Neck lift (Neck tuck, Lower facelift)

What is a Neck lift?

The Neck lift is a surgical procedure designed to give better definition to the neck line. The procedure can diminish unsightly ‘banding’ in the neck, as well as tighten loose skin at the jawline (jowls). There are two types of Neck lifts and each one serves different functions for the patient. To reduce risks , both of these procedures can be performed under monitored IV sedation instead of General anesthesia. My facility uses only board certified anesthesiologists to administer your anesthesia. Neck lift types are:

• Platysmaplasty, or Neck tuck: This procedure exclusively addresses the bands in the neck, under the chin. These bands can hang and make the neck look unsightly and ‘out of shape.’ The muscles of the platysma are tightened to reduce the ‘banding.’ This procedure does not focus on tightening the loose jowls at the jawline.
• Lower facelift or Lower rhytidectomy: This procedure solves the same problems that the Platysmaplasty addresses (neck bands), as well as tightening the loose skin at the jawline or jowls. It is a more extensive procedure and refines the jawline.

What problems does a Neck lift address?

How can I get rid of my turkey neck?

a Maryland patient

Platysmaplasty (Neck tuck)

Patients who only need a Platysmaplasty have these complaints:

• 'banding' or 'cording' on the neck
• double chin (excess fat under the chin and neck)

These patients typically do not have hanging skin on the jowls or jawline. The focus is more on the area immediately under the chin. It will not address loose skin on the jowls.

Lower facelift (Lower rhytidectomy)

Patients who need the more extensive Lower facelift (Lower rhytidectomy) procedure have these issues and concerns:

• wrinkling on the neck
• loose neck skin (turkey neck)
• loose jowls due to aging or massive weight loss
• undefined jawline
• 'banding' or 'cording' on the neck
• double chin (excess fat under the chin and neck)

Other neck procedures

A younger patient with good skin tone who has some fatty tissue under the chin and on the neck might be better served with only Liposuction.

A patient who has a small chin in addition to some fatty tissue or hanging skin will often appear like he/she 'has no chin.' A Neck lift in combination with a Chin implant will dramatically improve not only the neckline, but also the overall appearance of the face.

How is a Neck lift performed?

Both types of Neck lift procedures are performed under IV anesthesia in our AAAASF accredited surgery center here in Baltimore, Maryland. Here is a summary of the surgical technique involved in each type:

Platysmaplasty (Neck tuck)

The goal of the procedure is to tighten the platysma muscle. To do this, a small incision is made under the chin. The muscle is tightened, excess skin is removed, and the area under the chin is sutured. The only scar that the patient will have is a small horizontal scar under the chin. The length of the procedure is approximately 2-2.5 hours.

Lower facelift (Lower rhytidectomy)

This procedure combines all of the elements of the Platysmaplasty to tighten the bands of the neck, and additionally addresses the loose skin at the jowl line. Therefore, incisions are made 1) under the chin and 2) in front of the ears. The incisions in front of the ears allow the surgeon to dissect, lift, and remove the excess skin. Since the incisions are in front of the ears, plastic surgeons commonly refer to it as a Lower facelift. The length of the procedure is approximately 5 hours.

What are the preoperative requirements?

During your consultation with a board certified plastic surgeon it's important to discuss the surgical plan and review risks associated with the procedure. Your surgeon should also provide a copy of the ASPS Informed Consent so you can read it carefully in advance of your surgery. This document will list all the possible risks and complications. Preparations for this procedure involve the following:

• Quit smoking 4 weeks before the surgery so that healing is not compromised.
• Read the Informed Consent document which lists the possible risks and complications for the surgery. Make a list of questions.
• Stop taking multivitamins, herbals, and aspirin two weeks prior to surgery
• Within 30 days of your surgery date, get a medical clearance for surgery with a Physical examination (H&P) and CBC (anemia detection).
• Schedule a pre-op office appointment with the surgeon to review the surgical plan and sign the informed consent forms. Out of town patients may have this appointment the day before their procedure
• Get all of your prescriptions filled out before your surgery date.
• Do not drink anything (NPO) after midnight the night before surgery

Your procedure should be performed by a Board Certified Plastic Surgeon in an accredited surgery center. The most highly recognized accreditation agencies are Medicare, AAAASF, and JCAHO. Be sure that your facility is accredited by at least one of these organizations! In many cases, a facility will have accreditation from Medicare, and either AAAASF or JCAHO. Our surgery center is accredited by both Medicare and the AAAASF.

What is Neck lift Post-Op recovery like?

Prior to leaving the surgery center a surgical garment or headband will be placed around your neck. It is important that you leave the garment in place without touching it for the first 24 hours, as the garment helps to maintain good contour of the neckline.

For both types of Neck lifts you'll be asked to sleep with your head elevated (above your heart) to aid in the healing process and diminish swelling. While there will be some swelling and bruising, you should NOT apply ice to your neck area since it can hinder blood flow. Drains are sometimes used with the Platysmaplasty (Neck tuck), and almost always used with the Lower rhytidectomy (Lower facelift).

In summary, the Neck lift post op instructions are as follows:

• Sleep with head elevated for first week post operatively
• Drain removal in office on day 2
• Wear neck garment for 1 week
• Post op appointments: 2 days, 1 week, 1 month, 4 months
• Return to work: Platysmaplasty at 1 week , Lower Facelift at 2 weeks
• Exercise: Moderate low level exercise at 2 weeks, All activities 4 - 6 weeks
• Majority of bruising will be gone at 1 month

What are the risks and possible complications?

As with any medical procedure a Neck lift poses certain risks and complications including, but not limited to:

• risks associated with anesthesia
• bleeding
• hematoma
• infection
• swelling
• unfavorable scarring
• possible revision surgery to fine tune results

How much does a Neck lift cost?

Neck lift procedure cost depends on the type of Neck lift performed. Total costs include the surgeon's fee (board certified plastic surgeon), operating room fee (AAAASF accredited surgery center), anesthesiologist fee (board certified), recovery room and Post-Op garment. In 2020 the total estimated costs for the 2 common types of Neck lifts performed under IV anesthesia are as follows:

During your initial evaluation and consultation you will be given an exact quote that will be customized to your particular needs. But the above prices do provide a excellent guideline for the two types of Neck lifts.

Can I finance my Neck lift?

Yes, we work with a number of finance companies so that you can have a low, affordable, monthly payment. Please call the office at 410-494-8100 or see our financing section for more information.

Modified on 02-03-2020 | by Dr. Ricardo L. Rodriguez
Board Certified Plastic Surgery, ASPS Member