Neck surgery can take place in the surgeon's office-based surgical facility, an outpatient surgery center or in a hospital. Any patient over 50 requires an electrocardiogram (EKG) in addition to full laboratory testing which includes blood counts, coagulation profile, and even electrolytes as it has been shown certain medications can cause potentially serious electrolyte disturbances perioperatively. Of course, it's very important to leave an adequate cushion of "essential fat" under the skin when you elevate the flap. Swelling under chin after neck lift. I undermine the skin along and above the jawline, and release the mandibular ligaments, and then I look directly through the submental incision and remove the glob of excess jowl fat with the extended micro-tip electrocautery so there's no bleeding.
Although very well tolerated, a facelift is a major surgical procedure and will require some downtime. The improvement of neck and jawline contour is relatively simple in this case. The high-superficial musculoaponeurotic system technique in facial rejuvenation: an update. The major signs of age – including deep creases and sagging of the face – can be treated with a surgical procedure known as a facelift, or rhytidectomy. Do not underestimate the importance of head elevation. Dr. Puckering under chin after neck lift procedure. Feldman: I would first do an appropriate subcutaneous defatting, either by an open fat resection technique or by lipoplasty, and then reassess the contour and definition of the hyoid angle. 68 year old female before and 2 months after mini lateral neck lift (2 small 1 cm incisions). Remember, this was a quick procedure done with minimal sedation and local anesthesia that took about 30 minutes! On the day of your procedure, you'll arrive at the surgery center, usually in the morning.
If so, a neck lift could create a smoother, younger-looking neck to take years off of your appearance. There is a parking garage for the surgery center with direct elevators from the garage to the center. To fill this area, fat could be injected at a later, separate procedure. Getting Started with Facelift Surgery - What's the First Step? His scars are still a bit red and we suggested he continue using the scar product and massaging aggressively. How to Take Care of Your Face After a Facelift. 5 to 6 cm from the angle of the mandible and then rotate that flap to enhance the posterior mandibular contouring. As Dr. Feldman recommended for an earlier case, filling her prejowl area with a bit of fat would be worthwhile. In the scenario of prominent submandibular glands, 10 units of Botox (Allergan, Inc., Irvine, Calif. ) are directly injected into the gland intraoperatively and then at 6–8 weeks postoperatively to promote submandibular gland atrophy. The SMAS is secured with figure-of-eight 3-0 Mersilene (Ethicon, Inc., Somerville, N. ), followed by running 4-0 Mersilene (Ethicon, Inc. ) to prevent SMAS irregularities.
The transverse skin creases in the neck will be improved, but not entirely eliminated, simply by undermining and releasing the skin creases from their underlying attachments to the superficial platysma fascia. Monitor your incisions for signs of infection: spreading redness, swelling, tightness, pus or drainage, excessive pain, increasing warmth. Once her skin has been widely freed, I think that it will shrink down smoothly and allow her to have a nice result. Cardiovascular disease. Second Photo: AFTER FACELIFT BY ANOTHER SURGEON, PATIENT WAS LEFT WITH CONSPICUOUS STAIRSTEP SCARRING, PUCKERING IN THE CROWS FEET AREA AND UNDER THE EAR LOBE. The extent of skin undermining is individualized to the shape and width of the patients face (Fig. In McCarthy JG, Galiano RD, Boutros SG, eds. She needs a full neck lift because she has a lot of extra skin but was happy with this tiny scar approach. The Pros and Cons of the Different Types of Neck Lifts. But it would not be easy to flatten the submandibular area the way she would like or the way we would like to see her. Filling the facial compartments during a face lift.
In patients such as this, I usually do a wide lateral platysma dissection with the SMAS to get a significant rotation and flap elevation. Dr. Pitman: Would you approach her neck anteriorly, as well as laterally? 30 On a technical note, preplatysmal fat is resected from lateral to medial as it is easy to inadvertently enter the subplatysmal plane with a medial approach. We inform patients that it can take up to 6 months to see the final results of their procedure. Getting Better Results in Facelifting : Plastic and Reconstructive Surgery – Global Open. We encourage patients to have a good intake of fluids to aid in this process. But rough use of a blunt instrument could theoretically disrupt the anatomic branch.
LATERAL PLATYSMAL WINDOW AND SMAS MANEUVERS. All photographs are of actual patients. Feldman, if you performed a corset platysmaplasty and a vertical platysma plication overlying the gland, do you think you could get enough improvement without actually having to resect the gland? Her small degree of chin ptosis is easily correctable with a leveling technique, which simply means reapproximating the subcutaneous fat and the skin at an even level on each side of the submental incision. Standardized facial photographs are obtained and essential for preoperative planning, patient counseling, and medicolegal purposes. Considerations include the amount and location of excess cervical adiposity, the presence of jowling, severity of dynamic and static platysmal banding, and the distance between the medial platysmal borders (< or >2 cm; Fig. Dr. Aston: I would like to add another point. I think the secondary lift is risky if any conditions such as smoking are still present. We will advise you of complementary procedures that could help you reach your goals and whether they should be combined or done separately. Non-surgical treatments like laser treatments and Botox are popular also. The location for these incisions is critical for minimizing scarring. POSTOPERATIVE MANAGEMENT.
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