While there are many changes that occur in the face as we
age, one of the most bothersome to many patients is the
changes that occur in the neck.
Progessive fullness of the neck, loose sagging skin, the
development of vertical banding, the numerous horizontal
wrinkles that appear low in the neck and the loss of a good
sharp neck angle all capture the eye of the patient and
others as well. These neck changes rank right up there with
aging around the eyes as the most concerning facial aging
concerns to most patients.
Like the rest of medicine, it is important to determine
what the anatomic problems are in the neck to match up the
best operation to improve it. Younger patients often just
have some beginning neck fullness and a little bit of
jowling. Simple liposuction and a little jowl tuck-up may
be all that is needed in these younger patients. In some of
these cases, I have used LipoDissolve injections alone and
have gotten a good result if the patient can tolerate the
temporary swelling that comes after eacj injection session
and the 3 to 4 months to get the final result. Older
patients usually have more sagging and loose skin and
something like a more extended facelift (neck-jowl lift) is
more appropriate. This is where sitting down with your
plastic surgeon and going over your concerns with the aid
of a mirror is so important. The selection of which
operation is best for you will depend on a good
understanding on your part of what do you want to see
changed and what are you willing to go through to get it.
The aging neck in the male poses some different issues.
They often have more skin excess and the facelift incisions
that are used in females have to be altered to account for
the male beard pattern. In addition, males have a much
greater tendency towards some relapse after facelift
surgery due to their thicker and heavier skin. Men also
have a much greater aversion to major facelift surgery and
may opt for an alternative procedure known as a direct neck
lift. This procedure dramatically reshapes the neck and can
produce a very sharp neck angle...but at the cost of a
midline neck scar from below the chin down to the adam's
apple. For some older men this may be a good trade-off and
this scar usually turns out fairly well due to how better
hair-bearing skin heals scars.
In the aging neck, a young patient may be able to get by
with some limited procedures such as lipodissolve,
liposuction, skin tightening device treatments, or some
limited neck manipulation. In the older aging neck (> 50
years old), the amount of loose skin will require more
invasive facelift approachs for significant improvement.
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Dr Barry Eppley, board-certified plastic surgeon of
Indianapolis, operates his private practice at Clarian
North and West Medical cenetrs in suburban Indianapolis. He
writes a daily blogs on topics and trends in plastic
surgery at http://www.exploreplasticsurgery.com
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