Seattle Facial Plastic Surgery Center Patient's Complete Guide To Neck Lift©
copywrited William Portuese MD
NECK LIFT
The Neck Lift Procedure: The Day of Surgery and Anesthesia
On the morning of surgery, Dr. Portuese and his medical staff will greet the patient and go over the surgical procedure in detail again so that both the staff and patient understand one another clearly. Dr. Portuese and the patient will discuss the surgical plan and any last minute modifications to ensure a realistic expectation. The patient will also meet with the board certified anesthesiologist, from Swedish Medical Center, during this pre op visit before surgery. The anesthesiologist will verify that the patient has had nothing to eat or drink since midnight the night before and will ask about allergies to latex, medications and anesthesia. The patient is then brought into the operative suite where an intravenous line is started. A sedative is given through the IV, which relaxes the patient, and then an anesthetic is started, usually propofol, to put the patient to sleep. After the patient is asleep, a small breathing tube is inserted between the vocal cords and is left in place for the duration of the surgery. Patients usually breathe on their own under general anesthesia however, there is no conscious recollection of the actual surgery or neck lift procedure itself. Anesthesia today is extremely safe with electronic monitoring under the direct supervision of the physician anesthesiologist; heart rate, blood pressure, oxygen, breathing and circulation levels are all monitored. Additionally, an EKG is used to monitor the heart, a blood pressure cuff monitors the blood pressure, a pulse oximetry is used to measure the oxygen concentration in the bloodstream, a carbon dioxide monitor measures the carbon dioxide a patient exhales and a ventilation monitor is monitoring the patient’s own breathing and respirations. Temperature monitors are also used during surgery for patient safety. Because we are very safety conscious, the physician anesthesiologist monitors a patient’s vitals during the time of surgery at The Seattle Facial Plastic Surgery Center, including into the recovery room.
The Neck Lift Procedure – Surgery
The neck lift procedure takes approximately two hours to perform. The operation involves fat removal and the tightening of the muscles, which is a resculpting and reshaping of the neck and jawline to return the neck to its youthful state. The goal of the neck lift operation is to remove the excess fat in the neck only (not the face) and to tighten the muscles in the neck. Although there is no skin removed in the neck, the goal for the neck lift is to clean up the neck and jawline. The incisions for the neck lift are a 1-inch incision in the submental portion of the chin and two 0.5-inch incisions behind the ears where the drains come out. The sutures are a combination of both removable and dissolvable. There are two Jackson-Pratt drains that stay in place two days for women and are left in place for four days for men. Men have more serous fluid excretion from the neck after the procedure, which is why the drains stay in longer. There are no facial wraps or wrap around dressings used in the neck lift operation post operatively – only drains. After the surgery, patients wake up in the recovery room and the neck will be numb from the local anesthetic given during surgery. Most patients experience some form of mild headache and dull pain for the first few hours in the post operative recovery phase however, this resolves with some mild pain relievers. Recovery time usually takes two hours and then the patient is discharged to home with instructions and their caregiver.
Additional Procedures Performed at the Same Time as the Neck Lift
It is very common to perform other procedures, such as a Blepharoplasty or Rhinoplasty, at the same time as a neck lift without any complications. These surgeries usually compliment one another for a facial rejuvenation.
Post Anesthesia – Recovery Room
Once the neck lift has been completed, patients are taken to the recovery room for approximately two hours. Patients will stay with two of our four nurses being monitored and observed closely. When drowsiness from the anesthetic subsides, our nurses will discharge the patient to home in the care of a responsible adult who can drive them home and help to care for them during their convalescence and postoperative recovery. There is usually very little pain with a neck lift surgery; the drains are uncomfortable, but they do serve the function of draining blood out from underneath the skin so that it does not accumulate underneath the skin in the first two to four days following surgery. Patients will also note that they are quite tired and exhausted in the first week or two after the surgery due to the healing process and recuperation from the surgery.
Post Operative – Neck Lift Procedure
It takes approximately two weeks for all of the bruising and swelling to subside from the neck lift. There is usually a very small amount of residual bruising and swelling around the jawline and the lower portion of the neck even at two weeks, but this can be camouflaged with makeup. Most patients are able to resume normal activities including exercise and social activities at two weeks after the procedure. Full healing takes approximately two to three months to see the final end result. Post operative instructions are designed with patients in mind to help minimize any complications, swelling, pain or discomfort in the postoperative and recovery healing phase. There are no facial wraps associated with this surgery, only the drains in place which are removed at two to four days after the surgery and sutures. Cleaning the face can be done with soap and water two days after the surgery after the drains are removed. A shower is then acceptable (even with the sutures still in place) and the crust along the incision lines can be cleaned off with saline solution or the warm shower water. Do not use any ice or heat on the neck because the neck area will be numb during the first month and it is suggested that patients sleep with their head slightly elevated above their heart for the first two weeks to keep the swelling down. At one month following the surgery, it is important to avoid contact sports or hitting, rubbing and bumping the face that might necessitate additional surgery.
Post Operative Neck lift – Pain Control
There is very little pain associated with a neck lift. This is an uncomfortable surgery, but not painful. The neck muscles do become stiff and sore for the first week after the procedure. Dr. Portuese gives a narcotic prescription for pain relief, but most patients take less than 10 pain pills in the entire post operative phase.
Post Operative Neck Lift – Side Effects
- Bruising: Some patients do experience a small amount of bruising in the neck, but the Jackson-Pratt drains are placed underneath the skin in the neck and actually remove most of the blood which causes bruising.
- Swelling: The neck lift operation does cause some swelling in the neck that lasts approximately two weeks after the surgery. Any type of emergent swelling (that rapidly expands the neck) in the first 24 hours after the surgery will need to be addressed quickly with revision surgery. This is called a hematoma and happens approximately 2% to 3% of the time. The incisions will take approximately two moths to heal, but are hidden underneath the chin and behind the ear in the natural crease.
