What is a lower face lift? How is it performed? Where are incisions/what tissues and muscles etc. are altered during a lower face lift?
Lower face lifts or cheek lifts are performed through incisions around the front of the ear. This procedure improves the appearance of the jawline and improves the area of the jowls. There are various techniques used to perform a cheek lift. Most plastic and facial plastic surgeons currently perform techniques that reposition the SMAS – a layer of fat and muscle that is under the skin. By repositioning this layer, tissues and fat pads that have descended are put back to their original positions. This also allows improvement in the appearance of the nasolabial folds and marionette lines.
What is a neck lift? How is it performed? Where are incisions/what tissues and muscles etc. are altered during a neck lift?
A necklift is similar in concept to a lower facelift, but the main goal is to improve the appearance of the neck. Therefore the incisions are continued further behind the ear and into the hairline to remove excess skin of the neck. The SMAS layer is repositioned in a similar fashion but extends further down and includes a muscle called the platysma. Additionally, if a patient has prominent bands in the front of the neck, these are addressed through a small incision under the chin at the same time. This procedure is great for extra skin as well as extra fat of the neck. This improves the profile view to create a sharp neckline. This is often combined with lower facelifts for optimal results.
What are the main differences between the two procedures?
The procedures are similar in concept: the extra skin is removed and fat pads and muscles are repositioned to the positions they were in when the patient was younger. The main difference is what they are addressing and as a result, the location of the incisions. The lower facelift or cheeklift adresses the nasolabial folds, marionette lines, and jowls while the necklift addresses excess skin and sagging of the neck and under the chin.
Who is a good candidate for a lower face lift and who would be a better candidate for a neck lift?
The ideal candidate for a lower facelift is a patient with some jowling but their neck has minimal sagging or extra skin. There is no ideal age for this procedure since all patients age differently, but could range from mid 40’s to 50’s. Ideal candidates for pure necklifts are a little more rare. The goal is always to look natural. When patients develop enough skin laxity to warrant a necklift, many of them have enough skin that will probably need a lower facelift as well. To understand why, simulate a necklift by lifting the skin of your neck. The small puckers of skin that appear in front of where you are lifting also need to be addressed. By extending the incisions up the cheek, these puckers are avoided and the results appear more natural.
Do the risks/complications differ between the two procedures? What are they?
Risks and complications for both procedures are the same and are most commonly, swelling and bruising. Other more rare complications include the following. Patients may experience some bleeding underneath the skin called a hematoma. In some cases hematomas need to be drained surgically if they occur. Risks of nerve damage are very rare but can include temporary or permanent weakness that can affect facial movement. Sensation of the skin is temporarily altered after surgery but eventually returns back to normal. Small scars are expected, but with my techniques and incision placement they heal very well.
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