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Neck lift

1.Examples of neck lift

See examples here

 

What is a neck lift ?

A neck lift addresses the specific problems of the neck and part of the problems of the jaw line.

This procedure can be done under local anesthesia and in day care. It is often combined with a facelift.

 

3.How is it done ?

1.Sagging skin

Hanging skin is always the biggest problem in the neck. It needs to be stretched from the sides, a direct excision would leave a visible scar.

If the skin is bulging because of underlying problems, there is no need to resect skin. If however, there is a clear excess of skin, then a facelift is also needed to remove this skin by stretching it to the sides. The removal of skin is done around the ears, avoiding a long and visible scar in the neck.

2.Superficial fat in the midline of the neck

This fat can accumulate over the years between skin and muscles. It is the main factor creating an obtuse angle between chin and neck.

In many cases a lipo in this area is all that is needed. Many times this fat is very dense and needs to be resected rather than liposuctioned. Surgical experience tells the difference. In that case, a small 4 cm wide incision is made into the crease behind the chin to excise this fat completely.

3.Deep fat under the muscles

Fat can also be found under the muscles. It needs to be resected and not liposuctioned.

4. Platysmal bands

When aging of the neck starts to become visible, it is almost always by the emergence of two vertical bands in the middle of the neck. These are the anterior borders of the platysma muscle, which starts to show under the skin. In thicker patients it may be obscured by the fat above and under the muscle, in thinner patients it is very visible.

The muscle edges are sutured together , which is called a “corset platysma "plasty”

The obtuse angel this creates is brought back to an almost 90° angle. The bands do not leave an imprint in the skin anymore and this skin should be left untouched.

5. Deeper structures

There are even deeper structures that can be corrected. They will not be discussed here, as they are quite uncommon.

 

3.Possible complications short and long term

Bruising of the skin (Ecchymosis)

http://en.wikipedia.org/wiki/Ecchymosis

When blood migrates into the skin, the skin first turns blue after a day or two. Over a period of 10 days it further turns into green and finally yellow before disappearing completely. No ointments should be used to speed up this resorption of blood. They could only add a rash.

Blood collections (Haematoma)

http://en.wikipedia.org/wiki/Hematoma

When even more blood accumulates under the skin this is called a haematoma.

Its natural course is to convert to hard nodules -over a period of weeks- that sometimes can be felt and trouble the patient. It also disappears very slowly, over the course of months. The incidence of this complication is less than 2%.

Irregularities in the contour of the neck

Neck surgery needs to be done with the outmost care for detail. A small amount of fat can lead to a visible bump under the skin, which then needs to be treated again.

Renewed banding of the platysma

In case a resection of part of the platysma has been done, both ends can be linked to each other again by the scar tissue that develops in between. The muscle can stretch and the banding gets visible again through the skin. A re-operation is necessary

 

Links

Here is the website of Dr.GFeldmanwho wrote a book about neck lift with several examples

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The platysmal band correction is done through a small incision under the chin

The platysma bands are sectioned and the upper and lower part are sutured together with a continuous suture

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