¬ Face, Neck Lift

FACELIFT, NECK LIFT (RHYTIDECTOMY, PLATISMAPLASTY)

Facelift and neck lift surgeries are performed to improve the signs of aging like creases and sagging skin in the face and neck especially on the jaw line. Lately, on deep creases and sagging skin along the nose extending to the corner of the mouth (nasolobial fold) dermal filler or fat injections are frequently used to enhance the appearance.

Even injectables can resolve the aging effects they are insufficient for the sagging and loose skin in the neck. While fillers contribute to the upper part of face, the lower part of face reveal the real age. In the lower part facelift works best in conjunction with neck lift to rejuvenate the sagging skin and creases.

There are various approaches to improve sagging skin and deep creases in the face and neck due to aging and weight fluctıations. Highly individualized surgical approach and/or non-invasive filler or fat injections might help resolve the problem. During my visit to American Society of Plastic Surgery for annual meeting and New York Hospital (Nov,2012) neck lift surgeries are fast  gaining popularity. Filler and fat injections in facial rejuvenation have changed the surgical methods and surgery approaches. Therefore, consultation with the surgeon before facial rejuvenation procedures is highly recommended.

Initial consultation before face and neck lift surgeries 

If you are considering face lift surgery you should seek an experienced plastic surgeon and consult with the doctor.In this consultation you should clearly tell your complaints and expectations with this surgery.

Over the course of consultation  your doctor will evaluate your emotional and physical state   then he/she will take notes for necessary  calculations . Considering your expectations and examination findings your doctor will offer you the best and tailor made option and give you detailed information that includes what should you realistic ally expect from the surgery. Also, your doctor will explain the surgical method, anesthesia ,the place of operation room(theatre), complication of risks associated to the procedure and pre-op instructions. Before deciding  face and neck lift surgery ask all the questions you have in your mind and until you get satisfactory answers and fully comprehend . In this consultation you may also get a quote. Based on the whole information you got you may finalize  your decision.

Once you decide to go with the procedure you will be asked  to have several tests done . If  test results are normal, the surgery time, date  and  place will be  determined. Facelift surgery should be undertaken at a hospital.

The surgery date

Following registration in the hospital you will be smoothly transferred to your room. Doctor will make your surgery plan and then anesthesist will inform you about the anesthesia and ask related  questions. Before the operation, a sedative  injection that will soothe and encourage you, will be administered.   It will help you relieve the anxiety and the  excitement related to surgery which is very common.

In the operating room anesthesia will be applied. Face and neck lift surgeries can be performed under general anesthesia. During the surgery under general anesthesia you will be sleeping. Your doctor will offer you the best choice that fits your case.

What are the methods in face and neck lift surgery?

A typical face lift surgery is performed to remove sagging and loose skin in the face and neck area. Size of the surgery depends upon what you require according to the assessment of your surgeon and changes you desire. Thus, various methods can be applied (short scar, full face lift, neck lift alone)that determine your appearance. Technique is determined during the consultation with your surgeon. In conjunction with facelift surgery eyelid surgery (blepharoplasty)or alone blepharoplasty can be performed to get rid og eyebags. 

Facelift surgery begins with one side of the face then the other. Before incision is made hair is attached with a special clip. Incisions may vary according to the procedure that patient requires and technique used by the surgeon.. In most cases incision begins in the hairline at the temples extending to surrounding of natural line of earlobes continues downwards and back of ears ends in the lower hair scalp. In short scar facelift incision begins in the sideburns continues at the front of ears and ends in the back of ears. To correct the bands in the neck under the chin a small incision may be made if necessary. 

While surgeon is making the incision also fat and muscle underneath the skin is seperated. Tissue underneath skin technically called SMAS is also tightened.  To tighten the underlying tissue different closure techniques or disections are made. After lifting top of the skin upwards and backwards excess skin is trimmed away then operation is completed.

Permanent face and neck lift necessitates tightening the underlying tissue SMAS and therefore permanent result is achieved. If there are bands in the neck resulting from platysma muscles in the middle part, by performing platysmaplasty they are sutured together to make lifting. Also the procdeure can be performed in conjunction with liposuction in the neck.

To avoid drawing others’ attention to surgical scars, incisions are hidden in the natural creases or folds and closed with fine sutures. Scars are unavoidable but in many cases scars fade gradually and become barely noticeable. The most visible scars are left behind the ears but they can be easily covered with your own hair.

After the surgery behind the ears fine tubes can be temporarily placed to drain excess blood that may collect under the skin. Face and neck is wrapped in wide and loose dressing for couple of days. However, in recent years  dressing leaves its place to very thin gauze bandage.Depending upon the size of the surgery the procedure takes 3-5 hours.

How should be the face and neck lift post-operative position in bed ?

Following the surgery you will have mild pain that can be controlled easily with simple pain killers. You will be told to keep your head elevated for couple of days. If neck lift is performed you will be asked to prevent your neck from bending forward and keep it straight while sleeping. While you are asleep or awake bending the neck forward will cause the skin to fold that may lead to eudema and circulation problems. Following the instructions is important for fast healing. In addition,  you may be told not to sleep on a pillow or use a special pillow to sleep in the right position.

How will be the initial healing process after face and neck lift surgery?

If drains are placed they will be taken off on the following day or the second day of surgery.  Then a special band will be placed. This band mask will be provided by your surgeon and  the application will be explained.

Swelling and discoloration varies. Even bruising is not expected in case it happens it will fade within 1-2 weeks. Most patients report that they feel numbness and tighteness over the face and the neck area. Intensity of post-operative conditions vary, so do their healing process depending on the case. Discomforting changes  mentioned will subside in a few weeks.

The ultimate goal of face and neck lift is to have a natural, youthful, rested and attractive appearance. After a fast recovery you will notice a significant improvement over the face and neck. Swelling and soreness to dissappear takes some time. And healing process requires patience. Especially there may be soreness in the neck area. Soreness will eventually soften.

Sutures are mostly absorbable. Removable sutures are removed within a week. After this period cosmetics may be used. You will see your appearance is enhancing day by day. In this process, , consultations and evalautions  of your surgeon and follow up visits will help your individual recovery period pass comfortably.  For several months limiting sun exposure and using life-long sun protection  is a must. Following your physician’s instructions is key to the success of your surgery.

Prof. Dr. Muhitdin Eski