Sinno S, Schwitzer J, Anzai L, et al. 57 year old female patient before and 6 months after a Short scar facelift, midface lift and upper and lower blepharoplasty. Therefore, the need for repeat procedures, particularly to the neck is very rare.
Once patient's scars are mature and they are happy with their size and orientation, they can get FUE (minimally invasive hair transplants without cutting and big occipital scars) into the mature white surgical scars to further camouflage them. The case study above clearly displays how excess skin and fat can affect the neck area. The Pros and Cons of the Different Types of Neck Lifts. The patient had no other surgery. In a patient like this, I transect the platysma at about 5.
Although that may be attributed to her anatomy, I have seen this before, and from the profile views, she still has some fullness in the submandibular area. Anytime a human being gets cut (with surgery or trauma), scars heal the following way: Initially they are red, raised and hard. As previously described by the senior author (R. J. R. ), venous blood is drawn upon induction to extract platelet-rich plasma. Ten minutes are allowed to elapse after infiltration before incision for optimal hemostatic effect. I would possibly, on the right side, perform a small partial platysma transection, laterally only, for 2. When you meet with us, we may be able to offer other ideas for achieving your desired look. Prevention of acute hematoma after face-lifts. Puckering under chin after neck lift video. For details regarding the senior author's (R. R) technique, please refer to our prior article by Pezeshk et al. The marked facelift incisions are then completed with a 15 blade and the skin flaps are raised in the subcutaneous plane with facelift scissors. The incision continues into the retroauricular sulcus and is carried cephalically up to the midear. It is very important not just to look at static pictures. It may take up to three months for the swelling to go down. Secondary rhytidectomy: comprehensive review and current concepts.
Operative Plastic Surgery. Lipoplasty marginal mandibular injuries usually recover. She also has a mildly weak chin. Quality Medical Publishing. Despite the plethora of available techniques, the authors feel that the most reproducible, safe, and efficient techniques are SMAS-stacking for patients that need volume (ie long and narrow faces; Fig. How to Take Care of Your Face After a Facelift. Some before and after photos shown are not exact, in that they vary in light, contrast, clothing, background, distance from camera, hairstyle and make-up.
Dr. Feldman, what would be your idea for treating this patient? 6 The platelet-rich plasma is then drawn into a 10-cm3 dual-port sprayer syringe, with the second syringe containing an activating thrombin solution. All patients receive 2 mg of midazolam in the preoperative holding area. For those patients, an isolated neck lift, which always includes a jawline clean up, is a reasonable choice in lieu of a face-neck lift. Farmington, Connecticut Facelift | Connecticut Facial Plastic Surgery. In the front view, I see prominent labiomandibular folds and platysma laxity under the chin that does not appear to extend down to the first cervical crease. The previous facelift was done using an outdated or improper technique. If she has, I would not be overly aggressive. While patients do experience bruising from this procedure, it is usually mild and on the neck and underneath the ears. Surgery Plastic Surgery Facial Procedures How to Take Care of Your Face After a Facelift By Millicent Odunze, MD Millicent Odunze, MD Facebook Millicent Odunze Geers, MD, MPH, is a plastic surgeon with Dignity Health Medical Foundation. She also has a very slight degree of chin ptosis. There are some risks to consider before you undergo a neck lift, but adverse side effects could be minor and are typical of any surgery.
Facelift surgery is often a good fit for our patients, but some may benefit from other procedures, including non-surgical options. Puckering under chin after neck lift services. The location for these incisions is critical for minimizing scarring. Our patients often look 10 years younger after surgery. Limited skin flap elevation is performed in faces with mild skin laxity and wide malar width. But in this limited approach, through a submental incision, I stay away from actually trying to resect the gland.
I use the grimacing pictures primarily to document anatomy and demonstrate the platysma muscle. A facelift restores a more youthful facial appearance, smooths away creases and hollows, and reestablishes definition along the chin and jawline. I am not, however, recommending submandibular salivary gland resection to other surgeons who are not already comfortable with this maneuver. No way it can be assessed in early postoperative period. I am concerned that she has mentalis hyperfunction, and along with her lower lip complex, this might be suggestive of a previous weak chin. Puckering under chin after neck life insurance. Dr. Pitman: Thanks to all the panel members for their analyses and comments. Over the years, I have tried suspension sutures; I have also tried plication sutures. She has poor skin quality, and this would significantly influence what I would do. 26 The neck, décolletage, and skin elasticity and quality are evaluated.
It looks as if there was a minor slough just below the earlobe on the right side. Dr. Feldman: Actually, to my eye, her skin looks reasonably smooth and taut. Neck liposuction and mini facelift. I would lift her because of the laxity. These lateral views are where you can most appreciate the amount of skin and fat removed. Neck rejuvenation with suture lift. Image Source / Getty Images After Your Procedure Here's what to expect after a facelift. Lift-and-fill face lift: integrating the fat compartments. Differing techniques could target extra skin, fat, or muscle causing sagging and an aged neck appearance. 37 Anxiety, pain, nausea, and vomiting are preemptively managed (Fig. However, work on the anterior neck surface with platysma plication, or dissection in that area, could obviously damage the marginal mandibular branch. That way, you can redrape her facial skin without a problem. After that, if the suprahyoid angle was still not as crisply defined as I wanted, I would next transect or remove a little of the white fascia (investing deep fascia) bridging across the hyoid angle, and if I found a vertical tilt or enlargement of the anterior digastric muscles, I would next release, or reposition, or shave down the muscles as needed. From the front view, you certainly do not see a lot of platysma banding.
The decision of which SMAS technique to use is somewhat a topic of debate, including SMAS plication, 44 SMASectomy, 10, 45 extended SMAS flap, 19 high SMAS, 46, 47 and deep plane 32, 48 techniques. In my hands, I would get the best result if I did a face lift procedure. So, through the submental incision, I would trim the jowls and defat the submental midline above and between the platysma as needed. Attitude and expectations. Pixie ear deformity (ie, tethered appearing and anteriorly rotated lobule) is common and requires anatomic posterior lobule rotation, scar excision and avoidance of skin flap tension. Factors that determine how long a person will enjoy their results include skin elasticity, sun-damage, whether they smoke, and their skin tone. Notice the dramatic improvement in neck skin laxity. Manifestations, prevention, and treatment. Jawline definition with neck lipo. The previous facelift resulted in issues with the mouth, ears, or hairline.
I would release the mandibular ligaments just under the skin, which I think would eliminate her prejowl notches, and then trim the jowls and defat along and just about the jawline on each side. Dr. Pitman: What happens to the skin in the jowl? In addition to a Necklift, the Mini-facelift portion of the procedure provides a more dramatic improvement to the jawline. Patients are kept overnight with strict postoperative blood pressure, pain, and nausea management to prevent hematoma. Accessed October 14, 2018. The swelling takes approximately 3-6 months to settle.
6–12 Other potential complications include seroma, nerve injury, skin flap necrosis, siaolocele as a consequence of submandibular gland debulking, and skin flap rhytid and hairline distortion. The visible change in these photographs has occurred as a result of the procedure/s undertaken. If the anticipated distance is >5cm, then a prehairline incision is chosen to prevent postsurgical sideburn distortion. The little platysma laxity evident in this picture does not extend down as far as the first cervical crease. If there is still a problem, that would certainly influence anything I would tell her. The possible pros and cons of the different types of neck lifts show that the benefits outweigh the risks, so consider a neck lift if you're looking to rejuvenate your appearance. She was treated with lipoplasty of the neck 2 years ago.
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