Too Tight Neck Lift - Permanent? Revision?

I am interested in a neck lift but hear and read many people complaining after the surgery that they feel "strangled" and "extremely tight". I have heard some patients feel as though there is a rope around their throat and mobility of the head is limited due to a pulling sensation. This sounds very alarming and I wonder if this ever results in a permanent situation or if revision is warranted because it is too tight. What would the proper revision be?

Doctor Answers 17

Tightness after Necklift

Every patient will have a sense of tightness after a good necklift. It is a sign that the "neck muscles" (i.e. platysma muscle) was truly tightened. If there is no such feeling, chances are that improvements within the neck will be limited in extent and longevity.

It is the surgeon's responsibilty to explain this to a patient before surgery and reassure her/him that this is a normal part of a recovery. Although all my patients have this sensation, it improves gradually and it never required revision surgery.

Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Tight Feeling After Neck Lift Surgery

Dear Phoenix9239,

A tight feeling in the neck is normal after neck lift surgery and will gradually improve over time. During neck lift surgery the muscle and skin are tightened. In addition to this there is temporary swelling  associated with the surgery. As this swelling goes away so does the overly tight sensation. 


Tom Kaniff

Thomas E. Kaniff, MD, FACS
Sacramento Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

Neck Discomfort after Neck Lift

Is is not uncommon for patients to initially experience some discomfort or tightness in the neck following neck lift (platysmaplasty) or lower facelift surgery.  As the procedures function to tighten the lower face and neck, some initial tightness is normal.  These sensations are often accentuated due to swelling in the immediate postoperative period.  As time progresses, the tissues will soften and these abnormal sensations will subside.  Good Luck..... Dr. Corrado

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 34 reviews

Neck tightness after neck lift

I have seen many of my patients over many years who have had neck lifts by many excellent plastic surgeons with excellent results and no major complaints about neck strangulation except for one patient who saw had a suture plication procedure during the lift in which a long stitch had been used as a sling to tighten the neck further. This was so constrictive that the surgeon had to finally reooperate and remove the stitch improving the symptoms immediately.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Tightness of the the neck after neck lift.

In 35 years of doing face and neck lifts I have have never had a patient complain of neck tightness (which is normal) for more than a few weeks. None have ever needed revision for tightness. See an experienced face/neck lift surgeon and you won't have this problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Neck Tightness after Neck Lift

A traditional neck lift does have some initial tightness but it always relaxes over time.  This has to do with what is known as 'creep' or the tendency of the skin to stretch when tension is applied to it.  What doesn't stretch are artificial products that have been used in the past.  Threads and strings have been used for "lunchtime lifts"  They are effective for giving the appearance of a tighter neck but patients feel like they have a noose around their neck.  This may be what these people had done.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Tightness in the Neck after Neck or Facelift

When the idea is to tighten and remove excess tissues, the tissues remaining are always tightened as much as possible in order to obtain as good a result as possible, especially long term. There is, therefore, always a feeling of tightness right after surgery. This always dissipates quickly, usually within a week. No revision is ever necessary. In fact, if the tissues are not pulled tightly, a revision to tighten them may later be desired. This also happens with other procedures. As an example, after a tummy tuck everyone needs to walk bent over because the abdominal skin is pulled so tight. They always stand straight in about a week. This prevents there being extra skin in a year, just like the tightness in the neck after a neck or facelift prevents loose skin later.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Can a neck lift be too tight?

It is pretty common for patients to say that they feel very tight initially, but it does get better. Some of this is because of swelling and some because of the muscles being tightened underneath.  The only time I have seen patients seek a revision is when they have had a particular type of suture placed that runs from behind one ear, under the chin, and ends behind the other ear. In this case simply cutting one end of the suture typically releases the overly tight sensation.

Byron D. Poindexter, MD
Reston Plastic Surgeon
4.8 out of 5 stars 28 reviews

Too Tight Neck Lift - Permanent? Revision?

It is a sensation after neck lifting that is personal to each patient. Most resolve over a few months. But if this feeling of tightness persists than revision by cutting the muscle or SMAS sutures ca be done. Best from MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Neck lift tightness

I agree that a tight feeling is often present after surgery.  Most patients are comforted by the knowledge that this tight feeling will soon go away and they will have a fantastic result. 

Excessive tightness in the facelift itself is a greater problem, especially if the ears cant forward of pull down, obvious signs of surgery. 

It is generally better to place great deal of tension on the deeper layer and the correct, not too much, tension on the skin itself for a facelift.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.