As people age, the effects of gravity, sun exposure, pollution, smoking and stresses of daily life can be seen in their necks. Deep creases form between the chin down to the lower neck; the jaw lines grow slack and jowly; and folds and fat deposits appear around the neck.
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Necklift (Lower Rhytidectomy)
A necklift can’t stop this aging process but it can “set back the clock,” by improving the most visible signs of aging. This is accomplished by removing excess fat, tightening the underlying muscles, and then re-draping the skin. A necklift can be done alone, or in conjunction with other procedures such as a minilift, forehead lift, eyelid surgery, nose reshaping, fat grafting, etc.
The technique has evolved from simple tightening of the skin, to tightening and re-positioning of deeper structures like muscle and connective tissues, whereby the skin “comes along for the ride.”
Deep folds on the neck, sagging skin, and jowls may be present at any age. Candidates for necklift procedures can be as young as twenty and our oldest patient was a healthy eighty-four year old.
Aging does not stop with surgery but “turning back the clock” can delay its’ appearance. The length of time, these improvements will last, depends on genetics, habits, and skin protection.
PLANNING YOUR SURGERY
In your initial consultation, Dr. Ciano will evaluate your neck and jawline, including the skin and underlying muscle. It is important to discuss what goals you wish to achieve from surgery.
Certain medical conditions may cause problems during or after surgery. Uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars are some examples. Be sure to tell Dr. Ciano if you smoke, take any drugs or medications, especially aspirin, or other drugs that affect clotting.
PREPARING FOR YOUR SURGERY
Dr. Ciano will give you specific instructions on how to prepare for surgery and to stop or avoid certain vitamins and medications. Carefully following these instructions will help surgery go smoothly. If you smoke, it’s especially helpful to stop at least a week or two before and after surgery, if possible. Smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.
A necklift usually takes 2.5 hours under conscious sedation anesthesia although it can be longer if you’re having more than one procedure done. General anesthesia is not necessary.
Incisions usually begins under the ear, then behind the ear into the hairline. A small incision will also be made under the chin.
In the vast majority of cases it is not necessary to use a general anesthesia. We use a conscious sedation ( a type of twilight sedation) whereby you are up and ready to go home after your procedure.
AFTER YOUR SURGERY
There usually isn’t significant discomfort after surgery. If there is, it can be lessened with the pain medication prescribed by Dr. Ciano. Severe or persistent pain or sudden swelling of your face should be reported to Dr. Ciano immediately. Some numbness of the skin is quite normal and it should disappear within a few weeks or months.
You will be instructed to keep your head elevated and decrease your activity level for a couple of days after surgery, to keep the swelling to a minimum.
Bandages will be removed after two days and showering is possible.
GETTING BACK TO NORMAL
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. The risk of bleeding under the skin, requiring a return visit to the operating room to treat the hematoma (blood collection) is at the highest during the first week. Since there is little pain and boredom sets in, you must resist the temptation to be too active!
Dr. Ciano will give more specific guidelines for gradually resuming your normal activities. They’re likely to include these suggestions: avoid driving a car for 1 week and strenuous activity, including sex and heavy housework, for at least two weeks. Avoid steam baths and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your features may be distorted from the swelling and your facial movements may be slightly stiff. Some bruising may persist for two or three weeks, and you may tire easily.
By the third week, you’ll look and feel much better. Most patients are back to work within ten days to two weeks after surgery. Any bruising that remains may be covered by special camouflage makeup.