Neck Lift

A neck lift is a surgical procedure that corrects the signs of ageing and laxity in the neck: loose skin, visible vertical muscle bands, excess fat under the chin and loss of a clear angle between the neck and the jaw.

The procedure may include tightening the superficial neck muscle, removing excess fat and redraping the skin. It can be performed on its own or, frequently, together with a facelift. At Detalii Med, in Baia Mare, the procedure is performed by the clinic's plastic surgeons.

A neck lift may be suitable for people who:

• have loose skin or folds in the neck;
• have visible vertical muscle bands at the front of the neck;
• have a build-up of fat under the chin (a “double chin”) that does not respond to diet and exercise;
• have lost the clear contour between the neck and the jawline;
• are in good health, do not smoke and have realistic expectations.

In younger people with elastic skin and only excess fat under the chin, the doctor may recommend a more limited procedure, for example liposuction of the area.

A neck lift can improve the contour of the neck, reduce loose skin and visible muscle bands, remove some of the fat under the chin and restore a more defined angle between the neck and the jaw.

The procedure does not treat fine horizontal neck lines or skin quality, which may require complementary dermatological treatments. It does not correct sagging cheeks, for which a facelift is recommended. A small chin or a particular bone structure may limit the result, and the ageing process continues.

At the consultation, the plastic surgeon examines the skin of the neck, the position of the muscles, the amount of fat under the chin and its relationship with the jawline and the face. The medical history, medication, smoking and any previous procedures are discussed.

The doctor explains whether a neck lift alone is enough or whether a combined facelift would give a more harmonious result. The position of the scars, recovery and risks are presented. Blood tests and a pre-anaesthetic assessment may be recommended.

A small incision is usually made under the chin, in the natural crease, and sometimes also behind the ears, possibly extending into the hair-bearing skin. Through the incision under the chin, the surgeon can remove excess fat and bring together the edges of the superficial neck muscle to soften the visible bands.

Through the incisions behind the ears, the skin is lifted and redraped and the excess is removed. At the end of the procedure, a compression dressing is applied, sometimes with thin drains. As a guide, it lasts two to three hours, longer if combined with a facelift.

A neck lift is usually performed under general anaesthesia. For limited procedures, for example correcting only the area under the chin, local anaesthesia with sedation may be used, depending on the case and on the anaesthetist's assessment.

In the first days, the patient wears a compression band and sleeps with the head raised. Swelling, bruising and a feeling of tightness in the neck are usual and improve gradually. Stitches are usually removed after about a week.

A return to usual activities normally takes place after about two weeks. Wide neck movements, strenuous exercise and sun exposure are avoided for a few weeks. Numbness of the skin may persist for a while and gradually lessens.

The risks are discussed in detail at the consultation. They include:

• haematoma or fluid collection, which may require drainage;
• infection or delayed healing, especially in smokers;
• contour irregularities or asymmetry;
• injury to nerve branches, causing temporary weakness of the lower lip or numbness;
• thickened or visible scars;
• the general risks of anaesthesia.

Following post-operative advice and attending regular check-ups help identify and resolve any problems early.

The new contour of the neck begins to show once the swelling subsides, within a few weeks, and the final result is usually assessed after three to six months. The effect generally lasts for many years, but the skin continues to age. Keeping a stable weight and using sun protection help to maintain the result.

A neck lift can give the neck a firmer contour and a better-defined angle under the chin, with a natural look. It is important that the plan is tailored to each case, and at the consultation the plastic surgeon decides whether the procedure is done alone or combined with a facelift.