Necklift

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NECKLIFTS

Aging of the neck presents in many different forms, from changes in the skin, to muscles, to deeper structures like submandibular glands and fat. There are myriad techniques we use for the improvement of these many changes.

Neck rejuvenation and contouring procedures are challenging and continually advancing. Although the techniques are evolving, the anatomy is constant, and surgeons with a firm understanding of the anatomic relationships within the neck are able to deliver consistent and aesthetically pleasing results for their patients.

“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT

WHAT IS A NECK LIFT?

On occasion, an isolated neck lift is possible. More often, it is performed in conjunction with a lower face lift. Isolated neck lifts take many forms, depending upon the changes that may be present and addressed. Limited incisions behind the ears are sometimes employed to tighten some of the loose neck skin. However, a complete neck rejuvenation is rarely possible with limited incisions.

A submental incision (incision hidden below the chin) is also used to remove fatty deposits in this area and to tighten muscle bands. Finally, Giampappa sutures are employed: these are criss-cross sutures which allow tightening of the deeper structures and fixation to the tissues behind the ear (mastoid fascia). As can be seen, isolated neck lift procedures take varied forms.

AM I A CANDIDATE FOR A NECK LIFT?

Patients that are good candidates for an isolated neck lift are patients with the following:
Loose neck skin without much laxity of the lower face and jawline
Moderate neck bands
Moderate submental fullness
Any combination of the above and as long as the patient understands that the lower face and jaw line will not be improved by the neck lift.

This patient had neck liposuction and the use of Giampappa sutures to give her a partial improvement of her neck. Surgery was also performed on the upper two-thirds of her face (brow lifts, upper and lower blepharoplasty and cheek lifts, that we designed and call the Hammock Lift

WHY THE NECK?

People divide the face and the neck, but the appearance of the neck has a huge bearing on the appearance of the face.

In the illustration to the right, I have only changed the fullness of the neck. The secondary effects make the face look much older. So it pays to define the neck as best as one can.

By choosing to do an isolated neck procedure with lasers or surgery, you will get some improvement of the neck and the face. By choosing to going for the whole Monty and improving the neck properly with a defined facelift and necklift, you get the best results!

“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.” D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT

HOW WILL I BE ASSESSED?

Examination of the neck structures as described under the “Conditions” Neck section will allow one to determine if an isolated neck rejuvenation procedure is a reasonable option. It is important to remember that with the neck, tissue restitution occurs: this is a concept that is not well-known in plastic surgery or, is at least not well appreciated.

Essentially, what you see immediately after surgery is NOT what you get in the medium or long term. The skin of the neck and décolleté is prone to develop fine lines, deep-set lines, loss of skin elasticity and discoloration. Neck skin is thinner than facial skin. The face has 30 times the pilosebaceous units than the neck or chest and 40 times that of the hands and arms. Therefore, neck skin responds more slowly to any surface skin treatments like lasers and chemical peels.

WHAT OTHER PROCEDURES MAY BE PERFORMED WITH A NECK LIFT?

The commonest procedure performed at the same time as a neck lift is a face lift. This combination gives a congruous improvement from the midface all the way down to the neck. Other procedures include liposuction of the neck, chin augmentation, and platysma plication.

This patient had a Hammock lift with neck liposuction which gives her an improvement in the jawline and neck without a full facelift and necklift.

ISOLATED NECKLIFT PROCEDURES EXPLAINED

This patient had an isolated necklift procedure where liposuction, Giampappa sutures to tighten the tendons and excision of a small amount of skin behind the ears was done. This was not a full facelift and necklift so you can see that although there is an improvement in the neck, there is still some laxity and presence of jowls.

However, the patient has a more defined neck and a better jawline. This procedure takes about one hour and 30 minutes (compared to a full facelift and necklift which takes 3 to 5 hours and is more involved)

ANOTHER EXAMPLE WITH EXPLANATION

The beauty of a well-performed Hammock Lift: the Hammock Lift includes manipulation of the brow shape, upper and lower blepharoplasty and cheek lifts, which gives her the nice improvement in the top two-thirds of the face.

The improvement in the neck is from liposuction and limited incision neck tightening. Again, not as great a result with the neck as we can get with a proper facelift and neck lift, but an excellent result with an isolated neck procedure. Patient sent her sister in for the same procedures!

BY COMPARISON, YOU CAN SEE THE MORE PRONOUNCED IMPROVEMENT IN THE NECK (AND LOWER FACE) WITH A FULL FACELIFT AND NECKLIFT

These photos allow you to compare the more definitive results that may be obtained with a proper facelift and necklift. It is important to understand the differences in results with more limited procedures. Caveat Emptor!

FOR THE BEST RESULTS

We performed a full facelift and neck lift which includes improvement in the cheeks, lower face, jowls, jawline, neck, and the texture of the skin.

Improvement is sought in the lip lines, lip fullness, cheek fullness, and a youthful chin. Only by combining all these improvements can an overall excellent result be obtained.

The gold standard gives golden results!

FAQs

WHERE WILL MY SURGERY BE PERFORMED

Facelifts are performed in an operating theatre for the sake of sterility and your comfort. We have a team of anesthesiologists and nurses who are trained to specifically look after patients undergoing these procedures. These procedures are generally performed using MAC sedation or general anesthesia

WHAT KIND OF ANESTHESIA WILL BE USED?

General anesthesia is best for facelifts and necklifts, although in some instances, sedation anesthesia may also be used.

WHAT KIND OF SUTURES ARE USED?

With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days.

DO YOU USE LASERS FOR THIS SURGERY?

Lasers will be used to treat peri-oral lines, “sleep lines” on the cheeks and other skin irregularities. The advantage of using all the skills and modalities available to us, rather than performing quick or weekend or one-hour facelifts is that it allows us to give you a remarkable improvement not only in the structure and appearance of the face, but also the health and smoothness of the skin as seen here:

HOW LONG DOES THE SURGERY TAKE?

Necklifts take 1 to 2 hours and Facelift surgery can take between 3 and 5 hours of surgery time, depending upon the planned procedures, patient’s face-type, age and other factors.

WHAT ARE THE MOST COMMON RISKS OF NECKLIFTS?

Bruising and swelling are de rigeur! However, significant long-lasting complications are rare.
Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.

Everyone will experience some numbness in the face: this resolves over weeks to months. This occurs because of the dissection of the face. This is not a complication.
Because of the dissection and repositioning of the tissues, it is common for there to be small differences in the smile between the right and left sides: this is usually only noticeable to the patient and to Dr. Patel! It recovers over a few weeks.

All faces have asymmetry and there will be some degree of asymmetry. This is to be expected.
Permanent weakness of nerves and muscles is rare.
The scars are usually very well hidden. However, some patients may have a tendency to cause hypertrophic scarring: in such cases, certain lasers and treatments will help. By-and-large, scars are rarely a problem. With Caucasian skin, pinkness of scars is to be expected for several weeks. With darker skin, some hyperpigmentation may occur.

HOW MUCH BRUISING AND SWELLING WILL I HAVE?

Bruising around the jawline and upper neck is common for the first two weeks. The face itself usually will not get much bruising, but may be pink from any laser work. Swelling is to be expected because of the extent of the surgery: the swelling abates over about two weeks.

DOES INSURANCE COVER NECKLIFTS?

Cosmetic procedures are not covered by insurance

HOW PAINFUL IS A NECKLIFT?

A sensation of firmness will be there because of the swelling: this is present for the first few days. Most patients do not need prescription pain medication after the first two to three days.

ARE THERE ANY RESTRICTIONS AND WHEN MAY I RETURN TO WORK?

We will provide you with a special neck dressing which you will wear as much as you can for the first couple of weeks. You will also apply a moisturizer (any brand will do) to the face as healing skin and lasered skin requires moisturizer. Icing the face also helps for the first two to three days. Many of our patients will ice the face for longer as it feels good. You may be up-and-about the day after surgery. Gentle exercise (treadmill and stationary bicycle) may be commenced by day 3. More vigorous exercise like skiing and tennis may be resumed by about day 10.

SHOULD I LOSE WEIGHT BEFORE MY NECKLIFT?

Ideally, you should be within about 3 – 5 pounds of your desired weight. Whereas I can create the most beautiful angles and curves in slim patients, if you are able to get close to your ideal weight, we can wonders as can be seen in this patient who lost some weight before her surgery and is absolutely chuffed at her result:

In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision.

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Contact Info

Dr. BCK Patel MD, FRCS
1025E 3300S
Salt Lake City, Utah 84106, USA

(801) 413-3599 (phone/text)
E-Mail: bckpatelmd@gmail.com
bckpatel.info

Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA
(435) 215-0014
E: drbckpatel@gmail.com