, is then undermined almost to the midline of the neck from both sides and tightened by pulling the muscle up to the sides and held in place with a few internal but dissolvable stitches. As part of the operation, the neck muscle will be positioned so that it creates the desired swan-like angulation of a youthful neck. Platysmal bands of the turkey neck and jowels will be removed and the jawline smoothened. In a second step the skin of the neck is tension-free draped over the re-shaped neck and jawline by lifting the skin to the sides and up behind the ears with resecting the skin which is overlapping the incision around the ears. By doing this two-step approach to a necklift, Dr Kremer makes sure the angles of the mouth aren’t pulled and stretched to the side. The result is very natural with no tell-tale signs of a necklift.

In some surgeries, fat pods under the chin are also removed through targeted, submental liposuction of the deep fat deposits.

Before the necklift

If, after an initial consultation with Dr Kremer, you decide a necklift is the plastic surgery procedure for you, there are a few ways to prepare in order to ensure your surgery is performed efficiently and safely. First, you should avoid drinking alcohol and smoking or vaping at least a couple of weeks before the operation; smoking and drinking can result in serious complications during the operation and they can also lengthen the recovery process.

If you are taking any medications, it is vital that you inform Dr Kremer about these beforehand, along with any special dietary requirements. As the surgery is commonly performed as a day case, you should arrange beforehand for someone to drive you to and from the hospital, and to any post-operative appointments.

After the necklift

While not as invasive as a breast augmentation, tummy tuck or breast lift, a necklift is still classed as an invasive plastic surgery procedure, which means you’ll need to take some time off work to recover; this will of course be longer if you had a necklift combined with a facelift. You will likely experience some bruising and swelling in the neck area especially on the earlobes for the first 24-48 hours. You could also experience some tightness in the neck area, but any pain is mild and responds very well to pain medications A head bandage must be worn for the first night, but after this, no head band needs to be worn unless you combined your necklift with a submental liposuction. You should be able to return to work within 1-2 weeks, but you should avoid any strenuous activities such as heavy lifting or work-outs. Any scarring should subside over the weeks and months following the procedure, but some can take up to 1 year to fully heal. Since they are well hidden around the earlobe and behind the ears patients can even wear their hair up in a tale after a few weeks.

Complications of a necklift

Any cosmetic surgery procedure carries risk, and can result in complications. However, with suitable pre- and post-operative care, these complications are extremely rare. Complications arising during or after a necklift procedure are very rare but include post-operative bleeding with hematoma, infection, swelling, skin numbness and abnormal scarring and stretched scars or earlobes which can be revised through a minor corrective surgery. Smokers also suffer the risk of skin necrosis and must stop smoking at least 4 weeks prior to the surgery.

Necklift in a nutshell

  • Length of procedure: 1.5 hours
  • Anaesthesia: Sedation or general anaesthesia
  • Time in hospital: Day case
  • Recovery period: Short - 1-2 weeks
  • Average age of patients: 40+

Book an appointment with Dr Kremer today!

Based on Harley Street in the heart of London, Dr Dirk Kremer is one of the best plastic surgeons in the world, and was recently voted as the UK’s No. 1 for necklifts by Tatler, and the world’s best by W Magazine. To book your consultation with Dr Kremer, contact us today on 0845 519 7232, email info@harleystreetaesthetics.com, or fill in our easy and convenient online enquiry form.

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FAQ

I am afraid of general anaesthesia. Can I do the necklift under local anaesthesia?

Generally speaking, yes, it is technically possible to perform a necklift under local anaesthesia. BUT, here are some things that the patient should carefully consider: When undergoing a necklift under local anaesthesia, large areas of the lower face and neck have to be infiltrated with local anaesthetic. The infiltration can be painful at the beginning. Also, it is important that you are aware that you are fully awake during the procedure. You will feel pulling and tagging, and even though this is not painful, many patients can’t handle being fully aware of what is going on. On top of this, you will have to lay for up to 3.5 hours on the theatre table while remaining completely still. Many people experience back pain after a while, and feel that they need to change their position. This must be avoided under all circumstances.

I generally prefer performing necklifts under general anaesthesia. If you feel uncomfortable about general anaesthesia, it may help if you speak to our anaesthetist, as they can answer all your questions and put your mind at ease.

If you decide that you do not want the necklift performed under general anaesthesia for personal reasons, I would advise that you have the necklift surgery performed with local anaesthesia while under sedation. Our anaesthetist will administer painkiller and sedatives through an IV line. You will sleep during the procedure, but you have full control of your breathing and will be fully awake as soon as the sedative administration is stopped.

How long does the neck lift procedure take?

For my neck lift procedures, I usually take 1.5 hours. In combination with eyelift or submental liposuction, the whole procedure can take up to 2.5 hours. A short surgery time is important to avoid dramatic swelling after the neck lift.

I don’t lift the SMAS during the neck lift because it stops at your jawline and doesn’t continue into the neck. I do lift and tighten the platysma muscle, a flat and thin muscle which expands from your jawline down on both sides of the neck. Loss of tightness results in the so-called platysma bands, which run over the middle of the neck. By tightening this muscle in a neck lift I can return or create a defined angulation and definition of your neck.

What are the complications of a necklift?

Complications of a neck lift are rare. An acute complication (within the first 24 hours) would be a post-operative bleeding. If the bleeding doesn’t stop or the built-up haematoma is too big, you will need to be re-operated on, so that the bleeding can be stopped or the haematoma emptied. Risk of an infection and seroma is small but existent. Parts of the skin dying (this is a major risk if you are smoking), loss of sensitivity, asymmetry, stretched earlobes, and visible scars (stretched or hypertrophic) are also other potential, but rare, complications.

I am a smoker. Can I have a neck lift?

You definitely shouldn’t have a neck lift at the moment. Due to the constriction of blood vessels, the blood supply to your face is compromised. Undermining and lifting your skin, as required in a neck lift, further compromises the blood supply of your skin and there is a real possibility that part of it could die. A further risk is that the wound might not heal successfully, and you could develop a seroma which would need to be drained a few times until you did successfully heal. My patients often say to me, ‘you are a fantastic doctor, this won’t happen with you’. I am afraid this has nothing to do with how qualified, experienced or skilled you are as a surgeon, and therefore it can happen to any surgeon operating on a smoker. Therefore, you must stop smoking at least 4 weeks prior to your planned neck lift procedure. This will provide your body with the time in needs to regenerate its blood vessels within the skin of your face and neck. A neck lift can then be performed without this heightened risk.

How long do I need to stay in the hospital after my neck lift?

I like my patients to spend one night in the hospital after their neck lift procedure. I will ask you to wear a tight head bandage which will put a considerable amount of pressure on your ears. Many patients find that this can cause some pain. While you are in the hospital, we can administer IV pain relief as well as monitor you closely in case you have some post-operative bleeding. In the hospital, you can relax and put your mind at ease. The following morning, I will remove your bandage before assessing your neck. If all is well, I can then discharge you from hospital and you can return home. If you live in London, it is possible for you to leave the same day. Many of my patients have requested this and there were no complications.

Does a neck lift hurt?

You should not feel much pain with a neck lift procedure. The head bandage can cause quite a lot of discomfort, but I only ask that you wear it for the first night. It can cause a lot of pressure on the ears, and this is what many patients find quite uncomfortable. Once the bandage has been removed the following morning, you will feel much better. You will experience tightness, but rarely any pain. I discharge you with painkillers, though many of my patients tell me that they never had to use them.

How long must I wear the compression bandage for after my neck lift?

I will ask you to wear the compression bandage for just the first night, then I will take it off the following morning. If I added a submental liposuction to create a sharper definition, I advise my patients to wear a chin strap for another week at home, and another week only at night.

I usually decide if you will need small drains (mini-vacs) during your neck lift procedure. If you are not bleeding very much during your neck lift I won’t use drains. If you are bleeding more than expected during your neck lift, then I will use two mini-vacs. These drains are removed before you leave the hospital the following morning.

In most cases, a patient that has undergone neck lift surgery doesn’t have to hide because the swelling is minor, and bruises can be easily covered. Your earlobes and lower face may appear swollen during the first few days, and in this case patients tend to avoid public places, even though it can be easily hidden with long hair and your choice of clothes. A scarf, or a turtle neck sweater usually conceals the swelling very well. The stitches are in front of the earlobe, but clear sutures are used which are not so visible. Again, long hair can easily hide the stitches.

Will I have drains?

I will usually decide during your neck lift procedure whether or not you will need small drains (mini-vacs). If you are not bleeding, or if you are only bleeding a small amount during your neck lift, then I will not be using drains. If you are bleeding quite a lot during your neck lift surgery, then I will use two mini-vacs. These drains are then removed before you leave the hospital the next morning.

What can I expect once i am home?

Usually, I do not expect any swelling on your neck after your neck lift procedure. The lower face and jawline area may be a bit swollen, which can sometimes cause your mouth to be stretched a little, though this is only for the duration of the swelling. Once this swelling settles after a few days, your mouth will look completely normal again. Your earlobes can also swell during the first 3 days, and this will usually begin to settle from day 4 on wards. Also, you may find that you develop some bruising around the neck. The bruises can drop with gravity into your decollete, before fading away over the next 10-14 days. Bruising and swelling is of course different with each individual, but rest assured, if you do happen to experience any bruising or swelling, it will soon begin to improve after just a few days with many patients returning to work after just one week of recovery. Your neck will feel very tight, and some patients express concern about mobility, but you should be able to turn your neck without any problems. The tightness that you feel around your neck is caused by the tightened Platysma muscle. After the first few weeks of recovery, this feeling of tightness should subside.

What should I do to not risk complications after my neck lift and to ensure i heal successfully?

I would ask that you please avoid drinking any coffee or black tea in the first 2 days, because these can raise your blood pressure and cause bleeding. Also, please avoid smoking cigarettes. This is because smoking can compromise the blood supply to your skin, potentially causing facial skin to die. You shouldn’t smoke for at least 2-3 weeks following your neck lift surgery. Avoid exercise during the first month of recovery. Ensure that you sleep with your upper body elevated under a few pillows so that any swelling is reduced. Also, avoid bending over during the first few weeks..

How long do I need to hide after my neck lift? When can I go back to work?

Usually, the swelling after neck lift surgery is minor, and any bruising on the neck can be easily covered, therefore there is no need for a patient to hide away following their neck lift procedure. Your earlobes and lower face may experience some swelling during the first few days of recovery, and in this case patients generally avoid public places, although again, this can be be easily hidden by covering your ears with long hair or with your choice of clothing, such as a scarf or a turtle neck sweater. The stitches are visible in front of the earlobe, but clear sutures are used which are much less noticeable. Again, long hair and clothing can easily hide the stitching.

Where are the incisions in my neck lift? Will the scars be visible?

The incision starts at the front of the earlobe, and runs around the earlobe and back up behind the ear in the post-auricular sulcus. The incision then crosses from the top of the sulcus into the area of the occiput. Behind the ear you will find that the scar is not visible, and only a very small part of the incision is exposed at the front. These areas can be hidden very easily with longer hair. If you have short hair, it can be more difficult to disguise. Men in particular who have short hair can find it a problem when covering it up. Once the sutures are removed, any scarring will turn red and become slightly elevated, which is all part of the normal process when a scar is healing. During this period, it can help if you cover the scar with some concealer. Once the scarring has completely healed, they are very fine, light lines, which are difficult to spot as they are almost invisible.

How long will the result of my neck lift last?

This is a very common question i get asked by many of my patients! Well, a neck lift can last 10-15 years, but this doesn’t mean that your face will look the same over this period of time. With a neck lift we only turn back the time (10-12 years), as unfortunately we can’t influence nature and the ageing process. But, you will surely look much better 12 years after your neck lift procedure, as opposed to how you would have looked without the neck lift!. It is vital for a long lasting result to condition your skin with a strict skin care regime. I advise my patients to use products from my skin care range, SkinDoc formula, which has proven to be very effective for my patients.

When are the stitches removed?

The stitches are removed 12 days after your neck lift surgery. Around the ear I use sutures, and in the hair I use staples as they cause less harm to your hair follicles.

Do you shave my hair?

No, I do not shave your hair, so there is no need to worry about that.

Question?

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