Facial aging happens differently from person to person. For instance, some people have sagging skin that is mostly concentrated around their eyes, while others have most of the bagginess along their jaw line and neck.
Nonetheless, facial aging often affects multiple areas almost to a similar degree and thus facelift and neck lift are commonly performed together. Combining them in one surgery also makes sense because the standard facelift incision is simply extended into the nape.
(Note: Standard facelift entails an incision that starts inside the hairline at the temple area, which then curves in front of the ear and behind it. And with a concurrent neck lift, the scar is slightly extended into the nape, specifically behind the hairline, to hide any surgical stigmata).
Renowned Los Angeles plastic surgeon Dr. Tarick Smiley has recently demonstrated on Snapchat the rejuvenation effects of this combo approach, particularly when combined with a SMAS lift technique.
SMAS refers to a soft tissue layer found beneath the facial skin and fat. During facelift, Dr. Smiley not just removes the loose skin and elevates the remaining skin; he also tightens this underlying structure.
To further ensure a congruous result, he also tightens the platysma muscle of the neck by using internal sutures, which essentially act as a sling.
The compounded effects of these techniques are tauter jawline, restored volume of the cheek, more youthful chin-neck transition, and smoother neck appearance.
The direction of pull also plays a critical role in facelift and neck lift. The correct vector can create a tauter jawline and restore the youthful plumpness of the cheek, whereas an incorrect one can spell disaster—e.g., wind tunnel effect or overly tight mid face, lateral pleating of the neck skin, and skin bunching around the earlobe.
In a recent Snapchat video, Dr. Smiley says the correct direction of pull is 45 degrees angle, adding that in no way that the soft tissue should be pulled in a blunt horizontal or vertical manner to avoid any telltale sign of surgery.