Neck lift / Face Lift swelling - where does it go?

Swelling is removed by the face in a specific method.  Swelling is fluid that is outside of the cells of the body.  The body absorbs this fluid through lymphatic vessels and then processes this fluid through the lymph nodes.  After filtered, it eventually would be returned to the blood system.  This process generally flows towards the heart.  That is why if you have a swollen leg or arm, you want to keep it elevated so gravity will help the lymphatics remove the swelling.  This is the same reason why you would want to keep your head elevated to speed up your recovery and swelling after a facelift or neck lift. I hope this helps.  

Our office specializes in neck lift procedures in Los Angeles. We ask patients to sleep upright so that gravity can help dissipate the swelling. Best, Dr. Karamanoukian Los Angeles

I think in the end, this is one of those things that us surgeons say without really knowing if it works. But like the saying goes, if it ain't broke, don't fix it. In my opinion, the position really plays a small role in the resolution of swelling after a face lift. When fluid builds up in your skin from the inflammation and irritation of surgery, it eventually gets absorbed in the "lymphatics" in your skin. These are little channels that take it back to your blood. There are also other mechanisms involved but I will spare you the biochemistry! Gravity does play a role in bringing the fluid "down" your face and into your neck, but how much it matters, i have no idea. No one does as there as never been a large scale study proving it. Finally, fluid building up in your skin will NOT stretch your skin, the skin is designed for this. So in the end, there is no hard fast rule, but the way it has been done (ie no laying flat) has worked and we dont want to switch. James P. Bonaparte, MD, MSc, FRCSCHead and Neck Surgerypracticing in Facial Plastic and Reconstructive SurgeryAssistant Professor, University of OttawaOttawa, Ontario, Canada

Facial and neck swelling after multiple facial and neck cosmetic procedures drains into a kymphatic vessel that eventually drains into a bigger lymphatic vessel close to your heart. Gravity increases the flow of swelling fluid and thereby the resolution of swelling. Faster flow occurs when your head is above your heart. Therefore we all recommend that you keep your head elevated for 5-14 days after a face and or neck lift. I would not be concerned about your neck becoming stretched after a facelift as your facial swelling flows to your heart. Hope this helps 

The type of swelling that occurs after a facelift is two- fold.  One is swelling in the tissues themselves due to being injured, and the other is fluid that may collect a little within the surgical plane of dissection.  With both of these, having an upright position for at least a few days allows it to migrate out if the face and be absorbed lower down.  If you lay flat it will have a tendency to pool in the facial tissues longer.  I hope this helps.

Hello Imagingboomer.This is a really good question and one I am asked a lot. The key to understanding this is tissue fluid compartments. The swelling that we speak of is inflammatory fluid in the tissues (fat / connective tissue and skin) that temporarily moves into the wrong compartment. Think about waking up in the morning - we all have puffy eyes in the bathroom mirror! - why? because fluid has moved into a different compartment as we sleep, as we get on with the day (and have a cup of coffee!) this improves. Similarly, people with heart failure get swollen ankles as the 'failure' is the heart to maintain the fluid in the correct compartment.So in facelifting, trauma to the facial tissues and to some extent cutting through lymphatics causes swelling. Keeping upright (or at very least the head above the heart) for the initial recovery stage, helps this fluid move back into the right compartment. Similarly running yourself a little dry (thirsty) encourages your body to recruit fluid in the face back into the vascular compartment.The weight of tissue fluid is not enough to alter the lift dynamics unless it has collected as a seroma or haematoma - these would need specifically addressing.Hope this helps a littleDominic

I really think that there are a number of things that are important for after care after your facelift procedure.  Keeping the head elevated and above the heart helps the swelling to diminish better with the aid of gravity.  When you lay down flat then the post procedure edema can remain and even increases the face and neck swelling and bruising.   Also it is important to keep the wrap on firmly as instructed by your surgeon for a few days after.

The swelling after a facelift is due to interruption of the lymphatic drainage system in the face and neck. The interstitial fluid  is trapped in the skin and cannot work its way out immediately, therefore swelling ensues. Most visible swelling has dissipated at 2 weeks and it is okay usually for patients to go out socially  and back to work with some makeup after 2 weeks.

Most surgeons will encourage the elevation of the head after facelift surgery to help resolve facial and neck swelling faster.  As mentioned, the body removes swelling by draining the tissue fluids into the lymphatic system which eventually then drains into your blood stream and is removed by your body.  Gravity helps speed this process along.  The drainage of swelling fluid from your face doesn't stay in your neck or stretch out the neck tissue or skin , instead the swelling from your neck and your face are just cleared more easily elevation. Sometimes the temporary swelling does make your face and neck skin look more smooth with less wrinkles because of the increased volume.  Skin wrinkles aren't usually resolved with facelift surgery alone, so once the swelling is completely gone, some people do see a slight relaxation of the neck and facial skin with some some fine lines returning.  These fine lines aren't caused by the stretching from the swelling but rather become evident again when the added volume from the swelling has resolved.  Fine lines and skin changes are usually addressed with resurfacing procedures.  

In short, surgical swelling resolves when lymphatics/ venous drainage moves the residual swelling fuid to the heart.  Gravity assists this process when you head is above our heart.Hope this helps.