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What to Do with Neck Laxity when General Anesthesia Isn't an Option?

I'm a 39-year-old with mild/moderate neck laxity, but I'm not after a face lift. I understand that invasive lifting has the highest guarantee of success, but for medical reasons, I prefer not to have general anesthesia (especially considering its an elective procedure).

I have consulted 7 MD's who are respected and reputable plastic surgeons in the Stanford/Palo Alto area (head and neck and general Plastic surgeons) and have had a range of responses. One suggested a "mini" facelift (which is basically a face lift) with submentoplasty and chin implant, a couple recommended an isolated submentoplasty and chin implant, 2 recommended an isolated neck lift, and one MD said I'm not a candidate for face/neck lift surgery and should get a chin implant, Botox in the platysmal bands, resurfacing, and Titan Laser. One also said Active/Deep FX all over my face and neck would be the best. I'm now frustrated and feel as if there's no hope but to live with my prematurely wrinkled neck. Any advice?

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age 35-44 neck anesthesia minimally invasive options skin laxity

As you can see, there are multiple options!

There are a wide variety of options to rejuvenate the neck. Because you are young, some of the more conservative options might be the most reasonable but it really depends on your anatomy and your expectations. You are hand-cuffing the doctors by placing restrictions on the anesthesia. I would suggest going back to the ones you liked most (I would recommend Ben Maser, MD at the PAMF) and ask them what they would advise if anesthesia were not an issue. Then ask them what anesthesia they... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

There are multiple ways to rejuvenate a neck

While it's difficult to know what options you have without examining you, what I think you are seeing is that depending on the surgeon, there are multiple options for neck rejuvenation. I think you have been offered a wide range of options, some more invasive than others, and each with its advantages and shortcomings. I don't think you have to live with your neck if you're unhappy with its appearance, and I do think you can have a procedure done to improve it. The key will be to decide... more

Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

Neck lift and general anesthesia

Your situation illustrates my usual advice to patients that if you see three different surgeons about a single problem, you will usually get three different answers. Personally, I do not understand why no one offered to do a neck lift procedure on you under local anesthesia. This would almost certainly address your concerns.

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Lawrence Kass, MD

Saint Petersburg Oculoplastic Surgeon

The Best Necklift

The best way to lift a sagging neck is to have surgery. Necklifting can be performed under local anesthesia quite comfortably. All necklifts require removal of the submental fat. If there are platysmal bands, these must also be corrected. Lasers cannot address sagging skin no matter what they advertise. There are two different necklift procedures to address sagging skin. Depending on how much sagging skin is present will determine which incisions are required... more

Paul S. Howard, MD

Birmingham Plastic Surgeon

ASAPS ASPS

It depends on your goals: Your neck profile or skin texture

All of the proposed options can all be performed without General anesthesia. Some can be performed under local anesthesia alone with oral or intramuscular sedation, while other surgeons may prefer local anesthesia with IV sedation. This helps to avoid the general anesthesia which you have your reason for avoiding. Some people have a history or family history of Malignant hyperthermia from general anesthesia inhalational anesthetics (the anesthesia gases), which... more

George Yang, MD

New York Facial Plastic Surgeon

There Is No Best Answer In Facial Rejuvenation

Unfortunately as you have found, there is no right or wrong answer in facial rejuvenation. While anesthesia concerns are always present, most procedures can be done with less than general anesthesia so I wouldn't let anesthesia alone preclude your more optimal procedures.

D.J. Verret, MD

Dallas Facial Plastic Surgeon

Restore the triangle of youth.

Many women identify the first signs of aging in the central lower third of the face (around the mouth and neckline). The development of mandibular jowls and neck skin laxity, neck muscle splaying and subcutaneous fat accumulation in the neck all contribute to making the face a "pyramid of age". In your consultations with local experts, you have discovered that there isn't one "solution" to a so called problem, as evidenced by the variety of approaches... more

Lavinia Chong, MD

Orange County Plastic Surgeon

ASPS

Options to Improve Neck Laxity

There are several different options to improve the neck skin laxity. Without assessing a picture, it is difficult to make a recommendation. Your young age and some of the other plastic surgeon opinions lead me to believe you would benefit from a midline platysmaplasty or neck lift performed with a incision just under the chin. Using this same incision, you may also benefit from a chin implant. Both of these procedures can be performed under local anesthesia with minimal scarring and... more

Ankit Desai, MD

Jacksonville Plastic Surgeon

ASPS

Neck Lift and Anesthesia

With regards to your question, there are several topics to discuss. Anesthesia: If you have some form of cardiac, pulmonary, or metabolic reason for not having anesthesia, the discussion should end here. Elective facial cosmetic surgery is for healthy people; there is no good reason to take unnecessary risks. However, if you are healthy at age 39, the techniques available for anesthesia in a neck lift procedure do not require general anesthesia and are very safe. The technique used... more

Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Neck Lift or Facelift will treat neck laxity

The only way to really treat neck laxity is with a neck lift or facelift. The Titan lasers may give you about a 10-20% improvement. You can forget about the Fraxel.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Neck lift

Hello You have seen 7 surgeons who examined you and each gave his opinion based on their exam and your medical condition. We here have not examined you and not knowing your medical condition will not be able to give you an intellegent advise.

Samir Shureih, MD

Baltimore Plastic Surgeon

ASAPS ASPS

All facial procedures can be done under local anesthesia

A combination of sedation and tumescent local anesthesia will do a great job of making for a comfortable surgical procedure. Although I am not suggesting the type of procedure for you, a word of caution, Lasers and radiofrequency procedures are expensive and temporary. The only way to get a durable result is to have surgery.

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Tumescent local anesthesia works fine for surgical neck lifts.

Your surgeon can do the same surgical neck lift with just tumescent local anesthesia without general anesthesia. Many anesthesiologists now do the local anesthesia instead of the general anesthesia for face lifts and neck lifts. If you've decided on your surgeon , then the next step is for you to discuss your wishes with your surgeon so he has time to locate an anesthesiologist who can do the tumescent local for you. It is a win-win situation. There are always options. That is why this... more

David Hansen, MD

Beverly Hills Dermatologic Surgeon

Non-Surgical Necklift

Hi Betty, You can have a jowl and neck lift under local anesthesia. This is becoming more commonplace as more and more patients do not want to have general anesthesia. Best, Dr. S.