Cosmetic eyelid surgery (Blepharoplasty)

Generally speaking, yes, it is technically possible to perform a necklift under local anaesthesia. BUT, here are some things that the patient should carefully consider: When undergoing a necklift under local anaesthesia, large areas of the lower face and neck have to be infiltrated with local anaesthetic. The infiltration can be painful at the beginning. Also, it is important that you are aware that you are fully awake during the procedure. You will feel pulling and tagging, and even though this is not painful, many patients can’t handle being fully aware of what is going on. On top of this, you will have to lay for up to 3.5 hours on the theatre table while remaining completely still. Many people experience back pain after a while, and feel that they need to change their position. This must be avoided under all circumstances.

I generally prefer performing necklifts under general anaesthesia. If you feel uncomfortable about general anaesthesia, it may help if you speak to our anaesthetist, as they can answer all your questions and put your mind at ease.

If you decide that you do not want the necklift performed under general anaesthesia for personal reasons, I would advise that you have the necklift surgery performed with local anaesthesia while under sedation. Our anaesthetist will administer painkiller and sedatives through an IV line. You will sleep during the procedure, but you have full control of your breathing and will be fully awake as soon as the sedative administration is stopped.

For my neck lift procedures, I usually take 1.5 hours. In combination with eyelift or submental liposuction, the whole procedure can take up to 2.5 hours. A short surgery time is important to avoid dramatic swelling after the neck lift.

I don’t lift the SMAS during the neck lift because it stops at your jawline and doesn’t continue into the neck. I do lift and tighten the platysma muscle, a flat and thin muscle which expands from your jawline down on both sides of the neck. Loss of tightness results in the so-called platysma bands, which run over the middle of the neck. By tightening this muscle in a neck lift I can return or create a defined angulation and definition of your neck.

Complications of a neck lift are rare. An acute complication (within the first 24 hours) would be a post-operative bleeding. If the bleeding doesn’t stop or the built-up haematoma is too big, you will need to be re-operated on, so that the bleeding can be stopped or the haematoma emptied. Risk of an infection and seroma is small but existent. Parts of the skin dying (this is a major risk if you are smoking), loss of sensitivity, asymmetry, stretched earlobes, and visible scars (stretched or hypertrophic) are also other potential, but rare, complications.

You definitely shouldn’t have a neck lift at the moment. Due to the constriction of blood vessels, the blood supply to your face is compromised. Undermining and lifting your skin, as required in a neck lift, further compromises the blood supply of your skin and there is a real possibility that part of it could die. A further risk is that the wound might not heal successfully, and you could develop a seroma which would need to be drained a few times until you did successfully heal. My patients often say to me, ‘you are a fantastic doctor, this won’t happen with you’. I am afraid this has nothing to do with how qualified, experienced or skilled you are as a surgeon, and therefore it can happen to any surgeon operating on a smoker. Therefore, you must stop smoking at least 4 weeks prior to your planned neck lift procedure. This will provide your body with the time in needs to regenerate its blood vessels within the skin of your face and neck. A neck lift can then be performed without this heightened risk.

I like my patients to spend one night in the hospital after their neck lift procedure. I will ask you to wear a tight head bandage which will put a considerable amount of pressure on your ears. Many patients find that this can cause some pain. While you are in the hospital, we can administer IV pain relief as well as monitor you closely in case you have some post-operative bleeding. In the hospital, you can relax and put your mind at ease. The following morning, I will remove your bandage before assessing your neck. If all is well, I can then discharge you from hospital and you can return home. If you live in London, it is possible for you to leave the same day. Many of my patients have requested this and there were no complications.

You should not feel much pain with a neck lift procedure. The head bandage can cause quite a lot of discomfort, but I only ask that you wear it for the first night. It can cause a lot of pressure on the ears, and this is what many patients find quite uncomfortable. Once the bandage has been removed the following morning, you will feel much better. You will experience tightness, but rarely any pain. I discharge you with painkillers, though many of my patients tell me that they never had to use them.

I will ask you to wear the compression bandage for just the first night, then I will take it off the following morning. If I added a submental liposuction to create a sharper definition, I advise my patients to wear a chin strap for another week at home, and another week only at night.

I usually decide if you will need small drains (mini-vacs) during your neck lift procedure. If you are not bleeding very much during your neck lift I won’t use drains. If you are bleeding more than expected during your neck lift, then I will use two mini-vacs. These drains are removed before you leave the hospital the following morning.

In most cases, a patient that has undergone neck lift surgery doesn’t have to hide because the swelling is minor, and bruises can be easily covered. Your earlobes and lower face may appear swollen during the first few days, and in this case patients tend to avoid public places, even though it can be easily hidden with long hair and your choice of clothes. A scarf, or a turtle neck sweater usually conceals the swelling very well. The stitches are in front of the earlobe, but clear sutures are used which are not so visible. Again, long hair can easily hide the stitches.

I will usually decide during your neck lift procedure whether or not you will need small drains (mini-vacs). If you are not bleeding, or if you are only bleeding a small amount during your neck lift, then I will not be using drains. If you are bleeding quite a lot during your neck lift surgery, then I will use two mini-vacs. These drains are then removed before you leave the hospital the next morning.

Usually, I do not expect any swelling on your neck after your neck lift procedure. The lower face and jawline area may be a bit swollen, which can sometimes cause your mouth to be stretched a little, though this is only for the duration of the swelling. Once this swelling settles after a few days, your mouth will look completely normal again. Your earlobes can also swell during the first 3 days, and this will usually begin to settle from day 4 on wards. Also, you may find that you develop some bruising around the neck. The bruises can drop with gravity into your decollete, before fading away over the next 10-14 days. Bruising and swelling is of course different with each individual, but rest assured, if you do happen to experience any bruising or swelling, it will soon begin to improve after just a few days with many patients returning to work after just one week of recovery. Your neck will feel very tight, and some patients express concern about mobility, but you should be able to turn your neck without any problems. The tightness that you feel around your neck is caused by the tightened Platysma muscle. After the first few weeks of recovery, this feeling of tightness should subside.

I would ask that you please avoid drinking any coffee or black tea in the first 2 days, because these can raise your blood pressure and cause bleeding. Also, please avoid smoking cigarettes. This is because smoking can compromise the blood supply to your skin, potentially causing facial skin to die. You shouldn’t smoke for at least 2-3 weeks following your neck lift surgery. Avoid exercise during the first month of recovery. Ensure that you sleep with your upper body elevated under a few pillows so that any swelling is reduced. Also, avoid bending over during the first few weeks.

Usually, the swelling after neck lift surgery is minor, and any bruising on the neck can be easily covered, therefore there is no need for a patient to hide away following their neck lift procedure. Your earlobes and lower face may experience some swelling during the first few days of recovery, and in this case patients generally avoid public places, although again, this can be be easily hidden by covering your ears with long hair or with your choice of clothing, such as a scarf or a turtle neck sweater. The stitches are visible in front of the earlobe, but clear sutures are used which are much less noticeable. Again, long hair and clothing can easily hide the stitching.

The incision starts at the front of the earlobe, and runs around the earlobe and back up behind the ear in the post-auricular sulcus. The incision then crosses from the top of the sulcus into the area of the occiput. Behind the ear you will find that the scar is not visible, and only a very small part of the incision is exposed at the front. These areas can be hidden very easily with longer hair. If you have short hair, it can be more difficult to disguise. Men in particular who have short hair can find it a problem when covering it up. Once the sutures are removed, any scarring will turn red and become slightly elevated, which is all part of the normal process when a scar is healing. During this period, it can help if you cover the scar with some concealer. Once the scarring has completely healed, they are very fine, light lines, which are difficult to spot as they are almost invisible.

This is a very common question i get asked by many of my patients! Well, a neck lift can last 10-15 years, but this doesn’t mean that your face will look the same over this period of time. With a neck lift we only turn back the time (10-12 years), as unfortunately we can’t influence nature and the ageing process. But, you will surely look much better 12 years after your neck lift procedure, as opposed to how you would have looked without the neck lift!. It is vital for a long lasting result to condition your skin with a strict skin care regime. I advise my patients to use products from my skin care range, SkinDoc formula, which has proven to be very effective for my patients.

The stitches are removed 12 days after your neck lift surgery. Around the ear I use sutures, and in the hair I use staples as they cause less harm to your hair follicles.

No, I do not shave your hair, so there is no need to worry about that.

The prices of a necklift vary and are specific to the individual and the type of surgery required. If you are considering having necklift surgery in London then please get in touch with us to book in for a one-to-one consultation with Dr Dirk.