Can a complete neck lift be done under local anesthesia with ORAL sedation? Under the chin incision, does it help w/ lifting?

Question

I have excess skin under my neck (a turkey waddle) and dropped muscles. I need to have a plastysmaplasty. I have consulted with two fine surgeons who have different approaches to this matter. One proposes the use of local anesthesia with oral sedation, the other, local anesthesia with IV sedation. Both have almost the same approach to neck lift--a cut in front to back ear, down the neck. One surgeon also recommends a small incision under the chin I am OK with this, better than drooping.

Raymond E. Lee, MD · Answer

Thanks for your question. A lower facelift with neck lift including liposuction and platysmaplasty can be done under local anesthesia + oral sedation or with iv sedation. That said, administering the local + oral sedation does involve experience and skill. I have successfully performed several thousands of lifts this way and is my preferred method as I feel I get a superior platysmaplasty result and an easier recovery for my patients. Many docs are not comfortable with administering it and would rather put the patient to sleep.  In my opinion I would pick the surgeon who you think can deliver the results and not strictly on the anesthesia  method. Note, the submental incision is needed to perform  proper neck Lipo and midline platysmaplasty.

Jed H. Horowitz, MD, FACS · Answer

The type of necklift incision will depend upon your gender, your hairline and preferred hairstyles, any scars from previous surgeries, and a variety of other factors.  As a general rule, a #necklift #incision starts right in front of or within the hairline on the temple, follows the curve of the front of the ear, travels underneath the earlobe, and ends at the hairline behind the ear.  There are also shorter #scar techniques preferred by many patients, which do not have incisions in the hairline.  Some patients who wish to have liposuction or tightening of their neck will need an additional incision under their #chin, which can be hidden in a natural skin fold.It is important to be realistic with your desired results. Necklifts are designed to remove only deep grooves and #wrinkles, not fine ones. Smoothing out every tiny line in your face would leave you with an eerie, unnatural, and undesirable result. The goal should be to make your necklift look as natural as possible, simply turning back the clock a few years.  Local #anesthetic is usually used in combination with intravenous anesthesia during a necklift operation, allowing you to sleep peacefully through the procedure.  Though general anesthesia may be requested, it is not necessary in most cases.  A necklift and any additional procedures you may add on are outpatient procedures usually performed in a surgery center.  In some cases your surgeon may advise you to stay in a post-op care facility for a single night.  If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend non-surgical alternatives to address your concern. Consulting with a board-certified plastic surgeon who specializes in #neck lift procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question. Neck Rejuvenation (plastysmaplasty and neck lipo) can be performed under local anaesthetic with oral sedation and local anaesthetic with IV sedation, both which I frequently use (this will depend on your preference). Local anaesthetic still giving the same longevity and results however meaning a significantly faster recovery time. Local anaesthetic having minimal health risks compared to general anaesthetic. There will be no dressing or drains afterward. This is performed as a day case, walk-in walk-out procedure with minimal bruising and downtime. I make small incision running from the top of the ear toward the bottom, slightly around the back of the earlobe. After 3-6 months the scar is skin colour and almost invisible. I would make an incision under the chin if neck liposuction is required. This procedure if often combined with facelift, eyelid surgery, cheek lift etc

Please find a reputable and qualified surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve. Ask to see before and after pictures to gauge past patients results to help you decide on a surgeon.

All The Best

Please find a reputable and qualified surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  Ask to see before and after pictures to gauge past patients results to help you decide on a surgeon.

All The Best

Kevin Sadati, DO · Answer

I have performed
well over 2,500 lower face and neck lifts under local anesthesia with oral sedation for the
past ten years. Without doubt it is safe and well tolerated by patients.
Compare to the traditional facelift procedures that are performed under general
anesthesia, the post operative complications associated with local anesthesia
cases are lower and risk of bleeding is minimized. The key to a successful
facelift procedure using local anesthesia is selection of the right patient by
the surgeon and his or her comfort doing these cases.

Ross A. Clevens, MD, FACS · Answer

Dear beachgirlca,You are not alone in your concerns with anesthesiology. Keep in mind that a board certified anesthesiologist is monitoring your anesthesia during the entire surgery. Beforehand, the anesthesiologist and I - your board certified facial plastic surgeon - will have identified the right type of anesthesia for you, our patient, and will have described what the entire procedure entails so that you can feel comfortable in our expert hands.As far as the 'turkey neck' and drooped muscles are concerned, a Laser-Assisted Weekend Necklift will produce the improved look that you desire. I created and refined this technique that employs laser technology to give patients a very attractive neckline in less time and with less recovery time. Please see the link below to view pictures of my patients of the Laser-Assisted Weekend Necklift.  Sincerely,Ross A. Clevens, MD, FACS

Philip S. Schoenfeld, MD, FACS · Answer

It sounds like you have two good choices for surgeons at hand.  I prefer to perform neck lift and platysmaplasty surgery under IV sedation. For neck lifts  I also use incisions behind the ear and into the hairline in the back of the scalp and for platysmaplasty I like to have direct access to the muscles and use a small sub mental incision as well.  The procedures that you are looking to have  done provide a great deal of improvement in the appearance of your neck for your investment.  Both IV and oral sedation supplementation to local anesthesia are very safe and choosing between the two is less important than choosing the right surgeon.

Dilip D. Madnani, MD, FACS · Answer

Anesthesia techniques will vary depending on surgeon comfort and preference. Anesthesia techniques include local anesthesia with oral sedation, local anesthesia with IV sedation and local anesthesia with general anesthesia. The only difference is the increased risks associated with deeper levels of anesthesia, hence the need for certified facilities, monitoring and extra specialized personnel (Nurses, anesthesia specialists etc)Your results are essentially going to be the same if your surgeon has experience with facelifts/necklifts and has experience with the anesthesia techniques suggested.  I perform all my facial rejuvenation procedures using local anesthesia with oral sedation, so my patients get to review my before and after pictures showing results using this technique. Now, concerning a neck lift, I will perform the platysmaplasty, using an approach via an incision under the chin to get the best results, I also combine neck liposuction at the same time to further contour the neck profile. Hope this helps.

Michael I. Echavez, MD · Answer

A neck lift could be done with local anesthesia and oral sedation, local anesthesia with IV sedation or general anesthesia.  The choice of anesthesia is determined by preference of the surgeon and patient.  My personal preference would be for local anesthesia with IV sedation, but this does not mean you would not get a good result with a different type of anesthesia.  You should discuss your options with your surgeon.

Julian De Silva, MD · Answer

Yes, it is definitely possible to have your neck lift procedure under local anesthesia with the use of oral or intravenous sedation. Using this method, you will be conscious during your surgery but will be extremely relaxed and will not feel any sensations of pain. Some doctors and patients prefer this option as local anesthesia is generally associated with less feelings of nausea and an easier recovery from drowsiness associated with the administration of anesthesia. I recommend you to discuss all your anesthetic options directly with your surgeon, as he or she will be best able to guide you according to your goals and expectations

John A. Standefer Jr., MD, FACS · Answer

A complete neck lift with liposuction and platysma plasty can absolutely done under local anesthesia with oral sedation. I have done thousands of them with excellent results. If you have the turkey waddle as you suggest, the incision under the chin with correction of the platysma muscle will likely give you better results. Oral vs IV Sedation is merely a matter of personal preference and costs. Both are safe and effective, but neither changes the results. The surgery can be preformed equally as well using either oral or IV sedation with local anesthesia. The surgeon is the key.John Standefer MD