Neck Lift Surgery (Platysmaplasty, Cervicoplasty) Guide

What can a neck lift achieve?

In many people, the first signs of ageing start to appear around the face and neck. The skin around the jawline and neck can start to lose its elasticity and sag, and wrinkles may begin to show. A neck lift can address these problems and improve the appearance of the jawline and neck. Thus, a neck lift can:

• Improve the appearance of the skin of the neck.
• Tighten loose skin around the neck.
• Remove excess fat from the neck.
• Reduce wrinkles and lines in the neck.
• Achieve a smoother, more youthful-looking neck.

Overall, a neck lift can help to achieve a younger, rejuvenated appearance.

What won’t a neck lift resolve?

As a neck lift only adjusts the skin and muscles of the neck, it will only address the excess or sagging skin around the neck. Therefore, it will not resolve the visible signs of ageing that may appear in other areas of the face, such as sagging skin and wrinkles of the forehead or cheeks. If patients have other areas of concern, they can discuss with the surgeon what other procedures may suit them. Often the surgeon can perform these at the same time as a neck lift. Some of the procedures commonly performed with a neck lift include:

• Facelift – this will smooth and tighten the skin of the lower half of the face.
• Brow lift – this can reduce forehead wrinkles by lifting the brows.
• Blepharoplasty – this can correct the sagging of the eyelids and eyebags.

Neck lift surgery techniques

To perform a neck lift, the surgeon must adjust and reposition the skin and soft tissues of the neck. Typically, the surgeon will also use liposuction to remove any excess fat. Overall this is a relatively straightforward surgery that lasts two to four hours. However, the length of the surgery does also depend on whether patients undergo additional procedures. Most often, it is performed with a facelift. The two main techniques of a neck lift are as follows:

• Platysmaplasty
• Cervicoplasty

How much does Neck Lift surgery cost?

The price of Neck Lift Surgery can vary between about £5000 and £9000. However, the exact price can vary depending on certain factors such as:

• Which hospital or clinic is chosen for the procedure
• Surgeon experience
• Anaesthetist experience
• Surgical techniques or combination surgeries
• The time required in surgery for each patient’s case

To get an exact price, a patient will be examined by a surgeon in their consultation. Decisions will be made to iron out the specifics of the procedure to reflect the wants and needs of the patient. The price will then be all-inclusive and include no extra hidden fees.

After the consultation, the price for the procedure is set; that price will not include any hidden fees or add-ons. It will cover:

• Highly rated CQC hospital costs
• Surgeon costs
• Anaesthetist costs
• Overnight stays (if required)
• Aftercare and follow-up appointments

Why choose to have a neck lift?

For many people, it can be difficult to come to terms with the effects of ageing on their appearance. Some of the first visible signs of ageing can appear around the jawline and neck area. This may be in the form of sagging skin or wrinkles. As a result, this can make you look older than you feel. If this is a concern, patients may be considering a neck lift. Neck lift candidates will feel that the appearance of their neck is making them look tired and aged. A neck lift can help to reverse these signs of ageing and will, therefore, make individuals look more youthful and rejuvenated.

Who are the best candidates for a neck lift?

To allow for the best results, ideal neck lift candidates will be patients with the appropriate features that can be improved from this procedure. Features that a neck lift can correct include:

• Loose, slack skin around the throat.
• Wrinkles in the neck.
• Jowls (fat or excess skin under the chin).
• Excess fat or skin of the neck.

Furthermore, the best neck lift candidates will have the following:

Good skin elasticity

Ideally, patients should have skin that stretches well to allow it to conform to its new position. However, if the skin is too tight or thin, it may not be possible to pull it back to its new position after trimming and adjusting it.

Good physical health

Being in good general health is important before any surgery. Serious medical conditions, a high BMI and smoking can all increase the risk of complications. Therefore, ideal neck lift candidates will have stopped smoking at least 6 weeks before surgery. The surgeon will also advise that patients reach a stable, healthy weight before the procedure.

How is a neck lift procedure performed?

Undergoing surgery can be quite nerve-racking if patients don’t know what to expect. Therefore, knowing what a neck lift procedure involves may help relieve any anxiety about the surgery. This page will explain what will happen on the day of the neck lift procedure.

A neck lift itself is a relatively straightforward procedure. However, after discussing the best options with the surgeon, patients may have decided to have other procedures performed simultaneously, such as a facelift. This will mean the surgery will take longer. Regardless, overall a neck lift procedure can take anything between 2 to 5 hours.

On the day of the surgery, patients can expect to go through the following steps:

Consent

Undergoing any surgery requires patients to give their consent. Patients might sign this on the day of their surgery or during the pre-operative assessment. By signing a consent form, patients agree to undergo a neck lift surgery; therefore, they should be fully informed about the benefits and risks of the procedure.

Anaesthesia

Once patients change into a hospital gown and are ready for the surgery, they will go to the anaesthetic room. Here the anaesthetist will administer the anaesthetic. Patients will have discussed with the surgeon which type of anaesthesia they will have well before the day of the surgery. A general anaesthetic will put patients to sleep throughout the procedure so that they aware throughout the surgery. A local anaesthetic will numb the treatment area so that patients do not feel any pain, and they will be given a sedative alongside this to help them relax. Both options are perfectly safe, so which one the patient has depends largely on personal preference, previous reactions to anaesthesia and the length of surgery.

Incisions

Before the surgeon makes any incisions, they will thoroughly clean the treatment area to reduce the risk of infection. They will then make discreet incisions under the chin and behind the ears. The size of the incision will depend on the extent and technique of the surgery. The two main techniques are as follows:

Cervicoplasty

This technique mainly focuses on removing excess skin. First, the surgeon will lift and remove the excess skin around the neck. For some patients, removing excess skin alone may be enough to achieve the results they desire. The surgeon will then reposition the skin over the neck and suture it in place, giving the neck a smoother appearance.

Platysmaplasty

This is a more extensive type of neck lift surgery, as the surgeon tightens and sculpts the underlying muscle of the neck, called the platysma. Once the surgeon has tightened the muscle, they will pull the skin taut and close the incisions. By adjusting the underlying muscle, this technique achieves more dramatic results as it can reduce the banded appearance or folds of the neck.
To achieve the best results, the surgeon may use both of the above techniques. Furthermore, with both methods, the surgeon can remove excess fat through the incisions made under the chin. They will perform this either through liposuction or by surgical excision.

Closing of incisions

The surgeon may use dissolvable or non-dissolvable stitches to close the incisions. Afterwards, the surgeon will wrap the neck with a light bandage. Patients may also have drainage tubes put in place, which drains any fluid from the treated area.

Return to the ward

Once the surgeon completes the operation, patients will wake up gradually in the recovery room. Then, they will return to the ward, where they will recover from the anaesthetic under the supervision of nurses and hospital staff. Patients may stay one night at the hospital, or they may be able to go home on the same day. This will depend on what type of anaesthetic they had and whether there were any complications from the surgery.

What to expect from the neck lift consultation?

If individuals are considering a neck lift, then the next step may be to have a neck lift consultation with a BAAPS/BAPRAS surgeon. This will be an opportunity for the patient to talk to a highly skilled and experienced surgeon about the procedure. Overall it will take between 15 minutes to an hour. During this consultation, patients will discuss their concerns about the appearance of their neck and what they wish to change. The surgeon will listen carefully to and then examine the neck and skin. They will also ask important questions about the patient's medical history. This is to assess whether or not the patient is suitable for a surgical procedure. Some of the questions they may ask include:

• Any medical conditions?
• Any previous surgeries?
• Medications, including over-the-counter and herbal remedies
• Alcohol intake
• Smoke/vape and nicotine use
• Any allergies

When discussing desired outcomes from the neck lift procedure, it is recommended to be as open as possible with the surgeon. Making the surgeon understand all expectations and goals will help in the realisation of these in surgery. However, remember that if the surgeon does not think the expectations are realistic, they will clearly tell the patient. It is important to listen to the surgeon and their expertise. It may be that alternative procedures would be more appropriate. The surgeon will be able to suggest and discuss all options.

Questions to ask during the neck list surgery consultation

If patients have questions about any aspect of a neck lift procedure, the consultation is the best time to ask. The surgeon will be happy to answer any queries the patient has. No question is a silly question. Here are some questions that patients may wish to ask:

• Is a neck lift right for me?
• Are my goals achievable with a neck lift?
• Can I see any before and after pictures of previous neck lift surgeries you have performed?
• What other procedures might I benefit from to get the results I want?
• Will the scars be obvious?
• How long is the recovery period?
• How much time should I take off work after the surgery?
• Will I be in pain after the surgery?

What are the main risks of neck lift surgery?

As with any surgery, a neck lift carries some risks. In addition, complications can occur either during or after the operation. Therefore, patients should think carefully about their decision to undergo a neck lift procedure. This also means taking the time to consider possible neck lift risks and complications. The BAAPS/BAPRAS surgeon will talk through the potential neck lift risks during the consultation.

Bruising, bleeding & haematoma

Patients can expect to have some bruising around the neck after the surgery. Bruising will usually fade after about two weeks. Less commonly, a larger amount of blood may collect under the skin. This can lead to the formation of a hard mass under the skin, called a haematoma. These can be swollen and painful. Smaller haematomas may disappear on their own. However, if one persists or grows, the surgeon may need to remove it surgically. If patients have high blood pressure or take certain medications such as aspirin, they may be more prone to developing a haematoma.

Skin or tissue necrosis

Tissue necrosis is the death of tissue. This is a potential but rare complication of a neck lift. It occurs when an area of tissue does not receive enough blood and oxygen. During a neck lift, the surgeon makes some incisions that may disrupt the blood supply to certain parts of the neck. This can, therefore, result in skin necrosis. The risk of this occurring is much higher if patients smoke in the weeks before or after the surgery. An infection can also lead to tissue necrosis. Therefore, it is better to detect tissue necrosis early to prevent further damage.

Infection

As a neck lift involves the surgeon cutting the skin, bacteria can enter the wound and infect it during or after surgery. Infections will usually occur within the first few weeks after the surgery. Whilst an infection may start on the skin, it can spread deeper into the tissue and muscle. If the wound becomes infected, it may look red and be warm to the touch. Patients might also notice pus draining from it. There may be pain and discomfort in the area in which the pain medication does not resolve.  Furthermore, wound infections can make you feel unwell. If patients develop a fever over 38° C or notice any of these signs, let the surgeon know as soon as possible.

Scarring

A scar will form where the surgeon makes an incision in your skin as the body heals itself. Scarring will fade over time but will never disappear completely. The surgeon will make the incisions as small and discreet as possible. However, it is not possible to fully control the extent of scarring. This is because some people’s bodies have a better ability to heal or less tendency to scar than others.

The surgeon will provide advice on how to care for the wounds to help minimise scarring after surgery. On the rare occasion that patients are left with excessive scarring, some treatments can help minimise this, such as further surgery, laser treatment, or chemical peels.

Nerve Injury

During the course of the surgery, the scalpel might cut a nerve, the tissue around the nerve might become inflamed, or the nerve can lose its blood supply. This can all result in damage to the nerve. It is quite common to experience some numbness of the incision site in the neck after surgery, but this is usually only temporary. A more persistent change in sensation and long-term pain in the area may result from permanent nerve damage.

Aesthetic

Asymmetry and other irregularities of the skin can leave patients dissatisfied with the results of any cosmetic surgery. In addition, some irregularities, such as excessive scarring or discolouration of the skin, may be out of the surgeon’s control. However, patients should ensure that their chosen surgeon has the necessary qualifications and experience to reduce the chances of a disappointing outcome.

General surgical complications

There are some risks and complications that can occur regardless of the type of surgery. These include postoperative nausea and vomiting or the development of a blood clot in the leg or lungs. It is also possible that patients may have an allergic reaction to the anaesthetic agent. However, these are rare, and some steps will be taken to minimise these risks as much as possible.

The surgeon will talk through all of the neck lift risks and complications during the consultation.

How to prepare for neck lift surgery?

A neck lift is an invasive surgical procedure, so it is important to ensure that the body is well-prepared for the operation. This means that patients may need to adjust their lifestyle in the weeks before the surgery. For example, patients want to make sure that they eat a healthy diet and restrict the amount of alcohol they drink. In addition, if patients smoke, it is advised they stop smoking at least 6 weeks before having the neck lift surgery. These small lifestyle changes can make a dramatic difference in helping patients achieve the best results from the procedure.

Household work

Complete some household errands, like taking the bins out or cleaning the house, before the day of the surgery. Returning home to a clutter-free house will put patients at ease whilst they recover for the first few days.

Shopping

In the early days after surgery, patients will need to rest as much as possible. It is also important that they don’t lift anything heavy, such as bags of groceries, after the operation. It is recommended that patients do a food shop at the supermarket before the day of surgery. Alternatively, make an online order to have groceries delivered on the return home.

Children and Pets

Feeling relaxed and stress-free is essential during the recovery period. So patients might consider arranging a pet-sitter or babysitter to come and look after pets or children. Alternatively, ask a close relative or friend. This can be a real help for the first week or so after surgery, when patients may still lack their usual energy.

Driving

Surgical procedures such as a neck lift can leave patients feeling tired and groggy due to the effects of anaesthesia. For this reason, patients will not be allowed to drive for the first 24 hours after the surgery. Be sure to arrange for someone to drive home from the hospital. Patients might want to ask a family member or one of their friends. If there is no one else at home, it is also recommended to ask them to stay overnight for at least the first night after surgery. The surgeon may advise that patients do not drive for 5 days to 2 weeks after the procedure.

Diet

As part of your neck lift preparation, eating a healthy diet is a good idea. This will allow the body to prepare for the operation. A healthy diet is also just as important after the surgery to help with recovery and the healing process. Be sure to eat plenty of green vegetables and fresh fruits. Eat high protein foods like chicken, fish or tofu. Keep sugar and salt intake to a minimum, as well as the amount of caffeine consumed. Finally, stay hydrated by drinking lots of water.

Clothing

Be sure to have appropriate clothing for after the neck lift surgery. This includes loose, comfortable lounge clothing to rest in and shirts and tops that do up at the front. Patients will want to avoid pulling any clothing over their head for at least the first week. Doing this could cause the clothes to rub against the healing wounds on the neck.

Sleeping

Get plenty of sleep in the days before the surgery to prepare the body for the procedure. Furthermore, it helps prepare any sleeping arrangements for after surgery when patients need to rest as much as possible. For example, patients may wish to buy some extra pillows to have at home. This is so that they can rest and sleep on these in an elevated position. In addition, keeping the head and neck slightly raised on pillows can help to reduce swelling.

These are just some of the things that can help in neck lift preparation. The surgeon will give more specific instructions on how to prepare, and patients should make sure to follow these instructions strictly.

What to expect after neck lift surgery?

To achieve the best results, good neck lift aftercare is almost as important as the surgery itself. Patients must take it easy for the first few days after the procedure to allow themselves time to recover from both the anaesthetic and the surgery. The surgeon will give specific advice on precautions that should be taken during the recovery period.

The neck lift aftercare process also includes having a post-operative appointment with the surgeon. This will be arranged before being discharged after surgery. This is an important appointment where the surgeon will check how the neck is healing and change any dressings if necessary. Also, if the surgeon used any non-absorbable sutures, they would remove these at this appointment too.

Waking up

Immediately after the surgery, the treated area of the neck may feel slightly numb. This can be due to the effects of the local anaesthetic. The neck might also feel tight or tender in the area where the surgeon operated. All of this should gradually resolve with time, so do not worry. Furthermore, there will inevitably be some swelling and bruising around the treatment area. This is normal and should start to settle within a couple of weeks. For the first few days, take pain medications as needed to control any discomfort and help to reduce the swelling.

The first 24 hours

Anaesthetic drugs can make patients feel quite tired, groggy and weak immediately after surgery. Therefore, patients should arrange to have a family member or close friend stay overnight for at least the first 24 hours post-op. If possible, ask them to drive home, too, as patients won’t be able to drive for the first few days after the procedure. Patients want to rest as much as possible on the first day home not to move the neck too much. Ask your friends or family members to help with any light errands.

Time off work

Patients should be prepared to take at least 2 weeks off from work, and maybe more if the job requires them to be active. Even after returning to work, be sure to not lift anything heavy for the first few weeks. Take it easy at first, and don’t overwork the body; patients should be back to normal daily routines within 4 to 6 weeks.

Exercise and sports

Patients will most likely need to spend the first few days after surgery resting in bed. However, it is recommended to get up and moving about as soon as patients feel able to do so. Patients can then resume light exercise such as walking after two weeks. They should, however, avoid any strenuous physical activity for at least 4 to 6 weeks. After this time period, patients can resume sports such as running, cycling and swimming.

General care

Be sure to have comfortable, loose clothing at home after the surgery, including shirts that button up at the front. Patients want to avoid pulling tight clothing over the head, as this could contact the treatment area. In addition, this may interfere with the healing process.

The surgeon might also recommend that patients rest and sleep in an elevated position for the first few days. To do this, patients can use several pillows to prop themselves up. This will help to reduce swelling.

Final results

Patients may not immediately see the results they hope to see right after the surgery. This is because the healing process takes time, and whilst swelling and bruising may have settled after some weeks, it can take up to 9 months until patients can appreciate the full benefits of the neck lift. In addition, this is because the results will generally improve over time.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.nhs.uk/conditions/cosmetic-procedures/facelift/ NHS
• https://baaps.org.uk/patients/procedures/12/facelift_and_necklift British Association Of Aesthetic Plastic Surgeons
• Understand.com Understand

Our content is written by our Medical Quality Managers and Patient Care Advisers, all of who have medical backgrounds and training. In addition, before publishing, all the information is reviewed by a surgeon specialised within the relevant field.