Lower Face and Neck Lift
“I have everything I had twenty years ago, except now it’s all lower”
Gypsy Rose Lee
Aging and the effect of gravity cause sagging, jowling and bands to form in the neck. The goal behind facelifts and neck lifts is to restore a youthful jaw line and neckline.
Skin flap vs. SMAS flap?
There are different ways to perform facelifts. That is why a facelift by Dr. A is not the same as a facelift from Dr. B. Both are done by making an incision around the ear, but the similarities stop there. In the skin flap facelift, the surgeon primarily removes skin and then stitches everything back together. This kind of facelift will not be long lasting. In a SMAS flap facelift, cutting and lifting the skin is just the start. The SMAS is the layer of connective tissue and muscle below the skin. This is the layer that gets tightened. There are different ways to do this, depending on what we are trying to achieve.
In the neck, we repair abnormalities in the underlying muscle layer. These abnormalities cause bands to form and hang down. We often perform concurrent liposuction of the neck if there is a need. A neck lift can be done in isolation without performing a facelift.
Healing
Bandages and drains are removed after two to three days. Patients then wear a chin strap to support the lower face and neck. During the first two weeks the chin strap will worn full time. The remaining two weeks it will be worn part time. 95% of my patients look great after one month. It takes six months to fully heal.
Complications
The most troublesome complication of this procedure is injury to the facial nerve. This may cause the mouth to droop or the brow to sag. From my knowledge of anatomy and conservative dissection in the danger zones, I have been able to avoid this complication. Another infrequent complication is necrosis. Necrosis affects the outer edge of the wound. This is more frequent among smokers. We insist that you stop smoking for two weeks prior to undergoing a lower facelift. Wound necrosis is also more common with severe diabetes. Fortunately, this tends to occur behind the ear where the resulting scar is less visible.
Things to look for in a good facelift and neck lift
A nice straight, well defined jawline, good neck definition, minimal sagging in the face and neck, no visible scar, no distortion of the ears eyelids and hairlines both in the temple and behind the ears, no skin distortion, normal function and movements of all the parts of the face.
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