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It looks as if there was a minor slough just below the earlobe on the right side. So that's another way of improving posterior mandibular contouring. 2 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The rejuvenating effects of a rhytidectomy are primarily focused on the mid and lower face. Lift chin and neck. Dr. LaFerriere: She does not have platysma function on the right; you can see the muscle on the left. Narasimhan K, Stuzin JM, Rohrich RJ.
Furthermore, the history of nonsurgical treatments including neuromodulators, fillers, and energy-based devices is noted as the authors have observed increased scarring in these patients during dissection. The feeling of tightness is usually due to swelling. Dr. Puckering under chin after neck lift. Aston: Then I suspect the damage was connected with undermining of the SMAS platysma flap. I would like to point out a couple of things that have not been mentioned. A thread lift cannot come close to any result like this. 2017 Plastic Surgery Statistics Report, American Society of Plastic Surgeons, Available at. This versatile procedure addresses common signs of facial aging including: - Creases in the middle and lower face. Her profile view confirms the need for a chin implant.
She underwent a face and neck lift with lateral SMASectomy and anterior platysma plication 1 year ago. Decreasing prolonged swelling and pain associated with deep plane face lifts. There may be a little platysma banding on the right. The procedure itself takes several hours, during which the surgeon makes small incisions around and behind the ear, and a very small one under the chin. How to Take Care of Your Face After a Facelift. I have yet to see a marginal mandibular injury from closed lipoplasty that did not resolve within 10 days to 6 or 8 weeks. A general anesthesia puts the person in a deep sleep for the surgery. To achieve this, I would use a submental incision and a postauricular access incision on each side without removing any skin from her neck.
Dr. Pitman: The patient gave no history of having had a parotidectomy. Platelet gel sealant use in rhytidectomy. Keep your head elevated for two to three days to minimize swelling and to speed recovery. From the grimace view, she has absolutely no platysma function on the right. She had two previous face lifts; the most recent surgery was 4 years ago. Dr. LaFerriere: I would like to know the cause of the skin slough. I would also like to point out that we have mentioned a chin implant. These photographs are obtained from patients of the Dr Lanzer Clinic, who have given their consent for their photographs to be used for patient education. We invite you to have a consultation about the procedure you need. Farmington, Connecticut Facelift | Connecticut Facial Plastic Surgery. Dr. Feldman: I certainly agree with Dr. LaFerriere that if the surgeon is not really familiar with the gland resection procedure, he or she should not do it, because it can result in dangerous bleeding. In addition, this patient has poor jawline definition. Focusing on reducing the neck's banded appearance, this type of method removes, tightens, and realigns neck muscles under the chin and midline neck for a slimmer appearance.
Feldman, if you performed a corset platysmaplasty and a vertical platysma plication overlying the gland, do you think you could get enough improvement without actually having to resect the gland? Loose skin and excess fat. I personally do not resect glands. In these patients, either reoperation or Botox (Allergan, Inc., Irvine, Calif. ) can be used. Dr. Feldman: It is never just skin when it hangs over the jawline like that. Most people I see, requesting this kind of neck lift are more concerned about that midfacial laxity and the laxity from the corner of the mouth to the jawline than they are about a little band in the front of the neck. 20–22 Furthermore, the gradual loss of skin elasticity and dermal thinning contributes to rhytid formation and can be exacerbated by smoking and ultraviolet radiation exposure. There are various pros and cons of different neck lifts, depending on the neck's specific issue. However, available evidence at this time does not support the use of postoperative steroid use. The thyroid cartilage is very prominent. We will provide you will pain medication for your comfort during recovery. The visible change in these photographs has occurred as a result of the procedure/s undertaken. What is a neck lift? Getting Better Results in Facelifting : Plastic and Reconstructive Surgery – Global Open. Surgery Plastic Surgery Facial Procedures How to Take Care of Your Face After a Facelift By Millicent Odunze, MD Millicent Odunze, MD Facebook Millicent Odunze Geers, MD, MPH, is a plastic surgeon with Dignity Health Medical Foundation.
Dr. Aston: In posterior mandibular contouring, in this kind of patient, as Dr. Feldman said, you have to understand what is there. 55. da Silva EM, Hochman B, Ferreira LM. Despite the plethora of available techniques, the authors feel that the most reproducible, safe, and efficient techniques are SMAS-stacking for patients that need volume (ie long and narrow faces; Fig. The little platysma laxity evident in this picture does not extend down as far as the first cervical crease. Ideal results are a tighter and smoother neck for a younger-looking appearance. The deep-plane rhytidectomy. A 20-year experience with secondary rhytidectomy: a review of technique, longevity, and outcomes. A facelift is a surgical procedure that treats age-related changes to the face. Ready to schedule a consultation with one of our board-certified plastic surgeons? I would use a submental incision and a three-quarter–length sulcus incision for access. Scar under chin after neck lift. The results from the previous facelift do not look natural.
Excess skin and fat on the face. There is always sagging fat, which is the real culprit. 5-inch "helper" incision behind the earlobe on each side to blindly undermine the lateral neck and to make it easier to exit the neck suction drains behind the ears at the end of surgery. Please wait for 4 - 6 months. If the estimated postoperative lateral orbital rim to anterior hairline distance is ≤5cm (ie minimal temporal skin resection), then the temporal portion of the incision can be concealed behind the hairline. Otherwise, areas of necrosis are conservatively managed with daily cleaning and triple antibiotic ointment application until the ischemic margins fully declare themselves and the eschar falls off. The damage could have occurred with a lateral platysma SMAS dissection. 19 Skeletal regression, particularly in the inferolateral orbital rim and alveolar ridges, contributes to loss of midfacial support and loss of overall facial height. Notice the mini neck lift scar is tucked naturally and imperceptible. Stuzin JM, Baker TJ, Gordon HL. If there is still a problem, that would certainly influence anything I would tell her.
The little earlobe base incisions are just used for blind lateral neck skin undermining, never for fat removal. I agree it is possible to injure the nerve with lipoplasty. The likelihood is that she is probably bothered by her labiomandibular folds, and if so, then a lower face lift combined with a neck lift is called for. Persistent/Recurrent Jowling. There is little if any excess fat in the neck, and the neck skin is smooth other than those two moderately prominent transverse skin creases. 5 to 3 cm, to get more jawline definition posteriorly. Of course the scar is red because not enough time has not passed for scar maturation which can take 6 to 12 months. 2008;121(Suppl 1):1–19. She has moderate jowling and a full and slightly ptotic chin.
Avoiding surgery in high-risk patients (ie, nicotine product users) and maintaining at least 3 mm of fat on the skin flap undersurface prevent the majority of cases. I would release the mandibular ligaments just under the skin, which I think would eliminate her prejowl notches, and then trim the jowls and defat along and just about the jawline on each side. Paper presented at: American Society of Plastic Surgeons "The Meeting"; September 30, 2018; Chicago, IL. Aston, how would you approach this patient? Griffin JE, Jo C. Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature. Neck Liposuction Case Studies Explained. Alternately, I could just use a lipoplasty cannula and then widely undermine her skin.
There is still some puckering which usually disappears within 1-3 months after the procedure. The major signs of age – including deep creases and sagging of the face – can be treated with a surgical procedure known as a facelift, or rhytidectomy. Anatomical and clinical implications of the deep and superficial fat compartments of the neck. Grover R, Jones BM, Waterhouse N. The prevention of haematoma following rhytidectomy: a review of 1078 consecutive facelifts.
Exacerbating factors such as excess skin tension is avoided and hematoma, if present, must be promptly addressed. Other than that, I would agree with Dr. Aston's plan. Same patient - notice the scars blending in without the use of any makeup or concealer.