Neck Lift Techniques & Types
Overview
All types of facelifts improve the jaw line and also elevates the area under the chin to improve the angle between the chin and neck. Some patients have excess fat under the chin and upper part of the neck superficial to the sheet of muscle, and also there is some excess of fat deep to the muscle in the midline of the neck.
INTRODUCTION
Some patients can benefit from liposuction of the area under the chin, and the facelift improves the appearance of the face and neck. However, patients, who have excess fat, severe laxity of skin at the upper and lower part of the neck with prominent inner edge of the platysma muscle creating prominent muscle bands require opening up the neck through a small incision under the chin in the skin fold.
We then extend the incision behind the ear in the crease and also over the mastoid area and hairline behind the ear.
OPEN NECK LIFT
This procedure can be combined with a macs facelift with a scar around the sideburn, in front of the ear and a full scar behind the ear in the crease and over the mastoid area and hairline, also with a small scar under the chin. The skin is elevated from the cheek and upper part of the neck. The excess fat on the outer surface of the sheet of platysma muscle and some fat from the midline is excised.
The medial or inner edge of the platysma muscle is approximated in the midline in one or two layers and then the outer edge of the sheet of platysma muscle is lifted with a suture to fascia over the mastoid area and the line of angle between the chin and upper part of the neck which creates a nice definition of jaw line and also creates a nice tight cylindrical appearance of the neck. Whenever there is moderate to excess skin of the neck, then the skin is excised both at the cheek and also behind the ear and is re-draped in an upward and backwards direction.
An open neck lift takes longer to perform and at the same time there is more risk of oozing and bleeding with post-operative bruising, but the open neck lift gives a very youthful appearance of the jaw line and upper neck with longer lasting results.
ISOLATED NECK LIFT
In younger patients, when there are no changes on the face in the area of cheek and jaw line requiring facelift, but they have a heavy neck with excess fat and some excess of skin, and also in patients who do not like to have a longer scar in front of the ear or around the sideburn and prefer to have a better appearance of the neck with improved angle between the chin and neck, they are suitable to have an isolated neck lift.
The scar is kept around the earlobe in the crease and to a variable distance behind the ear either in the skin crease only or in cases where there is some excess of skin then the scar is extended over the mastoid area and hairline behind the ear. Isolated neck lift also needs access through a small scar under the chin in the crease.
Excision of fat, plication of medial edges of platysma muscle and elevation of the outer part of the sheet of platysma muscle to the mastoid fascia is performed as in the open neck lift.
KEY FACTS:
People benefit most from a facelift when their face and neck has begun to sag
Facelifts work better for the lower half of the face, particularly the jawline and neck
If you are overweight and intend to lose weight, do so before the surgery to increase the effect of the facelift
If you smoke, you should stop smoking at least two weeks before the operation
Facelifts can be carried out under either general or local anaesthetic
Facelifts do not stop the clock, but does put the clock back