Seattle Facial Plastic Surgery Center Patient's Complete Guide To Neck Lift©
copywrited William Portuese MD

NECK LIFT

Recovery Room

Once the neck lift surgery has been completed, patients are taken to the recovery room for approximately two hours. Patients will stay with our recovery 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 a function. Drains will extract 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.

Side Effects of Anesthesia

There is some post operative nausea after the neck lift surgery due to the anesthesia or from the narcotic pain medication. These are the two most common reasons. Dr. Portuese will give anti-nausea medication during and after the surgery to help prevent any further postoperative nausea. Patients may also occasionally complain of dry mouth and sore throat, which is again related to anesthesia and a temporary condition.

The Neck Lift Procedure After Surgery

It takes approximately two weeks for all of the bruising and swelling to subside from the neck lift. 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 with soap and water can be done two days after the surgery when 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. The neck muscles do become stiff and sore for the first week after the procedure. 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 two weeks after the procedure. Full healing takes approximately two to three months to see the final end result. 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 Side Effects & After Care of a Necklift

• 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 immediately with revision surgery. This is called a hematoma and happens approximately 2% to 3% of the time. The incisions will take approximately two months to heal, but are hidden underneath the chin and behind the ear in the natural crease.

Potential Complications of a Necklift

Complications associated with a neck lift are few, but can include some mild asymmetry where there is a small residual pocket of fat on one side or other of the neck that needs to be addressed through a touch up procedure. If a small touch up is required, it is usually a simple liposuction of the affected area to address any asymmetry. Excessive postoperative bleeding within the first 24 hours after surgery would constitute a hematoma and this would need to be surgically removed immediately. It is very rare, however if this should occur, the incision needs to be opened up, the blood removed, any bleeders cauterized and the incision sewn back together. Infection is extremely rare after the neck lift but is more common in smokers. Our patients are given antibiotics to prevent any infection in the neck. There is some numbness around the ears and chin area, but this does go away in several months 99% of the time. Permanent motor nerve loss is extremely unlikely and has never occurred in our practice. Temporary lower lift asymmetry on animation can occur due to stretching of the marginal branch of the facial nerve, but this is temporary and usually goes away in approximately six weeks. On rare occasion, healing of the incisions can cause hypertrophic scarring behind the ears or underneath the chin, which can be addressed through cortisone injections.

Follow-up Appointments

After the neck lift operation, patients return to Dr. Portuese’s office approximately two days after surgery to have the Jackson-Pratt drains removed. Examination of the face and neck is performed at that time and the incisions are cleaned. Two to three days later, the sutures are removed. The sutures behind the ears are dissolvable. Patients return again in approximately two weeks for further examination to monitor their postoperative course. Patients are able to put makeup on after the sutures are removed at about one week.

Conclusion

Dr. Portuese has performed thousands of face lift and neck lift procedures throughout his 21 years in private practice. The goal of The Seattle Facelift Center is to fully educate patients and to prepare them for what is often a lifetime dream of changing their face and neck features to match how they feel. The neck lift operation is one of the most gratifying surgeries for Dr. Portuese and his patients and staff. We look forward to taking excellent care of our patients throughout this entire surgical process.

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