Too Tight Neck Lift - Permanent? Revision?

Question

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?

Frank P. Fechner, MD · Answer

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.

Jed H. Horowitz, MD, FACS · Answer

If your surgery was recent, it could still be too early into your healing to determine if a #correction is necessary. Though recovery from a surgical #necklift varies from person to person, patients are generally presentable within three weeks from surgery. Generally, it will take approximately 7-10 days for the early healing. Also, wearing a #compression garment may be suggested the first week and then nightly for up to six weeks.
The #incision scars from a necklift will soften and fade away within six to twelve months from the surgery date. During this time, the rejuvenating effects of the necklift will become most obvious and the neck feels the most normal (ex. little discomfort, soft, normal sensation, no more post-op firmness). Following this stage, the true restorative effects of your necklift result will be apparent. If during your healing, you have any concerns, it is suggested to call your board-certified surgeon or their medical staff and discuss those #concerns.

Andrew Campbell, MD · Answer

Necklift patients frequently feel a tightness under the chin due to the lift that has been acheived with the procedure. This is actually a good thing, since we are treating laxity, as long as the tension is placed in the deeper tissue (SMAS) and not the skin. This sensation of tightness subsides over the first few weeks and should not be permanent.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Anthony Corrado, DO · Answer

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

Ron Shelton, MD · Answer

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.

Toby Mayer, MD · Answer

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.

Thomas E. Kaniff, MD, FACS · Answer

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. 

	Sincerely,

	Tom Kaniff

Brent Moelleken, MD · Answer

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.

Samer W. Cabbabe, MD · Answer

Often times after a neck lift, a person will feel some tightness from the associated swelling. I don't think it's a severe, strangulating sensation; just a new feeling for the patient. This is short - lived.

Catherine Huang-Begovic, MD, FACS · Answer

It sometimes takes a little while to get used to the tight feeling after surgery, but it always gets a little looser over the next few weeks.  But the tight feeling means that the muscles and skin are nicely pulled.  If you have underlying anxiety or think that you won't be able to handle the feeling, I would advise against having this surgery.  But in general, the feeling is something that most people can manage.

	Dr. Cat Begovic M.D.

Too Tight Neck Lift - Permanent? Revision?

Answers (18)

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