Weekend Neck Lift

7 week post op view of a middle age lady who underwent simultaneous reduction rhinoplasty and neck liposuction. Rhinoplasty involved removal of a dorsal hump and narrowing and elevation of the tip, Although because of her age and looseness of her neck skin a facelift would have produced even more dramatic results she elected to have a less involved simple neck liposuction of the excess fat done through a 1/4 inch incision under the chin. The neck skin none the less redraped nicely for a significant improvement in her neck contour.

Chin implant & neck tuck/lipo all through 1 inch incision under chin. 3 weeks postop with swelling. With patient permission.

Three week postoperative view of a young lady who underwent multiple procedures including reconstructive rhinoplasty, septoplasty and adenoidectomy and turbinectomy to improve her breathing, upper lip vermilion border lip lift, chin implant and neck liposuction and submental neck tuck. As can be seen in the preoperative pictures, the patient presented with a markedly deviated nose to the right probably secondary to a prior fracture with a small bony hump and spicules. She also had a depression in the mid vault of her nose on the left side with narrowing of her mid vault region as seen on the three-quarter view. She also had a small upper red mucosa of her lip, elongated white upper lip region between the red lip and the base of her nose. She also had somewhat of a mildly recessed chin and submental neck fat hypertrophy. It was felt that her neck was not only in the subcutaneous compartment but also in the deeper facial planes of the submental area underneath the platysma. For this reason it was felt that both liposuction of the neck and a submental neck tuck with deep fat correction and platysma muscle suturing was necessary. Her rhinoplasty involved correcting a small bony hump and placing a cartilaginous graft over her left mid vault depression. The lip advancement was done by excising 4.5 mm of upper lip skin to make her upper lip more in proportion with her lower lip and the rest of her face. A nice Cupid’s bow was also developed. A small extended prejowl implant was placed through the submental incision and the submental neck tuck as previously described was done. As can be seen in the postoperative pictures, she now has a more pleasing appearance to both her profile and frontal views of her face. Her chin, neck, upper lip and nose have more pleasing contours now and in balance with all three zones of her face. In addition, her breathing is significantly improved after correcting the deviated septum and performing the inferior turbinectomy and adenoidectomy. Her appearance will continue to improve as she is only at a three weeks postop.

Six month postoperative view of a young lady who underwent septorhinoplasty with functional endoscopic sinus surgery and liposuction of the neck. As can be seen in her side profile, a prominent dorsal cartilaginous bony hump was corrected to give her a more aesthetically pleasing profile. In addition, she was noted preoperatively to have over-projection of her tip secondary to excessive nasal spine bone in her upper lip. This was corrected to set back the nose at the base of the nostrils, again to enhance the appearance of the nose. Her wide amorphous tip was also narrowed to a more pleasing triangular configuration. Liposuction of her neck was also done through a single quarter-inch incision in the submental area to correct excessive fat in her upper and mid neck. This helped contour and delineate her mandible in a cervical mental angle. She was very happy with her aesthetic result and improvements in her breathing and sinus symptoms.

Two-and-a-half month postoperative view of a middle aged man who underwent multiple procedures including a submental neck tuck, chin implant, partial inferior turbinectomy and modified UPPP. In addition to improving his appearance from this surgery, the patient also improved his nasal obstruction by shrinking down his turbinates and also by correcting some of the excessive palatal tissue that was causing his snoring. A small wraparound chin implant was placed to enhance his profile but yet to maintain a natural look. A submental platysmal neck tuck and liposuction was then done through a 2 cm incision below his chin that is well hidden and concealed. No incisions around the ear and no facelifting were necessary to achieve this significant improvement in his neck contour. The redraping of the neck skin and the improvement seen in the postoperative pictures is quite impressive despite the fact that his skin laxity for his age and elasticity is not as responsive as younger persons would be but yet he still developed an excellent result and significant improvement in his neck and jaw contour.

Early ten day postoperative result of a 22-year-old man who desired aesthetic improvement of his congenital fat hypertrophy of his neck and small chin. Despite being in good shape and normal weight for his height, the patient had excessive fat collection in his lower neck which has been present since his teen years and has progressively worsened. The patient desired a strong chin and for that reason a customized small wraparound chin implant was placed through an external incision. The apex of the implant was shaved slightly to have it fit more exactly into his profile. Also through the same under the chin incision, liposuction was done throughout his neck; however correction of superficial fat was not sufficient for creating the profile that we desired. It was determined intraoperatively that the patient’s obtuse neck angle and fat hypertrophy was mostly related to deep fat deep to his platysmal. For this reason, sub-platysmal fat was dissected out under direct sharp dissection through the one inch submental incision. His platysmal neck bands were then sutured to help tighten the platysmal and create a nice sharp neck angle. Even at ten days, his incision is barely visible. Over the next few months, the swelling around his chin should subside to produce an even better profile. In addition, the swelling around his mandible and angle of the mandible should subside to produce an even better contour of his jaw and neck. The patient also suffered from nasal obstruction secondary to septal deviation and turbinate hypertrophy and this was corrected simultaneously with an excellent improvement in his nasal air flow.

Two month postoperative result that demonstrates the remarkable transformation that can occur in a highly motivated individual who undergoes a combination of successful plastic surgical procedures and follows a strictly regimented diet and exercise program. Surgically, the patient underwent a reconstructive rhinoplasty utilizing the open approach so that her asymmetric drooping tip could be lifted in a more prominent, symmetric, and aesthetically pleasing position. As noted in the preoperative pictures, her nostril openings were absent from the frontal view whereas now some visualization of the nostrils, which is desired, can be seen. In addition, her flaring nostrils, especially on the left side, were corrected with a Weir excision. The twisted C-shaped deformity of her nose is now straight in the midline. On her profile, however, we can see that there is too much nostril/columella show preoperatively and this was decreased to compliment her now more defined, stronger tip that stands apart from a lowered, more streamlined dorsum as some bony cartilaginous hump was corrected. In addition, meticulously performed neck and jaw liposuction/sculpture was done in order to refine her neck. This was all achieved through a quarter inch incision placed in her submental, under the chin, skin crease. No facelifting or other invasive type procedure was necessary as her skin retracted quite well to her underlying bone structure. Good results for this portion of her surgery was already being seen after a weekend length of time. Losing weight in the postoperative period also positively impacted her final results and is obviously partially responsible for her final outcome and its importance should not be ignored. During the same procedure, the patient also had radio surgical ablation to correct small vessels of her cheeks and to correct small protruding lesions on her chin and other areas of her face. As can be seen in her postoperative pictures, the tone of her skin is more even and healthier appearing. The patient also underwent a small amount of Juvoderm injection to her to add some more pout and bulk to her upper and lower lips. Finally, some neurotoxin was injected in the glabella and forehead regions to further smooth her forehead and to allow for some eyebrow elevation which is especially noted on her three-quarter view. The patient’s breathing was significantly improved by simultaneously performing a septoplasty and turbinectomy during the rhinoplasty procedure.

Very early 10-day post-operative result of a young male who underwent neck liposuction only through a quarter inch incision underneath his chin. As can be seen especially in the lateral and three-quarter views, even at this early post-operative period his neck and jaw demonstrate a much more defined and youthful appearance. Facial hair in the post-operative pictures hinders some of the result but the improvements are still obvious. His neck will continue to heal and improve in appearance over the next several months.

Two-month post-operative views of a young lady who underwent liposuction of the neck only. Only one incision (1/4 inch) under the chin was utilized in this particular case. No skin was corrected because of her youth and excellent skin elasticity. Very significant results were obtained as depicted in the post-operative views. Especially note in the three-quarter view the more defined jawline. This was obtained by liposuctioning fat from her chin all the way back to the angle of her mandible. Proper placement of the cannula and taking just the right amount of fat allowed for a very natural yet aesthetically pleasing result.

Two month post-op view of a patient who underwent neck liposuction only utilizing one-quarter inch incisions hidden behind each ear and underneath the chin. No skin correction was necessary as adequate tightening occurred during the healing process.

Nine-day post-operative result demonstrating a patient with a congenitally weak/recessed chin. As demonstrated on the lateral pictures, the patient was also exhibiting early signs of aging/jowl formation along her jaw line. For this reason, augmentation mentoplasty/chin augmention was performed with an extended mandibular contouring chin implant that also added projection to the area right in front of the jowls to diminish the appearance of the jowls while simultaneously adding projection to the chin. As noted on the frontal shots, her face appears more balanced with smoother skin along the chin and jaw line. Liposuction also assisted in allowing for a longer, more youthful jaw line/submental plateau.

Six month post-op result of isolated neck lift procedure. No around the ear facelift incisions made. Fat correction and neck muscle tightening done through 1-inch incision hidden under chin. Note improved contouring of jaw line. Not a true “weekend procedure” since most swelling took about a week to resolve.

Six month post-op result of neck liposuction and placement of small customized chin implant. All work done through small incision under chin and 1/4 inch incisions behind ears. Facelift will be required in the future to correct mildly sagging jowels and cheeks.