Face and Neck Lift

1. What Is Face and Neck Lift?

A face and neck lift is an aesthetic surgical procedure that addresses:

• The lower face area (jawline, jowls and sagging along the jaw),
• The midface (descent of the cheeks and cheekbone area),
• The neck and double chin line

with the aim of:

• Repositioning sagging tissues,
• Reducing excess skin and fat,
• Restoring the contours of the face and neck to a younger, fresher and more defined appearance.

The goal is not to change the person’s facial identity but to take their existing face to a fresher, more rested and better version for their age.

2. In Which Situations Is Face and Neck Lift Preferred?

Face and neck lift is usually considered when there are complaints such as:

• Marked sagging and loss of definition along the jawline and visible jowls,
• Deepening lines around the mouth due to descent of the cheeks,
• Fullness and a “turkey neck” appearance in the neck area,
• Wrinkles, laxity and band like lines in the neck skin,
• The feeling of “I feel younger than I look, but in the mirror I see a more tired and older face”,
• Situations where fillers, botox and skin care treatments alone are no longer sufficient.

Especially in patients where the lower face and neck are both affected, a combined face and neck lift provides a more holistic rejuvenation.

3. Who Is a Suitable Candidate for Face and Neck Lift?

Suitable candidates are generally:

• Individuals whose overall health is appropriate for surgery,
• Those who have evident sagging, laxity and contour loss in the face and neck area,
• Patients with reasonable skin quality and suitable facial bone and soft tissue structure,
• People who are not looking to turn back twenty years but who want to see a natural, refreshed and “better version of themselves”,
• Individuals who can tolerate being partially away from social life during the first weeks of recovery,
• Patients with realistic expectations about results, scars and the healing process.

Conditions such as diabetes, hypertension, smoking and clotting disorders are always taken into account in surgical planning and may require collaboration with relevant specialties.

4. Preoperative Evaluation and Planning

Before surgery:

The patient’s medical history, current medications, previous operations and allergies are reviewed in detail.

The face and neck are evaluated:

• At rest,
• While smiling, talking and making facial expressions.

The jawline, cheeks and neck contours are analysed for:

• Amount and distribution of excess skin,
• Fat tissue distribution,
• The presence and severity of bands in the neck muscles (platysma).

It is explained in detail:

• How much lifting can be achieved in which areas,
• Where the scars will be placed (in front of the ear, behind the ear, within the hairline),
• Whether an additional incision in the neck will be necessary.

In some cases, combined procedures may be planned such as:

• Upper and lower eyelid surgery,
• Temporal or brow lift,
• Facial fat injection (fat transfer),
• Skin quality improving treatments (laser, mesotherapy etc.).

Necessary blood tests, anaesthesia assessment and additional investigations are performed.

A plan is made for discontinuing or reducing smoking, blood thinners and certain herbal products before surgery.

The aim is to create a customised and realistic rejuvenation plan that sees the face and neck as one frame.

5. How Is Face and Neck Lift Performed?

Face and neck lift is performed under general anaesthesia.

a) Face Lift (Mid and Lower Face)

The incisions are usually:

• Planned along a line that starts in front of the ear,
• Then continues behind the ear and into the hair bearing scalp.

The skin is carefully lifted off the underlying tissues in a controlled manner.

Instead of pulling only the skin, the underlying layer called SMAS (Superficial Musculoaponeurotic System) is repositioned upward and backward and secured.

Excess skin is removed in harmony with the natural lines, and the incisions are closed with aesthetic suturing techniques.

In this way:

• Sagging of the cheeks,
• Laxity along the jawline,
• Deep lines beside the mouth

are tightened for a more youthful appearance.

b) Neck Lift (Double Chin and Neck Contours)

Neck lift can be performed alone but is most often combined with face lift:

• If there is laxity in the double chin area and neck skin,
• A small incision under the chin can be used to tighten the neck muscles (platysma) in the midline,
• The neck skin and muscles on the sides are then pulled upward and backward through incisions behind the ear and fixed in their new position.

If there is excess fat under the chin, liposuction may be applied in this area.

The aim is to:

• Define the angle between the chin and the neck,
• Reduce the “turkey neck” appearance,
• Tighten the neck skin into a more youthful contour.

6. The Role of SMAS and Neck Muscles (Platysma)

In modern face and neck lift techniques:

• Tightening the skin alone can lead to unnatural and short lived results.

Therefore, the SMAS layer under the skin and the neck muscles (platysma) are addressed.

These layers:

• Carry the sagging soft tissues of the face,
• Allow the surgeon not only to tighten the skin but also to reposition the supportive framework of the face upward and backward.

This helps to:

• Achieve more natural results,
• Avoid a “wind tunnel” look and instead create a younger but recognisable face,
• Provide a longer lasting effect.

7. Procedures That Can Be Combined with Face and Neck Lift

Depending on the patient’s needs, the following can be performed in the same session as face and neck lift:

• Upper and lower eyelid surgery (blepharoplasty),
• Temporal and brow lift,
• Facial fat transfer (fat grafting),
• In selected cases, small area liposuction.

Supportive treatments planned for the future may include:

• Botox,
• Fillers,
• Laser and skin rejuvenation procedures.

The goal is not only to tighten the skin but to achieve a balanced rejuvenation in terms of volume, tissue and skin quality.

8. The First Postoperative Days: Bandage, Swelling, Bruising and Pain

In the first days:

• Swelling, mild tightness and a feeling of pressure in the face and neck are normal,
• Bruising can occur around the ears, along the jawline and in the neck and usually decreases significantly within 10 to 14 days.

An elastic bandage or a special facial garment may be used in the first days. This helps:

• Control swelling,
• Support the tissues in their new position.

Pain is usually mild to moderate and can be managed with pain medication prescribed by the surgeon.

Temporary numbness, tingling or altered sensation around the ears and neck can be expected and usually improves over time.

For most patients, a stay of one night in hospital is sufficient. During this time:

• Bleeding and swelling are monitored,
• Initial dressings are carried out,
• The first mobilisation and changes in position are done under supervision of the medical team.

9. Staying in Istanbul, Follow Ups and Returning Home

For patients coming from abroad or from other cities:

• A stay of about 7 to 10 days in Istanbul is usually recommended to allow for:
  1. Early dressings,
  2. Removal of drains if used,
  3. Inspection and removal of sutures if needed (depending on the technique),
  4. Assessment of swelling, bruising and face and neck movements.

During this period, patients receive detailed instructions on:

• Sleeping with the head elevated,
• Avoiding direct trauma to the face and neck area,
• How to avoid lying on the side, sudden head movements and heavy lifting,
• What to pay attention to in terms of showering, hair washing, make up and skin care.

For long haul flights, the risks of clot formation and swelling are considered, and advice such as:

• Drinking plenty of water before and after the flight,
• Short walks and simple leg exercises during the flight

may be recommended.

10. Returning to Social Life, Work and Sports

At home:

• The first days are mostly focused on rest,
• Within 3 to 5 days, simple daily activities such as short walks and light household tasks become more manageable.

Return to work:

• Desk based workers usually return to work around 7 to 10 days after surgery, depending on the degree of swelling and bruising and the intensity of their job,
• For people whose face is very visible in their profession, such as those working on camera, this timeframe may be extended individually.

Social life:

• By the end of the first week, light make up and hair styling can help camouflage some of the swelling and bruising,
• Most patients begin to feel more comfortable in social settings between day 10 and 14.

Sports:

• Light walking is encouraged early in the recovery period,
• For running, weight training, yoga or pilates and activities that may place strain on the head and neck, a waiting period of about 3 to 4 weeks is often recommended,
• For contact sports or sports with a high risk of impact, 4 to 6 weeks is usually advised.

The exact timing is decided at follow up appointments based on the individual healing process.

11. Scars, Hairline and Natural Appearance

Incisions are usually:

• Placed in front of the ear along natural lines,
• Extended behind the ear and into the hair bearing scalp.

In this way, scars are hidden as much as possible:

• In the hairline,
• Within the natural folds around the ear.

Scars:

• Are more visible and reddish in the first months,
• Gradually lighten in colour and become finer over time,
• Their final appearance also depends on the individual’s healing characteristics.

Natural appearance:

The aim is not to give the face a different identity but to create a more rested and younger version of the person’s own face.

Instead of an over tightened, expressionless and artificial look, the goal is a balanced result where:

• The jawline is more defined,
• The cheeks appear higher and more lifted,
• The neck and double chin line look firmer and younger,
• The “dropped” areas of the face are repositioned.

12. Possible Risks and Complications

Face and neck lift is a procedure that requires experience and appropriate patient selection. As with any surgery, there are potential risks, such as:

• Bleeding and haematoma formation (collection of blood under the skin),
• Infection,
• Delayed wound healing and wound breakdown along the suture line,
• Temporary or sometimes longer lasting numbness, tingling or altered sensation,
• Asymmetry and contour irregularities,
• Scars that are more visible than expected,
• Rarely, temporary weakness of facial movement due to nerve involvement,
• General surgical risks such as clot formation and risks related to anaesthesia.

To reduce these risks, it is very important to ensure:

• Correct indication,
• An experienced surgeon and a well equipped centre,
• Thorough preoperative preparation,
• Avoidance of smoking in the postoperative period,
• Good adherence to recommended care and follow ups.

All risks and possible scenarios should be discussed in detail with each patient before surgery.

13. Results and Expectation Management

The goals of face and neck lift are to achieve:

• A more defined jawline,
• Cheeks that appear higher and more lifted,
• A younger and tighter neck and double chin line,
• An overall facial expression that looks rested, refreshed and more youthful.

In the first 2 to 3 weeks:

• Swelling, bruising and mild asymmetry may prevent the final result from being visible.

Within 4 to 6 weeks, the contours of the face and neck usually appear more natural.

The skin, deeper tissues and scars settle into a more mature form within 3 to 6 months.

The most satisfying results are seen in patients who:

• Have realistic expectations,
• Maintain a stable weight,
• Limit or stop smoking,
• Attend follow ups regularly and comply with recommended care.