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THE SEATTLE FACIAL PLASTIC SURGERY CENTER
1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Seattle Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon in Seattle WA

Neck Lift Seattle WA – Neck Liposuction

The aging process in the neck begins in the fourth and fifth decade. For a variety of reasons, the neck jaw line becomes unbalanced with the rest of the facial features and patients  become aware 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 our Medical 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 presents 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 after the neck lift procedure 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 neck lift.

Board Certified Facial Plastic Surgeons

Choosing the right facial plastic surgeon for your neck lift is very important. Our facial plastic surgeons have performed thousands of neck lift and face lift operations. This plastic 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 WA. Our surgical team consists of four registered nurses who have over 30 years of combined experience.

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. The neck lift consultation will include an extensive physical examination of the face 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 neck lift 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

Pre Operative Preparation for Neck Lift

It is important that patients are in good physical and mental health prior to undergoing elective cosmetic surgery. Depending upon the medical history and age of the patient, there are certain medical and laboratory tests that may be needed prior to the neck lift procedure. The physical examination will be done by; however, some patients may also elect to have a complete thorough exam done by their local internist or family physician. An EKG or heart tracing needs to be performed on men 45 years of age and older and on women 55 years of age and older. This is routine screening that is part of the preoperative requirements for anesthesia. Potassium levels should be done on patients who are taking a diuretic and women of childbearing age should undergo a pregnancy test a week prior to the elective cosmetic surgery and make sure that they are not pregnant. It is extremely important to avoid taking any aspirin, ibuprofen, vitamin E and herbal supplements two weeks prior to neck lift surgery and two weeks after. It is also strongly advised to quite smoking cigarettes 2 – 3 weeks before and after surgery. A caretaker for the first 48 hours after surgery should be present and assisting with drains. Patients are not allowed to take public transportation home following surgery because of the effects of anesthesia and should not be driving a car for the first week post op. The recovery period for bruising and swelling takes approximately two weeks. It is important to avoid any exercise during this two-week period of time and it is also suggested that patients sleep on several pillows to keep their head above their heart and to keep the swelling down in the first few days during the recovery period.

The Surgery Day and Anesthesia at The Seattle Facial Plastic Surgery Center

On the morning of surgery, one of our surgeons 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. Our doctor 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 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. The board certified physician anesthesiologist monitors a patient’s vitals during the entire surgery at The Seattle Facial Plastic Surgery Center, including into the recovery room.

The 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 sculpting 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 with their caregiver to home with instructions.

General Anesthesia vs Sedation Anesthesia

Board certified anesthesiologists from Swedish Medical Center perform anesthesia at our Medical 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

We have 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.

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.

Contact Dr William Portuese or Joseph Shvidler MD for more information about neck lift surgery or chin implants.



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