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Neck Lift

In fact, many younger people undergo platysmaplasty.  Many men and women who have undergone neck lift are often thought to have "lost a lot of weight" or "toned up" rather than having had surgery.  While some people only need a neck lift, and not a full face lift, the combination of the two can truly make a difference, giving you a younger and refreshed look.

You may need a neck lift if you have jowls (fatty deposits at the jaw line), loose hanging skin, or if the sheet of muscles under the skin of your throat (the platysma muscle that gives platysmaplasty its name) has grown lax. This neck muscle may have begun to separate and hang, creating bands. The skin of the neck may hang like crepe paper and look like a turkey’s wattle.  If this is you, a neck lift can help.

Most neck lift procedures are performed on an out-patient basis. This means that you go home a few hours after your surgery.

What Is a Neck Lift?

A neck lift, or platysmaplasty, is surgery designed to remove excess, sagging skin under the jaw line and on the neck. In some cases, the platysma muscle of the neck is adjusted and tightened, if it has begun to separate and sag. Some patients who complain of having a fleshy neck, "jowls", platysma or neck "banding", or a "turkey waddle" can benefit from this procedure.

Many times patients choose to have a neck lift when they are having a face lift or a face lift and brow lift. You may also have a neck liposuction done, if you have extra fat under your chin. These procedures can be performed in conjunction with one another to give you a complete transformation.

Are You a Candidate for a Neck Lift?

If you are healthy, have no underlying uncontrolled problems such as diabetes or asthma, and are mentally and emotionally stable, you are probably a good candidate for a neck lift surgery. You must have realistic expectations of the outcome of their surgery. A neck lift can make you look younger, but it won’t change anything else in your life.

You also have to be able to communicate what your goals are to your surgeon. If you are not clear with your surgeon about what you want, he or she cannot help you. Remember, the surgeon may have to tell you that your goals are not realistic or that you actually need procedures other than a neck lift or in addition to it, such as a chin implant.

You must be mentally stable to undergo cosmetic procedure. Going through surgery and the healing process takes patience and stability.  It is not uncommon to become depressed after any surgery and this depression can worsen underlying emotional problems. Please consider this before committing to a neck lift. We have information on the emotional changes that surgery can bring on here.  

What to Expect at Your Consultation

Collect the names of some good plastic surgeons, check out their credentials, and then make an appointment for a consultation with two or more of them.  You and the surgeon will sit and discuss your goals and your medical history. Make sure the surgeon knows every detail about your medical history, including a complete list of all medications you take, including supplements.  This is very important because many medications interact with anesthesia and other drugs. Visit our Medication and Supplements List for more information. 

Your surgeon will explain the techniques for a neck lift and incision placements that would be most appropriate for you.  He or she must discuss all the risks associated with neck lift with you, as well.

You will also discuss anesthesia and where the procedure will be performed.  Most neck lift procedures are performed under general anesthesia, light sleep sedation, regional anesthesia, or even an oral sedative and local anesthetic if it is a very minimal lift.  You must discuss this because all anesthesia carries some risk.   Read our Anesthesia Page  for a basic understanding of anesthesia and its risks.

We also have information about consultations and a list of questions to ask your surgeon at our Consultation Page. If you decide to book or reserve a surgery date, you will usually give a deposit to hold that date. This deposit may be refunded if you cancel your surgery before a given date, but not if you cancel too close to the day of surgery. 

Your Preoperative Appointment

This appointment allows you to ask more questions and make sure your surgeon is aware of what you want from your neck surgery.  Your surgeon will also make sure you know what it realistically possible from this procedure.

You will get instructions about the surgery and recovery period. You may be given prescriptions for antibiotics and pain relievers to fill before your surgery. You will be told what to do about any prescription medications or over-the-counter medications you use, and what products to avoid using (usually aspirin and ibuprofen) before your surgery.

Preparing for Your Surgery

For most surgery, you will be asked to have blood drawn for tests at least a week in advance. These tests will check your white and red blood cell counts and will be an extra out-of-pocket.  If you are a woman, you may be asked to have a pregnancy test done. Some surgeons ask that you have a general physical, which is another extra expense.

How a Neck Lift Is Performed

A neck lift procedure normally takes 2 to 3 hours to perform.  If it is combined with other procedures, as it often is, the surgery will take longer.

Usually, the first steps in a neck lift surgery are starting an intravenous (IV) line, which will be used to administer fluids and medications, and attaching you to monitors that will keep track of vital signs such as your heart rate. You may be given an oral sedative in advance of these steps, which will help keep you from getting anxious or nervous. Your surgeon may use a marker on your neck and face to give a guideline of what needs to be done and where tissue should be removed

Anesthesia will be started. The type used should be the one you discussed with your surgeon. If you are receiving IV sedative, they will inject it into the IV tube  or attach a small bag of it to the IV system.  Generally, gas anesthesia is not used with facial procedures like a neck lift. Effects of the anesthesia are felt soon after the IV sedative is administered. You may have a minimal neck lift with regional or local anesthesia, which means that injections of anesthetics are made into the areas that will be operated on. You also receive a sedative to keep you calm and relaxed.

If you are having a “skin-only” neck lift, the surgeon will usually make two incisions under or behind the ear, and then loosen the skin, redrape it, and remove excess skin. If you are having a platysmaplasty with the additional skin lift, you may have a small incision under the chin along with the ones behind or under the ear. With a platysmaplasty, a section of the platysma muscle may be removed and the ends are sutured to bring them together at the front of the neck. This will rearrange and tighten the platysma muscle and improve the look of the neck and throat area. With this procedure also, neck skin will be loosened and redraped with incisions under or behind the ear to further firm up the neck. Some surgeons prefer to perform a neck lift using sutures, mesh, or other materials as a sort of hammock to keep the neck tight and eliminate that turkey wattle look.

Your surgeon will close your incisions with sutures or tissue glue. You will have a pressure dressing placed that will wrap around the top of your head to underneath your chin. You are then gently awakened and brought into the recovery room. Usually, you will be released about 2 hours after your surgery, but this depends on how long it takes you to recover from anesthesia. 

Your neck may feel tight and sore as the anesthesia wears off.  You may feel emotional or upset, or cold. This is normal. If you are cold, ask for a blanket or a heating lamp. You may also feel nauseated. If this happens, alert the nurse so that they can give you a medication and a container to throw up in.

You will need someone to drive you home. You cannot drive yourself home after a neck lift surgery because you will still be groggy and sore. You may also get nauseated on the way home. It is a good idea to stock the car with a bucket and a bottle of water. Sipping the water can help settle your stomach. Some plain crackers can help with that, also.

Recovery

If you hurt take your pain relievers. Don’t tough it out and avoid taking them. It is a fact that patients with increased pain heal slower than patients who are not in pain.

You may be groggy from the anesthetic and or oral medications for the first day or two. You will have to take it easy. You will also have to sleep with your head elevated for one or two weeks. Use two or three pillows on your bed or get a foam wedge pillow at a surgical supply store. Some people sleep on a recliner, if they have one.

You have to keep your head and neck still after a neck lift. Avoid turning your head from side to side. If you have to turn to look at something, turn your whole body, and not just your head.

Your lower face and neck will get more swollen, and possibly a bit bruised, over the first 3 days after surgery. As the days go by, the swelling and bruises will dissipate.  This is part of healing.

If you have excessive pain, redness, pus at the incisions, or other symptoms that do not appear normal, contact your surgeon immediately! Take your temperature regularly because a fever could mean an infection. Take your antibiotics on time for as many days as they were prescribed. 

You will have one or more postoperative visits to your surgeon in the days  after your surgery.  Your dressings may be changed, if needed. Your sutures won't be removed until 7 to 10 days postoperative.

Your skin will be numb around the incision and everywhere it may have been moved. This is normal.  Give yourself time to recuperate. Take it easy and try not to do too much, too soon, but do get up and walk around the house a couple of times a day if you can.

For the first weeks after surgery, avoid bending over or lifting heavy objects. Your surgeon may give you a limit on how heavy an object you can lift safely, usually 10 to 15 pounds. Remember that this may mean that you can’t pick up your small child for some time! Do not participate in contact sports until your doctor says so.

Continue to avoid alcohol, aspirin, and ibuprofen for a few days to a week after surgery.  If you quit smoking before your neck lift, don’t start back up.  Smoking greatly increases your risks of improper healing and excessive scarring. This is a good time to quit smoking completely.

You may notice a change in how your face moves, tightness, tingling, sporadic sharp pains, pulling, burning, or cold sensations. These usually subside within the first few weeks. As the swelling subsides, you will see your new, firmer neck appear. 

Risks and Complications of a Neck Lift

There is no surgery that does not involve possible risks and complications. If you have a neck lift or platysmaplasty, you could have allergic reaction to the anesthetic, develop blood clots, or an infection. Your skin on your neck may end up being drawn a bit too tight and you could look like you have vertical cords under your skin. You may have some asymmetry, lumpiness, skin puckering, mottling of the skin, or just be generally dissatisfied with the results.

Numbness is possible. It usually subsides within the first few weeks, but may be permanent. Excess scar tissue is possible as well.  Please go over all risks with your surgeon at your consultation and your preoperative appointment.

The Average Cost for a Neck Lift

A platysmaplasty, or neck lift, can cost from $3,000 to $6,500 depending on the area of the country and the surgeon chosen.  This is the average fee for a neck lift alone and does not include other procedures such as face lift. Some surgeons include an under-chin liposuction in their fee for a neck lift,  so determine this in advance.