Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, and blood thinners 10–14 days before. Stop fish oil, vitamin E, ginseng, ginkgo. Smoking and vaping must stop 4 weeks before through 6 weeks after. Wash your hair and neck the morning of surgery. Bring zip-up or button shirts. Arrange home help for the first week.
The day of surgery
Neck lift is performed under general anaesthesia or deep sedation, runs 2–4 hours alone or longer when bundled with facelift, and discharges same-day or with a single overnight stay. You wake up with a head and chin-strap dressing supporting the neck, small drains in some cases, and significant under-chin and neck swelling already developing. Swallowing feels strange because of the dressing and the swelling.
Days 1–3: peak swelling
Swelling peaks day 2–3, concentrated under the chin, along the jawline, and into the upper neck. Bruising tracks down into the chest. Sleep with head elevated 45 degrees and avoid turning your head sharply. Strict blood-pressure control matters in the first 48 hours, a spike triggers the most common serious complication, neck haematoma. Take any prescribed BP medication on schedule and avoid straining, bending, and emotional outbursts. Cold compresses on the neck (outside the dressing). Soft diet. No straining, no bending, no lifting. Pain is moderate.
Week 1: stitches out, bruising fades
First dressing change day 2–3; drains usually out at the same visit. The chin-strap support is worn continuously for 1–2 weeks and at night only for another 2–4 weeks. Submental sutures come out around day 7, retroauricular (behind-ear) sutures at day 10–14 because they sit under more tension. Bruising shifts from purple to yellow-green. The neck still looks fuller than the final result.
Weeks 2–4: back to public
Office work from week 2 for some, week 3 for most. Visible bruising mostly gone. Residual neck swelling reads as a slight fullness under the jaw that softens through week 4. The neck feels stiff and slightly numb. The under-chin incision (if used) is pink and visible at close range but already healing well. No strenuous exercise until week 4.
Months 2–3: swelling resolves
Swelling resolves and the new jaw and neck contour becomes clearly visible. Numbness improves. Scars are pink and fading.
Months 6–12: the final result
Final result by month 6 with minor settling through month 12. Scars are largely faded and concealed by month 6. Numbness under the chin and along the upper neck is largely resolved for most patients; some small patches persist longer. Neck lifts age with you, durable but not permanent.
Red flags: when to call the clinic
Call the clinic the same day for: sudden firm one-sided neck swelling that is rapidly increasing (haematoma in the neck is more time-critical than in the face because of airway proximity), increasing one-sided pain, fever over 38.5°C, pus or yellow discharge, skin under the chin that turns dusky white or black, or sudden difficulty swallowing. Go to an emergency room immediately for difficulty breathing, sudden voice change, or stridor (high-pitched breathing sound), these can indicate airway-compromising haematoma and are time-critical in the first 72 hours. Tell the ER staff explicitly: "I have had recent neck surgery" so they avoid airway trauma during any intubation. Routine neck stiffness, intermittent tightness when swallowing, and asymmetric swelling in the first week are not red flags.