Concern regarding neck lift compression bandage delay. Is first week compression crucial?

Question

38yo male. Neck lift (muscle/fat/skin) to relieve pressure on throat complicating long-standing sinus issues. Great functional results, but now cosmetic aftermath. No compression bandage until 8 days post-op. Since then, double chin, etc have developed. Not told why no comp post-op but later told the hospital ‘no longer carried them’, hence the delay(?) Is first week compression crucial? Potential lost ground? Should I seek second opinion/examination? Thank you for your expertise and time.

Gregory Turowski, MD, PhD, FACS · Answer

Great question.  I always put drains in my neck lifts to prevent complications with hematoma or seroma, and remove them the next day.  I also wrap my patients with the football helmet dressing with cotton and coban which is removed also the next day.  I replace with a light dressing such as an ace wrap.  This usually stays in place for a few days, taking off to wash hair, etc. I also put a piece of flexan tape to minimize the swelling under chin.  I believe this is important for great results.  I really think this is a crucial step in post operative management to get those nice results.  Also, I tell my patients not to look down, keep head, neck area straight.  This prevents the "double chin" look after surgery.  I would definitely follow up with your surgeon so he/she can assess you for the swelling.  Good luck, I hope everything heals nicely for you.

Jason Emer, MD · Answer

compression after neck liposuction is essential for skin tightening and to help neck contour. it prevents seroma and hematoma.  I suggest using compression immediately and starting venus legacy to help improve the outcome.  Best, Dr. Emer.

Arnold Almonte, DO · Answer

It's highly unusual to not be given any type of compressive garment after a neck lift (or facelift). It's key to preventing hematoma or fluid collection which can ultimately alter the result of your operation. The "double chin" may be due to inadequate operation to tighten the neck, or from fluid collection under the skin which contribute to the irregular contour. I would return to your plastic surgeon and be re-assessed for the above. Good luck.

Scott R. Brundage, MD · Answer

Whether a band is placed after a formal neck lift is controversial. If it was liposuction alone, most will agree a compression garment of some sort is needed. If the skin was released and lifted not everyone uses a band (some fear compromising blood supply if too tight). It sounds like you are just a few weeks out from surgery. I suspect you have some swelling. At this point I would stick with the band (you skin blood supply should be stable now) and allow things to settle. Be aware that over the first month you can get irregularity in the area in the normal process of healing that will resolve with time. If your concerns persist a touch up revision is laways posible.

James H. Scheu, MD, FACS (retired) · Answer

Thanks for your question. In most cosmetic surgery practices a face/neck lift includes a wrap which supports the "lifted" elements and provides some compression---mainly to prevent bleeding. I place such wraps immediately after completion of the surgery and this is left snugly in place for the first 24 to 48 hours, and is then changed in the office, and replaced with a lighter dressing then, with an elastic "chin-strap" overall, and this is worn 24/7 for the next week, only being removed for showering--and not every day--during that 1st week. I personally think the early use of the wrapping is critical and am puzzled that you did not receive similar instructions. This is especially important with male facelifts, as we men tend to bleed more than our female counterparts. If you have some consequences, ask your surgeon for advice--a board-certified plastic surgeon, hopefully.

Concern regarding neck lift compression bandage delay. Is first week compression crucial?

Answers (5)

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