Can I have a face and neck lift done if I had a previous neck dissection and radiation?

Question

Hello all, first time posting. I am 63 and I had throat cancer back in 2020. I had neck dissection on both sides of my neck along with 30 radiation treatments. I am cancer free, I want to get a mid face lift to address my naso labial lines and how my face sags. I also would like a neck lift due to the way the skin hangs from the neck dissection. I spoke to a plastic surgeon and he said i cannot have those procedures due to the neck dissection and radiation. Is he correct?

John Michael Thomassen, MD · Answer

You should be able to have the midface and lower facelift without any increased risks.  The neck would need to be evaluated for the scar and radiation fibrosis.  It should be possible to do at least a skin only procedure to address the excess skin centrally without increased risk.

Tanveer Janjua, MD · Answer

Facelift recovery relies on vascularity in the skin. Unfortunately radiation causes a lot of scarring under the skin and loss of blood vessels. This means there is less blood supply and hence less  oxygen for the tissues. This can lead to skin necrosis after the facelift. 
Regards
Dr. J

Jacob Tower, MD · Answer

Hello, hope you are well. I have experience performing face- and neck lift surgery on patients who have had radiation and prior neck dissections. The short answer is that you are not necessarily excluded as a surgical candidate simply because of this history. However, it is almost certain that your recovery will be prolonged (swelling may take substantially longer to subside), and that your results may be more limited.

Best,
Dr. Tower

Best,
Dr. Tower

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs. However, it is known that radiation does cause damage to the small blood vessels in the area that is radiated. This may lead to the flap necrosis, particularly in the neck. However, your mid face may be capable of improvement with surgical intervention, particularly the nasolabial lines. One thing to help is a lip lift. A lip lift does 4 things: shortens the distance between the nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Manish H. Shah, MD, FACS · Answer

Hi,
Thanks for your question. Your history presents a very complex scenario to manage. You are at very high risk for poor wound healing in your neck. I’ve had success with a similar case in which I performed a direct neck excision down the midline of the neck and had the patient undergo multiple sessions of mHBOT (mild hyperbaric oxygen therapy) and he’s done well without any complications. 
This may be a possibility for you. 
As far as NLF softening by midface lift, you shouldn’t be at excess risk. You will stay swollen longer because of your bilateral neck dissection. 
If you have further questions please contact me via my profile.
I hope this helps.
Dr. Shah

Ronald J. Edelson, MD · Answer

There is certainly increased risk of wound healing problems because of the previous surgery. A conservative facelift couid probably be done to reduce the risk.  I have never done a facelift in somebody after radiation so I can’t speak from experience but I understand why the surgeon turned you down

Zoran Potparic, MD · Answer

In general,  dissection of the neck needed for neck lift  will compromise safety of surgery and result due to possibility of skin loss and excessive scarring. Face part of lifting may be dane more safely due to preserved, minimally compromised blood supply. However, depending of local findings a compromise can be made with all the risks involved. For further discussion you will need to see/find someone who is a real expert in face and neck surgery. Hope this helps. Good luck.

Thomas A. Mustoe, MD, FACS · Answer

You cannot undergo a conventional facelift where the skin is separated from the superficial muscle and lifted as a separate procedure. However a deep plane facelift in which the muscle is left connected to the ski would be safe and allow a more complete correction of the midface. For the neck some alterations in the procedure would have to be made, but I have performed deep plane facelift safely several times in patients with your history.

Kamol Pansritum, MD · Answer

Full facelift limit from neck dissection and radiation scar at neck. Thick and strong scar from radiation, full facelift not suggest for improved jowl. Mini facelift not through the neck dissection area may improved of nasolabial and jowl line.

Mats Hagstrom, MD (license on probation) · Answer

With your history, you should definitely not have a facelift.
A radiated tissues do not heal anything close to what normal tissues do, and the chance of having significant complications is high.
I can’t speak on behalf of the mid facelift.
Most likely that would be much safer.
You should definitely not have elective cosmetic surgery that involves your neck.
 You can consult with plastic surgeons, but I think almost everyone will have the same opinion about this.
Operating on tissues that have been radiated is often disastrous trade.
Best,
Mats Hagstrom MD

Can I have a face and neck lift done if I had a previous neck dissection and radiation?

Answers (10)

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