Aesthetic Facial Body Plastic Surgery
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Tightening the Neck as Part of Face Lift by Dr. Philip Young of Bellevue | Seattle’s Aesthetic Facial Plastic Surgery

Dr. Young finds great reward doing the facelift procedure using techniques that he has developed based on over 1200 neck and facelifts. Although, the high number can be a good indication of a surgeon’s skill. For Dr. Young, it is not necessarily the number that is important, it is whether that particular surgeon has improved how he has done things through all of those procedure. In his experience, he has seen surgeons that have said “I have done over 4 thousand (rhinoplasties, otoplasties,…etc)” who do the same procedure and are may not improve on a consistent basis. Improvement of your skills regularly is a key to constant improvement. Dr. Young this through: 1. participation in national academic educational meetings; 2. his travels to foreign countries to hone known techniques while learning new ones and new variations; 3. repeated literature searches on papers that review traditional techniques and research on novel approaches; 4. through his discussion with his world renown colleagues across the world; etc. He has learned that a lot of what is taught to surgeon’s doesn’t lead to the best results. Many surgeons take short cuts for many different reasons that don’t benefit you. A well done facelift can take up to 3-4 hours depending on the patient, their anatomy, etc.

We are now going to discuss a little more on this subject on how the neck can improve from the facelift portion of the procedure or if a facelift is done alone. Specifically, a face lift describes the procedure that concentrates pulling on the structures that are above the jawline. While a neck lift concentrates on shaping the tissues and muscles below the jawline. What you are going to see below are the facial and neck muscles that are important to the discussion of Facelifts and Neck lifts. The platysma muscle plays a key role in the neck lift and in the face lift procedure. The platysma muscle is central in the process of shaping the neck. Through a small incision under the chin the platysma muscle is tight wrapped with a suture starting just under the chin that progresses to the base of the neck and back to just under the chin. This has been stated before, on some of our other pages. This platysma muscle is also vital in a facelift as well. The platysma muscle eventually blends in with the rest of the muscles of the face. Within the face, the platysma blends in with the rest of the facial muscles to collectively be called the Submuscular aponeurotic system or SMAS. This association with all of the facial muscles makes this layer the ideal layer to pull in a facelift.

With a facelift this smas layer (associated intimately with the facial and neck muscles) is the main layer that is pulled and suspended to give the patient a lifted look. The more you lift superiorly, the more the effects can be seen superiorly, such as in the midface and around the nasolabial folds. The facelift procedure is related to the improvement in the neck through this SMAS’s association with the platysma. Through this association, pulling on the SMAS will have some pulling effect on the platysma. This is the reason that a facelift will have some effect on a person’s neck. However, this pulling will not have the full effect of tightening the neck. Ultimately, you need to work on the platysma in the lower parts of this muscle and in the mid line in order to really tighten the neck to the greatest degree.

Below is a picture showing an after picture of the incisions that we use for our neck and face lifts. This is without any diagrams showing where they are. The after picture shows where the incision was made to allow you to understand how to interpret the healing of these incisions. As you can tell, the incisions are very hard to appreciate and notice.

We do everything we can to make sure these incisions heal well. Some of these techniques include:

  • Using the finest sutures, some of which are smaller than your hair
  • Avoiding excessive pulling on the skin that can lead to post procedure stress on the incision line that causes more scarring to occur
  • Careful instructions to care for your incisions
  • Close follow-up to ensure that you are caring for your incisions with more frequent follow-up if we are detecting less than optimal care (we stress having us see you the next day after your procedure, then at least 6 days later)
  • Accessibility so that you can ask your questions easily you can always email, or call 425-990-3223 (Office) / 425-505-0938 (Mobile) anytime;
  • Careful closure of the incisions that incorporate slightly looser tying of the sutures which leads to less strangulation of the incision line and resulting more improved healing
  • We are always improving on this through frequent literature searches to find the best approaches to healing and incision care.

Below is the same image which shows where we made the incision in this particular patient. This patient had a face and neck lift. The dotted line shows where the incision is located behind the ear, hence the broken line pattern. This part of the incision cannot be seen because it is behind the ear. When we do facelifts only, the incision typically ends at the bottom of the earlobe. Whereas, neck lifts typically start around the earlobe and proceed behind the ear and along the hairline. It will now be helpful to refer to the picture above where the incisions are not colored coded to reveal where we placed the incisions. This will allow you to appreciate how the incision healed in this particular patient. As you can tell the incision in front of the ear and in the temple part of the hairline is imperceptible. When we show people this picture, they usually can’t tell where the incision is in the front of the ear. Behind the ear it is a little more noticeable. One thing to note is that this result is strictly from the original procedure with no additional scar improvement type techniques. Many surgeons incorporate additional techniques to improve the way the incision heals into their procedures at a later date.

The following link will take you to some Pre Procedure Care Packages. that should be very useful for preparing for your future Face and / or Neck lift.

If you are interested at anytime about scheduling an appointment you can email, call 425-990-3223 and even text message us at anytime. Click here if you would like to find out more about our consultation process. We can set up a phone consultation for you and show you how to take the 5 basic photos that you will need.

We want the best for you. Dr Young always maintains, as much as possible, an open door policy to help people. Even if you were to decide to go to another doctor for the same procedure, Dr Young would always welcome you to email or call our office anytime for help.

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