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.