FAQ

Neck Lift in New York

Frequently Asked Questions

What is a neck lift?

A neck lift can encompass many different things. This can include treating loose skin, fat in the neck, and platysma muscle banding.  The fat is found above and below the platysma muscle.  The platysma muscle is a thin muscle layer just below the subcutaneous fatty layer and just above the deeper muscles of the neck and trachea. The fat above the muscle can be delicately liposuctioned or directly trimmed. If there is fat below the platysma muscle, then the platysma muscle has to be elevated and the fat can be directly trimmed as well.  The platysma muscle can be treated in many ways. If there are specific bands that are appreciated either with animation or when at rest, then they can be directly divided.  In performing a neck lift, the muscle may be sutured together in the midline to create a hammock that can then be lifted or suspended from the side of the neck to improve the neck angle.  The lateral plastyma muscle along with the continuing SMAS (superficial muscular aponeurotic system) can be suspended or sewn in the neck region often just below or behind the ear to tighten the neck as well. If the neck feels tethered and the angle is obtuse, the muscle can act like a pulled window shade. In this scenario, the muscle can be divided to release the tension and thus allow for the neck angle to improve.  Loose skin in the neck can be elevated and excised laterally in or at the edge of the hairline during an isolated neck lift or face lift.

Where are some of the incisions used in a neck lift?

A neck lift can be performed through several different incisions.  If there is no excess skin, a submental or incision under the chin can be used.  The muscle and the fat can often be treated from this approach.  When there is excess skin, an incision along or within the hairline behind the ear can be used in addition to the submental incision. I prefer in many cases to use a hairline incision, as opposed to within the hairline, so that the hairline is not distorted.

Why do I have these funny bands in my neck?

Bands on the neck can be at repose (at rest) and/or with animation. These are often due to the overactive platysma muscle.  Sometimes these can be treated with injections of Botox, Dysport, or Xeomin as a temporary fix.  Other times, they can be divided during a neck lift so that they hopefully do not recur.

What is a turkey gobbler neck?

A turkey gobbler neck is a phrase referring to patients whose necks have very loose hanging skin and sometimes platysma bands. This is similar to what a real turkey would have.  Treatment usually requires treatment of the platysma bands through plication and/or division, and elevation of the skin and removing the excess.

Are drains placed with a neck lift?

In most neck lifts, I use drains. This is done to minimize the amount of fluid that can potentially accumulate in the often widely undermined space.  The drains are removed within a few days after surgery.

What is the recovery like after a neck lift?

The recovery after a neck lift is fairly straightforward.  Most patients will wear a light head dressing and have one or two drains in place. I recommend that patients keep their neck to chin angle at about 90 degrees for the first week or two so that they avoid tension at the hairline incision.  Typically, the drains and head dressing will be removed within a few days.  Sutures are removed within seven to ten days.  There is often some bruising that usually goes away within about seven to fourteen days, and most swelling subsides within a few weeks. However, a small amount of residual swelling may last for months. Patients can often go back to light aerobics within three to four weeks and heavy lifting within six weeks.

How tight will my neck be after surgery?

The neck may feel a bit tight after surgery if the platysma is sutured in the midline or pulled laterally to improve the contour of the neck.  This generally improves within a few weeks as the swelling subsides.

Can Botox be used on my neck?

Botox, Dysport, or Xeomin can be used to treat mild neck banding that is specifically related to the platysma.  Small aliquots can be injected into the bands and the bands will often soften after about a week or two.

I have a fat neck.  How can this be treated?

Fat in the neck can either be above the platysma muscle or below it.  If the fat is primarily above the neck, then oftentimes liposuction alone through very small incisions can be performed if there is no significant skin laxity.  If there is fat deep to the muscle, then an open procedure has to be performed to directly remove the fat.

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