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Question: What is the recovery like after a neck lift?
Answer: The neck lift is often performed as an outpatient procedure, allowing patients to return home the same day. A dressing or elastic neck sling is typically applied to the neck. Patients may experience some discomfort which can be controlled with medication. Some swelling and bruising can be expected and this typically resolves within two weeks. The final result is usually seen after one to three months.
Question: I'm debating between getting a neck lift alone and a full face and neck lift. My biggest concern is that I don't want to look overdone. I'm 61 years old and I've aged fairly well but in the past few years I've developed jowls. How much improvement would I seen in a neck lift alone and would this help to maintain a natural appearance?
Answer: I commonly hear this same question. Many women in your situation are concerned about looking overdone. Even for those who have aged well and have more changes in the neck than the mid-face, there most likely has been some volume loss and sagging in the cheek region. You should see dramatic improvement in your neck and jawline with a neck lift alone. You would most likely be completely satisfied with this procedure. I usually suggest to my patients, however that they have the full face and neck lift. This is primarily because there is virtually no difference in recovery time and only slightly more scarring with the full procedure. With this there will be equal improvement in the mid-face or cheek region which will dramatically improve the overall result. The mid-face portion of the lift can produce the desired improvement while still maintaining a natural appearance.
Question: I'm interested in getting a facelift. However, there are so many different techniques out there. In fact, it seems like there's a new type of facelift every day. Can you explain to me what some of the more common or more effective facelift techniques are and what they're best at treating?
Answer: There are many types of faceliftprocedures advertised. What is most important is for you to find a qualified, board certified plastic surgeon with whom you are comfortable and confident, and allow that surgeon to perform the procedure that he or she feels is best for you in their hands. A traditional facelift is still the gold standard by which all other modified procedures are judged. Some alternative procedures involve advances in technology (endoscopic facelift) and some represent partial facelift procedures (mini-facelift, mid-face lift, necklift). Many however are more marketing gimmicks that promise less scarring, minimal anesthesia and more rapid recovery. For some patients, these may be reasonable alternatives that provide reasonable results, but usually are not as effective or lasting as more traditional procedures.
Complete facelift procedures should equally address the parts of the lower two thirds of the face, those being the cheeks and the neck, with the jawline being the transition zone between the two. For those patients with more pronounced aging changes in one or the other of these two areas, a partial facelift procedure may be appropriate.
It is also important that a face or neck lift procedure address the deeper tissue planes beneath the skin and fat. These are the fascia or SMAS layer in the face and the platysma muscle in the neck, which are continuous. Procedures that involve tightening or lifting of these layers by flap advancement, resection or suture plication should provide more dramatic, more natural and more lasting results.
Question: I'm considering liposuction of the chin, but how do I know if this is what I really need or if I'd be better served with a necklift or even a chin implant?
Answer: This is a great question. As your plastic surgeon, when seeing you in consultation for chin or sub-mental liposuction, these are exactly the options that I am considering. Improving the aesthetics of this part of the face primarily involves correcting and contouring the angle between the chin and the neck (the cervico-mental angle) as seen on profile. Other factors include achieving the ideal volume, shape and contour of the chin.
When the size of the chin is deficient, particularly in outward projection, it is augmented either with an implant, or with fillers or even with orthognathic surgery which actually advances part of the bone forward.
When excess fat has accumulated beneath the chin and in the central neck, then contour is improved either with liposuction or with direct excision.
When the cervico-mental angle is obscured due to laxity of the skin and underlying soft tissues of the neck, then tightening of these tissues with a necklift is indicated.
In general, for my patients in their 20s and 30s I most often perform liposuction, with or without a chin implant. For patients in their 30s and 40s, using a small incision beneath the chin, I often perform liposuction and or direct fat excision combined with tightening of the muscle (platysma) in the central neck. This may also be combined with a chin implant. For my patients on their 50s and over, I am more likely to recommend a full necklift, with or without chin augmentation.
Question: I have too much skin in my neck that hides my chin. I would like a necklift but I would like to have it done under local anesthesia. I hope this is possible. Do you actually cut off the extra skin? Where do you make the incision?
Answer: A neck lift procedure can be performed under local anesthesia. Often, especially for more extensive neck lifts, both the patient and the surgeon may be more comfortable having the procedure performed with IV sedation given in addition to the local. The incision is usually made around the ear, front and back, and extending along, or just within the hairline behind the ear. The neck skin and fat is separated from the deeper layers, then pulled back and up, and the excess skin is cut off. The skin tightening improves the contour of the neck, particularly at the angle between the neck and chin, and along the jawline.