Sarasota Face & Neck Lift
Sarasota Facial Plastic Surgery
Who is a candidate?
The face and neck lift is designed to elevate the outer part of the brow, soften the nasolabial fold (the cheek tissue next to the nose and upper lip), eliminate jowling (fullness at the jaw line near the chin) and tighten the neck area. Because the surgery improves features in the temple, cheek and neck it is also referred to as a temple-cheek-neck lift.
Some patients elect to treat these changes "pre-emptively" as they are just beginning to occur (mid- 30's to mid-40's), while others become more motivated to undergo temple-cheek-neck lift after changes are readily apparent in the areas of the temple, cheek and neck (late 40's and beyond).
What causes these changes in my face and neck?
As we age, the brows descend gradually from their youthful position. The sagging brow tissue crowds the upper eyelid area often resulting in a tired, weathered look. The structures that support the face and neck soft tissues also weaken over time with increasing prominence of the nasolabial fold, jowls (with squaring of the jaw line) and "extra" tissue under the chin (sometimes contributing to a so-called double chin or turkey neck).
Medical evaluation for a temple-cheek-neck lift:
Important considerations include, but are not limited to previous surgery, smoking history, position of the temporal tuft of hair, facial nerve function, chin position, earlobe size and shape, configuration of neck fullness and position of the submandibular salivary glands.
Previous surgery:
Patients who have previously undergone facelift surgery are usually good candidates for a secondary (revision or tuck-up) facelift procedure. Current physical findings determine which procedure is best for a given patient.
Smoking history:
Smoking has a number of negative effects on the wound healing process. The main concern relates to diminished oxygenation of the tissues that results from both decreased oxygen-carrying capacity of the blood and impaired blood flow to tissues through damaged blood vessels. Individuals who smoke regularly are at increased risk for impaired wound healing after surgery. We strongly encourage individuals motivated to undergo facial plastic surgery to stop smoking for 2 weeks before and 2 weeks after surgery if not altogether.
Position of the temporal tuft of hair:
The position of the temporal tuft of hair should be a consideration in your surgeon's planning for the temporal portion of the temple-cheek-neck lift. The temporal tuft is typically elevated (moved up) to a certain extent during facelift surgery. It may not be advisable to further elevate the temporal tuft in patients undergoing secondary (revision or tuck-up) facelift procedures. Fortunately, an alternative technique exists (hairline or trichophytic approach) that allows for maintaining the position of the temporal tuft. While the peri-temporal incision is not hidden completely within the hair, visibility of the incision is minimized by meticulous surgical technique that enables hair growth through the thin suture line after surgery.
Facial nerve function:
The facial nerve exits through a small opening in the bone below the ear canal and travels through the parotid salivary gland en route to the various muscles of facial expression (muscles that control movement of the face). Different branches of the nerve control movement of the brows, enhance eye closure and control movement of the cheeks and lips as well as activity of the sheet-like muscle in the neck (platysma). While the various branches of the facial nerve are relatively close to the "action" during a face and neck lift, it is not common for branches of the facial nerve to be injured during these procedures. If weakness does occur in a particular area (e.g. forehead) it is usually temporary.
Chin position:
Results in the neck and lower cheek areas are sometimes improved through identification and treatment of unfavorable chin position. Adding length to a short chin (through placement of a chin implant) can dramatically improve the results of the lifting procedures.
Earlobe size and shape:
The earlobes tend to enlarge in width and/or length with the aging process. Earlobe reduction can easily be performed at the time of temple-cheek-neck lift. If the patient wears earrings, the previous piercing site is usually removed during the procedure. Re-piercing of the earlobe is usually done 8 weeks following surgery.
Configuration of neck fullness:
When evaluating the neck, your physician will determine whether the fullness below the chin is primarily related to loose skin, accumulation of fat or both. In addition, your doctor will determine whether you have prominent muscle bands (the edge of the platysma muscles). The difference between obtaining acceptable and very good results in the neck requires proper identification and treatment of these conditions.
Location of the submandibular glands:
The submandibular salivary glands may become prominent in certain individuals with advancing age such that a bulge is visible just below the jaw line on either side. The submandibular salivary glands are not usually removed for cosmetic reasons.
What is the recovery following the temple-cheek-neck lift?
The initial recovery period for temple-cheek-neck lift or any type of facial plastic surgery is 1 week. Any sutures or clips placed during surgery are removed on or before the 7th day after surgery. Mild swelling of the brow area, cheeks and neck is common following surgery. The swelling diminishes rapidly over the first and second week following surgery. It is common for patients to develop some bruising following surgery. While the bruising diminishes gradually over several weeks following surgery, the healing process (including resolution of bruising) can be enhanced significantly through the use of platelet rich gel.