Archive for the ‘Cervical | Neck Liposuction’ Category
Facial cosmetic surgery is a very personal and monumental decision. Universally, all patients want the best outcomes. In today’s corporatized America, with heavily influential marketing spin, pharmaceutical companies, medical device companies, and even practitioners promote a less is more mentality to push products and services that often over promise and under deliver on the results. In no way can skin creams, injectables, or lasers deliver the types of results once can achieve with surgery. In a similar manner, minimally invasive sounding surgeries are in no way a substitute for time tested peer reviewed procedures that provide quality long lasting results.
Unfortunately not every person will achieve acceptable results with Botox or injectable fillers such as Juvederm, Restylane, and Radiesse. These products have their place in facial aesthetic practices, in properly selected patients, but in general should be viewed as temporary treatments with less impressive results when compared to surgery. Their primary advantage is that they have minimal social while providing a benefit. Botox is being used more and more as a preventative cosmetic medicine that delays wrinkle formation. Fillers camouflage initial signs of aging, but ultimately putting too much filler in a face, the liquid facelift, can alter ones appearance creating an artificial overinflated appearance. Using filler to augment facial structures can be useful to patients wanting to get a general idea of the appearance prior to permanent surgical procedures such as lip and cheek enhancements procedures. Creams reverse the signs of photo aging and contribute to collagen formation and production but are limited in their effectiveness. Lasers are an excellent option to delay the signs of aging and treat sun induced skin photoaging, but in no way can they tighten skin like facial cosmetic surgeries such as a facelift.
Surgical procedures are the best option for impressive endurable results. Rhinoplasty can dramatically affect ones facial appearance in a way that almost no other cosmetic surgery can. The nose can cause undue and unnecessary attention drawing attention away from other attractive facial features. Aging face surgery has many layers of effectiveness based on the surgical techniques used and how they are applied. In general, minimally invasive techniques can produce an artificial appearance and or short-term results. When considering aging face surgery most sophisticated patients are looking for surgeries that will last as long as possible with the most dramatic natural appearing results. There are no shortcuts to achieving optimal results and when applied, shortcut techniques frequently under deliver on the surgical results end.
Becoming an informed patient who understands the benefits of finding the right intervention or surgery for the right patient will ultimately save one time and money over the long haul. Getting things done right the first time is of paramount importance to achieving optimal outcomes with a high degree of patient satisfaction, while avoiding problems and bad outcomes.
Posted by: Benjamin C. Stong MD
The topic of neck rejuvenation requires a discussion of skin rejuvenation, liposuction, facelift surgery, and direct skin excisions. Age related changes in the neck occur simultaneously with the age related changes in the face. These changes include sun damage to the skin, accumulation of excess fat and skin, and the formation of vertical bands. There is no absolute predictable pattern to how a neck will age and is intensely affected by an individual’s anatomy, genetics, diet and exercise patterns, and sun exposure. As such, there is no single way to address a patient’s concerns and a rejuvenation plan must be tailored to a patient’s specific issues.
As with any area of skin, the neck skin accumulates sun damage over years. The skin of the neck is thinner than the skin of the face and is more prone to complications with aggressive rejuvenation procedures such as phenol peels and traditional CO2 laser resurfacing. In general, the goal of laser skin rejuvenation is to be as aggressive as the tissue allows while balancing results with safety. Although most laser companies do not recommend the use of ablative lasers on the neck, clinicians routinely use laser rejuvenation therapies with excellent outcomes. A critical element to good outcomes is to use lower settings on the resurfacing laser or less aggressive chemical peel than in the face.
Many patients believe they are good candidates for liposuction as a sole rejuvenation procedure. In fact, the opposite is true, only a select few individuals are candidates for liposuction in isolation. As we age the skin loses elasticity and subsequently its ability to contract. The ideal candidate for neck liposuction is someone in their 20’s or 30’s with minimal sun damage or excess skin. These individuals usually have skin that will contract back down following liposuction with good results. Once sun damage has occurred and excess skin has accumulated, removal of skin becomes necessary. Excellent liposuction techniques are also critical for great results.
Most patients in their 40’s and 50’s have enough sun damage and excess skin to require removal. There are two primary ways to address this issue. The first is with a facelift or neck lift. An abbreviated mini facelift incision can be used. The neck skin is removed from the portion of the incision placed behind the ear. Some surgeons may offer patients an isolated neck lift procedure using only the portion of the facelift incision behind the ear to avoid more obvious incisions in the neck. Patients must understand that in no way will this address the excess skin and jowling of the face and is performed to avoid placing incision directly in the neck skin. During the facelift or neck lift procedure the vertical bands are addressed by tightening the platysma muscle which acts as a corset for deeper neck fat that protrudes as we age. The second way to address the excess skin of the neck is with a direct neck lift using a direct skin excision technique such as the Grecian Urn or another such procedures. It is offered as a primary procedure almost exclusively in men. Sometimes residual skin following a face or neck lift will be removed with smaller direct neck excision techniques, but in general it is a bad idea in women as a primary procedure because it will leave visible scars. In men, because of their bearded skin, a direct neck excision can be a good alternative to a facelift procedure. During a direct neck excision, the vertical bands should be addressed by tightening the underlying platysma muscle during the skin excision.
Total neck rejuvenation in older patients should include removal of the excess skin by a method the patient and the physician are comfortable with, along with tightening of the platysma muscle and liposuction as indicated. A staged skin rejuvenation procedure may be performed either before or after surgery to complete the rejuvenation. Consultation with a knowledgeable and skilled facial plastic surgeon will help avoid bad outcomes and disappointing results.
Post provided by: Benjamin C Stong MD