Endarterectomy artery carotid due to neck lift - has anyone seen this before?

Question

I had a revisional neck lift surgery over a year ago due to neck not being symmetrical (waited a full year after first surgery). Seven days after my surgery, a branch off of my carotid artery failed and I bled out into my neck area. I had emergency surgery and was placed on a ventilator because I couldnt breathe on my own. Doctors said I saved my own life by calling 911 so fast and I was 20 minutes away from suffocating. They said my arteries sat lower than average. Anyone seen this before?

Derek Fletcher, MD · Answer

I have not personally seen this complication with a neck lift.  It is hard to know what put you at risk without knowing exactly what was done during your neck lift, your initial recovery, and your specific anatomy.  If you had a deep plane neck lift and your surgeon worked on your salivary glands, they were close to several branches of the external carotid artery.  The carotid artery branch most likely to have been injured during a deep plane neck lift is the facial artery, which runs along the posterior and deep surfaces of the submandibular gland.  If the facial artery was accidentally injured it can bleed significantly after surgery.  Bleeding 7 days after surgery might suggest the the artery was clipped and the clip came off.  Another potential explanation connected to working on the submandibular salivary gland is a salivary gland leak.  If saliva is bathing the surface of the carotid artery it can cause it to rupture (carotid artery blowout).  Usually, additional vessel injury is necessary.  The most common scenario for carotid artery blowout is for head and neck cancer patients who have had a history of radiation (this causes additional vessel injury) and have surgery that exposes the carotid to saliva.

Thomas Spalla, MD · Answer

That's such an awful situation that you went through. I have not seen that exact situation from a neck lift, but I have dealt with dozens of patients over the years with expanding neck hematomas (even just last week!) from other neck surgeries. It's quite a scary situation, and I'm glad to hear that you were able to pull through this life-threatening situation.

Zoran Potparic, MD · Answer

It is questionable whether this unfortunate event can be directly related to your neck surgery? Face and neck lift surgery procedures, like SMAS mobilization and fixation, is done more superficial than major branches of internal carotid artery are located; injury of these elements in the course of surgery is very rare, unless vascular anatomy is significantly different in particular neck/patient. I am glad that you reacted so promptly because any bleeding in the neck area can have serious, even deadly consequences. Hope this helps. Good luck.

Endarterectomy artery carotid due to neck lift - has anyone seen this before?

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Endarterectomy artery carotid due to neck lift - has anyone seen this before?

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Our mission is to create a world where every investment in modern beauty is Worth It.