By Gunnar Bergqvist, MD
For 115 years, neck & facelift procedures have been performed by surgeons.
Over that time the procedure has change from being simply a slight skin tightening, to altering all elevations, tightening, and lifting of the deeper structures of the face, and to the current combination techniques involving lifting, removing extra skin in augmenting areas with reduced tissue volume and even some procedures that involve minimally invasive techniques.
As a person matures in age, facial structures change as does the envelope of the skin, migrating, stretching, and becoming less elastic in its natural state resulting in jowls, sometimes sunken areas or deep wrinkles and fatty deposits an area that we don’t consider attractive.
Neck and Face lifts are a restorative procedure, lifting tissues, where they were when a person was younger, giving a youthful appearance and turning back the clock.
Newer, minimally invasive techniques have great uses but often don’t have enough ability to reduce the amount of extra skin and tissue sag that has developed over the years; therefore, an open, surgical technique is necessary. A well trained plastic Surgeon will tell you when these approaches wont remove your sagging skin and thus will recommend the open, surgical neck lift.
With advances in technique, a deep facelift can be done in an office setting under local anesthesia. This involves an incision around the ear, (and often under the chin) from which you can dissect out the tissues of the face as well as the neck. Sometimes we must make an accessory incision in the area under the chin. Some of the bands that develop in your neck can be addressed via this incision, and now we can also sometimes address this through percutaneous approaches which use very small incisions to release his muscle bands.
Neck & face lifts are not a cookie-cutter procedure. Everybody tends to be a different person and often there is a variation in technique between patient and patient. Surgical technique has evolved to find use from some of the excessive tissues removed which may be placed in some areas of the head and neck. It’s common we would do some fat grafting or soft tissue augmentation with this tissue in areas that have lost volume, particularly the cheeks.
Sometimes one of the issues is not the fat under the skin, but rather the glands under the muscles in the neck. If this is the case, these can be reduced through a small incision under the chin. It is important to have an assessment by a qualified and experienced surgeon to recognize the difference between the structures which still need to be respected, augmented, lifted, or tightened and, to be sure that you have the right amount of soft tissue coverage. Occasionally less experienced surgeons will try to over resect tissue, particularly in the neck, resulting in a very unattractive contour, and even though it has less fat and tissues, results are not attractive or authentic looking.
I have included some pictures for a full face and neck lift down for deep plane, SMAS, (Superficial Musculo Aponeurotic System) lift using local anesthesia in the office. While results are immediate, you can see in these three years after photos, that her facelift stands up to time, because of the quality of the work.
Do not be confused by official sounding boards or certifications, as there is no recognized certifying board with “cosmetic surgery” in its title. Look for surgeons with the symbol from the American Society of Plastic Surgeons when seeking a trusted surgeon for any cosmetic procedure. The ASPS assures that a surgeon has met the most rigorous requirements in skill, patient safety as well has having had superior surgical training from an accredited residency program.
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