DR WILLIAM PORTUESE | 1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
Dr William Portuese - Board Certified Facial Plastic Surgeon in Seattle WA

Patient’s Complete Guide To Neck Lift©


The aging process in the neck begins to take place in the fourth and fifth decade. For a variety of reasons, the neck jaw line becomes out of harmony with the rest of the facial features and patients become self-conscious about the “turkey waddle” (too much fat) or that muscle bands are showing through. Excess skin in the neck can also be an issue. The neck lift operation is very popular at The Seattle Facelift Center and is done to simply rejuvenate the neck only. It is however, important to note that the neck lift alone will not tighten any lax facial or neck skin. It is simply a sculpting of the neck by removal of fat and tightening of muscles. If there is excess skin in the neck, a face / neck lift will be needed.

The neck itself has three components; skin, muscle and fat. The fat in the neck obliterates the clean jaw / neck angle and I present both above and below the platysma muscle. Fat underneath the platysma muscle has to be surgically excised, while the fat above the muscle is removed with both indirect and direct liposuction. The platysma muscle must be sewn together in the front, and tightened to the neck muscles, to create a new jaw line. The skin will then drape over the new neck contour. There is no skin removal in the neck lift operation. Patients appear as though they have lost weight because the fat in the neck has been removed. The neck lift surgery is a fantastic operation for both men and women in their 40’s or 50’s who has good skin tone, but simply has excess fat in the neck. Traditional liposuction of the neck is no longer performed because of the inconsistent results done blindly. The neck lift is done to redefine the jaw line, however, there are limitations as to what a neck lift can accomplish. The main limitation is excess inelastic skin. If there is excess skin in the neck, a full face / neck lift must be performed to tighten the skin. The incisions from the neck lift are approximately a 1 inch incision in the neck at the submental crease just underneath the chin and two 0.5 inch incisions in the sulcus behind the ear. Women are able to put their hair up off their shoulders after the surgery with no shift of hairline in the postauricular area. As soon as the sutures are removed under the chin, patients are able to place concealer over the incision until it is completely healed. It is also important that patients must be in excellent physical health, with no other preexisting medical conditions, and that they follow all pre and postoperative instructions for a seamless surgery and an easy postoperative recovery. Existing high blood pressure must be controlled on medications so as to not have any bleeding during or after the surgery.

Dr. William Portuese – The Facial Plastic Surgeon

Choosing the right surgeon for your neck lift is very important. Dr. Portuese has performed thousands of neck and face lift operations. Dr. Portuese is the founder and medical director of The Seattle Facelift Center. This surgery center is a Medicare certified (one of the highest qualifications of surgery centers available in the United States) and is a licensed ambulatory surgery facility by the Washington State Department of Health and is located adjacent to Swedish Medical Center on First Hill in Seattle. Dr. Portuese’s surgical team consists of four registered nurses who have over 30 years of combined experience.

General Anesthesia vs Sedation Anesthesia

Board certified anesthesiologists from Swedish Medical Center perform anesthesia at The Seattle Facial Plastic Surgery Center. The type of anesthesia used for a neck lift is usually general anesthesia and the anesthesiologists are in attendance with the patient during the entire pre, intraoperative and postoperative time until the patient is awake in the recovery room. The monitoring that occurs during the surgery includes oxygenation, blood pressure, EKG, pulse oximetry and regulation of the anesthetic solutions and gases.

Out Of Town and Out of State Patients

Dr. Portuese has many patients from out of the area and out of state. It is recommended that patients spend at least ten days in town to ensure the healing process is adequate, before leaving for home. There are four hotels located within two blocks of the office and surgery center and our Patient Care Coordinator can give phone numbers and help with hotel reservations when needed.

Pre Operative Consultation for Neck Lift

Realistic expectations and goals will be discussed and questions will be answered. It is the opportunity to discover what a neck lift procedure can and cannot do. There is a $75 charge for the consultation at Dr. Portuese’s office. The consultation will include an extensive physical examination of the face by Dr. Portuese and additional time with the office administrator and patient care coordinator, Janet Silver. Computer imaging can also be done during this time. One of the four registered nurses will also perform a preoperative exam within three weeks prior to the surgery date. Factors that are taken into consideration during the consultation include:

  • Medical history
  • Physical examination
  • Patient’s concerns about facial features, including the neck
  • Realistic expectations
  • Techniques of the neck lift explained, including drain placement and removal
  • Any previous records, past medical history and operative notes that may be pertinent to the procedure
  • Medication allergies
  • Medications and herbal supplements taken

copywrited William Portuese MD, 2007/8


Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self