Facial plastic surgery

Necklift

As the name implies, a necklift targets a drooping or sagging neck area. If the eyes are the first place we begin to show our age, then the neck is arguably the second. Vertical banding, horizontal creases, fatty jowls, the dreaded “turkey-wattle,” and a crepe-y quality to the skin all work together to make us look much older before our time. A neck lift (or platysmaplasty, so named for the plastysma muscles which run along the front of the neck) tightens the skin and the underlying muscles to lift the neck as well as improve and sharpen the contour of the jawline. It is often performed in conjunction with a face lift, but may also be done as a stand-alone procedure.

Before necklift (and facelift)		After necklift (and facelift)

Before necklift   After necklift         Before necklift   After necklift         Before necklift   After necklift

Problems Correctable With Neck Lift

Procedure of necklift

Incisions are typically shorter than those made during a traditional facelift and will normally be placed only at the earlobe and behind the ear. A platysmaplasty, involving a small incision under the chin, is commonly needed on necklift patients to remove any pronounced neck cords.

A platysmaplasty is a procedure which targets the platysma muscle which is located beneath the skin on the neck. As part of the aging process, many people will notice that these muscles begin to protrude from the neck resulting in two neck “cords” or bands running vertically down their necks.

The ideal neck. Tight platysma causes jaw line to be well defined and neck angle to be sharp.		Loose platysma and descended facial fat cause jowling and a poorly defined jaw line. In addition, neck bands form causing the typical turkey neck appearance.

Above picture demonstrates how the platysma muscle is suspended under the jaw bone giving a well defined mandibular border as well as creating a youthful neck angle. Midline platysma muscle suture eliminates Turkey Neck.

The neck muscles can then be tightened and any excess fat removed. The incisions near the ears also allow for removal of some excess skin. Finally, the incisions are closed with sutures.

In patients with excellent skin elasticity, a necklift may be performed alone. More commonly, when skin elasticity is fair or poor, a facelift is performed as well, to remove excess skin that would otherwise remain.

Recovery

The physical recovery (as in discomfort and anaesthetic recovery) after a facelift is usually fairly mild and lasts for several days. It is well controlled with regular pain mediation.

As well there is an "appearance" recovery. Typically swelling and bruising should subside within 2-4 weeks. Final results of a facelift may be apparent in 1-2 months. Incision lines will continue to refine and fade for 1 year.

A chin support is used for the first month to help mold the re contoured structures during the healing period.

Complications

Early complications

There are risks involved in any form of surgery, and although these are uncommon, they cannot be ignored.

Infection after a facelift usually causes redness and inflammation near the incision. This can usually be treated with antibiotics, but occasionally may have to be drained. It can lead to delayed healing and increased scarring.

Bleeding after a facelift can cause a blood collection called a hematoma. If this is large enough it may have to be removed otherwise it can cause healing problems.

Delayed wound healing or skin loss can be caused by infection or bleeding after a facelift. It can also be caused by poor skin circulation. This is most common behind the ear. Secondary "touchup" surgery may be needed for this. It is more common in smokers, and for this reason it is recommended that smokers be smoke free for one month prior to surgery, or have a "mini" procedure.

Nerve related problems can result in numbness or weakness in the face after a facelift. This is usually due to swelling or stretching of the nerves and resolves. Rarely this can be permanent. It is normal to have some cheek or ear numbness after facelift surgery which usually resolves over three months.

Late complications

Hair loss may develop around the scars after a facelift.

Wide or thick scars are unusual and tend to occur behind the ears. They are more likely in dark skinned patients. These can usually be improved with "touchup" procedures.

Ear lobe deformities can occur as the tightened neck and cheek skin heals. These may benefit from a "touchup".

Skin color variation (darkening or reddening) can occur in some facelift patients due to abnormal personal healing characteristics.