Can I have a neck lift if I had radiation on the neck? (Photo)

The risk of having surgery in an area of radiation treatment is that the radiation effect damages blood vessels and decreases wound healing capability.  Therefore, there is always a risk that having surgery in such an area will lead to significant healing problems and even skin or underlying soft tissue loss.  However, I have previously performed breast surgery on women whose breasts had been irradiated for cancer, and they healed OK.  I think each person's situation is different, so you need to be evaluated by someone with excellent experience in necklifting, a good knowledge of the relevant anatomy, and a careful evaluation of any apparent radiation effect on your skin. 

Since you are far enough out from your radiation therapy, it should be safe to perform the procedure at this time as long as the surgeon is mindful of the blood supply to your skin. That being said I would go to a board certified facial plastic surgeon since they are typically more aware of the underlying nerve anatomy that might be more visible and could be injured during the procedure.

It is possible to do a lift but complete undermining of the irradiated area into a long flap should be avoided. It is possible to limit risk by working on the central area of the submental neck combined with a short flap in the area around the ear. But success of this is very operator dependent as to the transmission of the lateral pull into the neck and the evening out of the skin, and a personal evaluation of the looseness of the skin and any irradiation changes need to be evaluated. Be there are risks associated with your condition not to be taken lightly.

Although a definitive answer cannot be given over the internet, I can tell you I have performed at least a dozen necklifts/ facelifts on patients who have had radiation to their neck.  Although the healing is slower, the chance of necrosis is not significant, assuming proper technique. However, the real answer lies in the quality of the skin, because radiation does permanently alter the makeup and small blood vessel supply to the area.  If a serious radiation burn occurred, you may not be a suitable candidate, but an in-person evaluation is necessary to determine this. 

Thank you for your pictures and questions. I am sorry to hear about the carcinoma and hope you are now on the road to recovery. The fact that there has been radiation damage to the area is very significant because even after radiation, that skin stays damaged permanently. This could mean that with a significant undermining of the skin such as with a necklift, there could be compromise of the blood flow to the skin which can lead to skin necrosis, death, and large open wounds. While it is true that this is a risk for all patients undergoing a necklift, significant problems are thankfully very rare, but in your case, that risk is significantly elevated, although no one can tell you a specific number. The bottom line is that the surgeon who told you "no problem" is being much too cavalier in my opinion and you (and your chosen surgeon) need to acknowledge the risk involved and decide whether the benefit outweighs the risk. If you do decide to go ahead with surgery, I would advise that you wait as long as possible after the radiation to proceed, one year minimum. Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  It would be helpful to feel the quality of this skin in the irradiated area during an in-office examination in order to determine the safety of performing a necklift.  I have done this is in a number of other patients who had neck radiation in the past without any skin complications.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

It looks like you have significant changes to your neck from surgery and radiation. The radiation should continue to cause tightness of the skin treated. Radiated skin is at greater risk then normal skin. In the hands of a skilled surgeon the risk is less but still there. A thread lift may tighten the neck enough for now. Good luck...

 Both are correct, depending on the type of procedure performed, a subcutaneous dissection versus a submuscular dissection. Radiation does put you at increased risk of having complications such as skin loss. With radiation, time is your friend and the longer you can wait, the better.  I would recommend waiting at least a year or more.  What would be the best result and most appropriate procedure would depend an examination and discussion about desired outcome.  Naturally appearing results can be obtained with surgery and the right procedure would decrease your risks.
Robert Schutz, M.D., FACS
Rapid City, South Dakota

As a double boarded head and neck cancer surgeon and a plastic surgeon with a large facelift practice I would say to absolutely avoid the neck lift. You may get away without complications but no good and reputable facelift surgeon would take the risk. The chance of skin necrosis (dying ) is significant, the chance of excessive scarring is significant and even the risk of infection has been elevated due to the poorer blood flow in the tissues post radiation. Enjoy your good health and forget about the tight neck, if you have complications you will be dealing with problems of a serious nature.

Dear 1234me, You can have a necklift performed however the risk associated with the procedure has largely increased due to the radiation and lack of circulation in the area that the tumor was removed. This would be a question of risk versus reward and you may want to try some less invasive procedures first. I am happy you are on a good road to recovery. Best regards, Michael V. Elam, M.D.