FIRST QUARTER 2006, VOLUME 20, NUMBER 1

Your neck tells all… here’s how you rejuvenate and improve its appearance

IN THIS ISSUE

Skin Blemishes, Birthmarks… Embrace, Conceal, or Remove

Your neck tells all… here’s how you rejuvenate and improve its appearance

Ask the Surgeon / Health Tip / What’s New

Complementary services boost patient satisfaction and care

Take a look at your neck. Excess skin and fat, along with weakened muscles may be adding unnecessary years to your appearance.

As we get older, our skin loses its elasticity. Bands of muscle that support the skin weaken and stretch, while fatty deposits may collect under the skin. The jaw line may appear less pronounced with loose deposits of hanging tissue-resembling a turkey wattle. Patients who have experienced significant weight loss, regardless of age, can have excess skin just hanging.

This can make you look older and feel less attractive. Maybe it is time to consider a necklift-which may include any combination of procedures-to improve the area of the neck. You and your facial plastic surgeon can review these options, from facelift to liposuction, and decide on the best plan for the new, rejuvenated you.

A Facelift
Your facial plastic surgeon may recommend a facelift, which revitalizes the lower two-thirds of your face. The procedure revitalizes your look by lifting and tightening sagging skin and underlying tissue, reducing jowls, and refining the jaw line. Incisions are made behind your hairline, around the ear, and possibly in the crease beneath your chin. The skin of the neck and of the cheek is lifted, the underlying connective tissue is repositioned, and excess skin is removed. The skin is secured with sutures. The facelift can be combined with fat removal in the neck (liposuction) or muscle tightening.

Excess skin removal
This procedure is for the patient who has extensive skin hanging, or a turkey wattle.

An incision is made, the skin is pulled smooth, and the excess is trimmed. The incision is closed in a zigzag pattern, also known as Z-plasty, to disguise the scar. While the technique is very effective in removing unwanted skin, some scarring will be apparent. For some patients-especially those that like wearing open necklines-this may be unacceptable, in which case a facelift or tightening procedure may be a better approach.

Tightening procedure
Younger patients may not need a full facelift, and instead may opt for tightening the sagging skin and protruding muscles in the neck. A small incision is hidden in the crease beneath the chin or by the ears. The platysmal bands, or supportive muscles, are tightened and sutured in place. Excess fat may be suctioned out through the same incision; a small amount of the skin also may be removed. Your physician may be able to perform the procedure endoscopically, which is less invasive. (An endoscope has a small camera attached to a thin tube, thus a smaller incision is necessary.) This tightening procedure results in a better angle between the neck and the jaw line, plus smooth skin.

Chin augmentation
If you have a weak or receding chin, problems in the neck area may appear more significant. A chin implant strengthens your jaw line and profile. For best results, your physician may combine the chin implant with removal of excess skin and tightening of the platysmal bands. If a combination of procedures are performed, the implant may be placed through an incision under the chin. If not, the implant may be placed through an incision made inside the mouth, between the lower lip and gum.

In a facelift, the hair and creases of the outer ear are used to hide facelift scars in women. The incision begins in the hair behind the temple, passes just within the ear, and then loops around it. In men, the facelift incision may pass in front of each ear where it can be hidden by the sideburns. It does not pass through the ear, as in women, because that the chin. If not, the implant may be placed through an incision made inside the mouth, between the lower lip and gum.

Liposuction
The goal of liposuction is to remove the fatty deposits in the neck area. A small incision is placed in a natural crease below the chin or near the ear. A small tube is inserted and the fat cells are vacuumed out. Liposuction is often combined with other procedures. It can refine the jaw line and improve your profile.

Overview of the surgery
Most of the surgeries mentioned are performed under local anesthesia and sedation. The time in surgery depends on how many procedures will be performed and to what extent. After the incisions are closed, a light dressing is applied. These surgeries are done as an outpatient procedure, so you get to go home on the same day as the surgery. Cold compresses should be applied during the first 48 hours to minimize swelling. Keep your head elevated! Your physician will give you pain medication to relieve any discomfort, along with strict postoperative instructions to follow. You’ll be back to normal-and work-usually within a week to 10 days.

Is it right for you
If you are considering any procedure, the first thing you should do is get information. Start with your facial plastic surgeon’s office, where you will find brochures, articles, before-and-after photos, and more. This will help you to discover your options and to formulate questions for your consultation appointment. Your surgeon will go over all of the specifics of the procedure(s) that you