Face
The face and neck have been considered the ultimate procedure for the aging face for many years. However, it is declining in popularity as lots of newer and less invasive options have been developed.
How do you know that you need a facelift?
Lots of loose skin is the best reason to consider and facelift or a neck lift. Ropy bands of muscle under the chin (the turkey gobbler neck) is difficult to fix with a laser alone. Extra skin that you can grab may be an indication that a neck lift is needed. Many less invasive versions of the procedure exist; shorter scars and less extensive work is needed to get the same or better results. A combination of liposuction, radiofrequency assisted skin shrinking, and external laser resurfacing can make the face and neck look younger, less droopy, and tighter. Many patients have some sagging skin because the face loses volume with aging. Fat grafting adds permanent volume, using (recycling) your own fat to fill in the hollows under your eyes, cheeks, and around the eyes. Thinning lips can be lightly contoured with fat grafting. Injectable fillers can add volume as well, but these will not last as long as fat grafting.
The procedure:
Incisions are made around the ears and under the chin. Skin is lifted and the muscle bands under the chin are sewn together to create a suspending “hammock” for the chin so it doesn’t droop. Skin is relocated up and behind the ears (excess neck skin) and slightly up and towards the front of the ear (excess face skin). The incisions are designed to show minimally. Great care is taken not to get the face or neck too tight; no distortion of features should occur. When the neck alone is treated, a shorter scar—or no scar—in front of the ear may be needed
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This patient is shown before (left) and after (right) a facelift and upper and lower eyelid surgery.
She looks younger, and less sad and tired. The effect of taking out extra skin carefully and in the right places can make a remarkable difference in facial appearance. Dr. Duncan appreciates the importance to avoid leaving a “signature”—no one wants to look as if they have had work done. The scars near the ear are not visible except with a very close examination.
Other Options for Facial Contouring:
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This 38 year old had a thick neck and prominent jowls, without a lot of extra skin. She had injection lipolysis, which involved a series of fat melting injections. Two injection sessions were done 6 weeks apart. She has a defined jawline after treatment, with no jowls, and a better angle between her chin and neck. There are no scars, and the downtime is about 7-10 days. This procedure does not need to be done in the operating room.
This type of treatment works best in younger patients that have very little excess skin.
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Liposuction combined with muscle repair can be done when there is a small amount of extra skin combined with banding of strong muscles under the chin. The straight line from the chin to the base of the neck is converted into an angle. This type of less invasive surgery helps give the patient the appearance of weight loss as well as a better jawline. In this procedure, 2 small incisions are made just behind the earlobe, and a 1 inch incision is made under the chin.
The recovery period is about a week. Moderate swelling and bruising can last 10-14 days. Most patients require a light anesthetic for this procedure.
