Treatments & Procedures

Neck Lift

There are a number of procedures available to enhance the appearance of the neck. They range from very minimal in-office treatments with no down time, to more invasive procedures requiring anesthesia and time off for recovery. Aging of the neck is usually a combination of loose skin and muscle and some excess fat. To decide what is best for you, start by consulting a board-certified plastic surgeon to address your concerns.

We’ve included basic information below on ways to address the most common concerns. These procedures can be performed alone or in combination to give you the best possible result. This general overview should not serve as a replacement for your doctor’s advice, however. You also should write down your thoughts on what you’d like to correct, and have that with you at the time of your pre-operative consultation.

Treatment options

Botox injections

The vertical bands that extend from under the chin to the base of the neck are caused by the neck muscle called the platysma. Botox can be injected into the muscle to temporarily reduce the appearance of these bands. This is a simple in office procedure that requires no anesthesia and allows you to get right back to your normal activities.

Neck liposuction for fat removal

During liposuction, your surgeon will make a small incision below the chin, and the excess fat will be removed. This procedure is often done alone are may be performed as part of a neck lift or facelift. If this is the only procedure you’ll need, you should plan to spend approximately an hour undergoing the operation. Your incisions will be stitched and bandaged. This procedure requires an anesthetic and you should allow five to ten days for recovery. It’s very important to follow your doctor’s instructions on properly caring for any stitches and bandages in the days following surgery.

Neck lift procedure

Sometimes called a cervicoplasty or neck lift with platysmaplasty, the procedure will last two to three hours. Of course, if you are having a neck lift in conjunction with liposuction, facelift, forehead lift, or other surgeries, the time will vary accordingly. Your exact procedure will depend on your desired results and your own personal circumstances. In order to undergo a neck lift, you must be in good general health, both physically and mentally.

Your surgeon will make a small incision under your chin and possibly in front of and/or behind your ears. These incisions allow access to the platysma (neck muscle) and any fat in the neck. The neck muscles can then be tightened and any excess fat removed. Your surgeon may choose to remove the fat with liposuction or by cutting it out. The incisions near the ears also allow for removal of some excess skin.

Once the muscle has been tightened and any excess fat removed the skin is re-draped over the neck. Any excess skin is removed and the incisions are closed with sutures. Your surgeon will let you know if the sutures will need to be removed or if they will dissolve on their own. It is possible your surgeon may place a drain under the skin on the neck to collect any fluid that would increase your post op swelling and discomfort. If you surgeon chooses to use a drain it might remain in place only a day or two. You would be instructed on how to care for the drain if it needs to stay in for a longer period of time.

You and your surgeon will discuss what type of anesthesia to use, depending on your level of comfort. If you want to remain asleep during the procedure, you should request general anesthesia. Otherwise, your surgeon can use local anesthesia with sedation. It’s up to you and your surgeon to decide what is best for your comfort depending on the exactly what surgery will be done.

Your surgeon might fit you with a compression bandage that you will have to wear to help reduce post-operative swelling. This is usually worn night and day for at least five to seven days and then only at night for a longer period of time. It’s important to follow instructions to ensure proper recovery.

How should I prepare for a neck lift?

During your consultation, your surgeon will instruct you on what medications to avoid prior to your surgery. Certain medications, vitamins, and herbal preparations thin your blood and can cause increased bleeding.

If you are a smoker, you will need to quit at least two weeks before the surgery and two weeks after. You cannot just plan to cut down; you must not smoke for this time period to ensure proper healing. You must stop all forms of nicotine. Nicotine gum and nicotine skin patches can lead to the same healing problems caused by smoking. Also, make sure that you eat properly because this will help your body heal.

Wear loose, comfortable clothing on the day of surgery. You should especially plan to wear a button-down blouse or shirt that does not have to be pulled over your neck or head.

You should plan to take at least one week off from work to recover; however, your doctor may adjust your time-off schedule based on your personal situation.

If you are having platysmaplasty, cervicoplasty, or a combination of any of the procedures discussed here, you should plan on having a home recovery area set up before you undergo surgery.

This should include:
  • Post-op pain medication
  • A two-week supply of any of you normal prescription medications
  • Gauze and towels
  • Thermometer
  • Supply of comfortable, loose clothing (button-down shirts or blouses that do not have to be pulled over your neck and head)
  • Antibacterial ointment for incision sites (use this only if directed by your surgeon)
  • Telephone within reaching distance of where you’ll be lying or sitting most of the time
  • Supply of pillows that will allow you to keep your head in a comfortable position
  • Someone who can stay with you at least the first 24 hours after surgery

Recovery takes time, and it’s important that you’re patient with the process. Most people can return to work in 10 to14 days. If you participate in other sports or are physically active, you will have to wait at least three weeks--if not longer--to resume those activities.

What are the complications and side effects of a neck lift?

You will have swelling and bruising that can last for several days. You may feel tightness or tingling and different sensations including burning or pulling. You also will experience areas numbness on the skin. These are all very normal in the first few weeks following surgery and should not be cause for concern.

As with any surgery, you run the risk of infection. Please keep a watchful eye on your temperature. At the first sign of a fever, contact your doctor. If you have unusual discharge, such as pus, from the incision site, contact your doctor immediately.

Although it’s very rare, you could have an allergic reaction to medications given during or after your surgery. That’s why it’s very important to disclose any drug allergies to your doctor in a pre-operative consultation.

Does insurance cover a neck lift?

Insurance carriers are all different, but one thing is the same -- they typically agree not to cover elective, cosmetic surgery. If your procedures will in any way correct a medical condition, it’s important that you express this to your insurance carrier. Your surgeon can write a letter detailing your case.

Also, it’s important to realize that cosmetic or plastic surgery can affect future coverage under certain insurance carriers. It can also affect your premiums. Make sure you ask your insurance carrier about how your future coverage or premiums will be affected should you undergo any of these procedures.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/24/2008...#11020