Several variables will determine the ideal neck lift procedure. Nevertheless, it remains imperative to place the scars behind the ears (specifically within the natural skin folds) and/or beneath the chin to hide the surgical stigmata.
Dr. Karan Dhir, one of the leading Beverly Hills plastic surgery experts, has provided simple explanations of the different techniques used in neck lift.
before-and-after photos of a neck lift patient
- Standard technique. In general, it aims to correct the turkey wattle appearance by making around 3 cm incision beneath the chin (and possibly behind the ear if there is some excess skin as well). The idea is to access the muscle called platysma, which is responsible for the sagging neck.
Because the goal is to achieve a smooth right angle under the chin, many patients will need their muscles to be sutured across the midline in what doctors refer to as a “corset approach.”
But for a few patients, cutting or removing some muscle might be indicated to achieve good results from neck lift.
- Skin lift. To remove the excess skin, incisions behind the ears are also needed. Nevertheless, it remains important to tighten and reposition the underlying structure such as the deep muscle and superficial fat to achieve long-lasting results and prevent tension on the wound, which is known to cause poor scarring.
In general, a skin-only lift is not practical because without reshaping the deeper structures the skin will only relax and sag over time.
- As a stand-alone procedure it is rarely performed in older patients because they generally have poor skin elasticity. To achieve good contour, platysma muscle tightening and skin excision are commonly used as well.
Through a small incision beneath the chin (and sometimes behind the ears), doctors are able to correct the double chin appearance. However, it is imperative to leave some fat to cover and hide the underlying muscle.
With over-liposuction, the muscle might show, leading to unnatural results and/or more aged appearance. For this reason, most surgeons will only remove a conservative amount of fat to anticipate further tissue atrophy (or volume loss) caused by aging.
A good number of neck lift patients can benefit from facelift that is performed simultaneously with their surgery. The idea is to achieve a smooth transition between the mid face and neck area, leading to a more rejuvenated countenance.
Other common ancillary procedures include Botox injection, dermal fillers, fat grafting, rhinoplasty (nose job), and chin augmentation via implants.
Surveys have shown that a good number of male patients cited stiff job competition as their main reason for getting a plastic surgery procedure. For the past several years, men accounted for 8-9 percent of all surgical enhancements performed in the US.
Los Angeles plastic surgeon Dr. Tarick Smaili explains the most commonly requested plastic surgery for men and the corresponding techniques to preserve their masculine appearance.
- Male breast reduction. This corrects a condition called gynecomastia in which the excess skin, tissue, and fat lead to the appearance of woman-like breasts.
Aside from removing the excess soft tissue, typically the procedure also involves reducing the nipple size to further achieve a more masculine contour. Meanwhile, failure to address an overlarge areola can lead to a disproportionate or “effeminate” appearance.
- Rhinoplasty. More commonly referred to as nose job, it should be able to produce results that respect the patient’s ethnicity, the rest of the facial features, and most importantly, his gender.
According to studies, the ideal angle between the upper lip and nasal tip for men is around 90 degrees, thus creating a straighter profile. For this reason, male rhinoplasty must avoid any procedure that may cause the tip to become more upturned, leading to a feminine look.
Nevertheless, some male rhinoplastic patients can tolerate a minimal droop and still look attractive and “manly” with such feature.
- Facelift. Compared to women, most male patients require less contouring in their jaw line since they tend to ask for subtle improvements.
Male facelifts and forehead lifts also tend to be more conservative because it is crucial to preserve the “heavy” brow look and the strong jaw. An overly tight appearance, meanwhile, can lead to feminine-looking brow, flat cheeks, “distorted” smile, and other telltale signs of surgery.
- Liposuction. In general, men have more fibrous fats and have bigger body-frame than women, so their surgery is more time-consuming, more challenging, and more expensive.
Liposuction only removes the excess “superficial” fat beneath the skin, and not the deeper visceral types that lead to obesity-related health condition. For this reason, men who are complaining about their “beer belly” are rarely considered as good candidates for the procedure.
- Eyelid surgery. There are some subtle nuances involved in male eyelid surgery. For instance, men tend to have thicker and more vascularized skin (increasing the risk of bleeding and more postop bruising), and shorter upper lid platform than women.
Facial plastic surgery such as facelift, rhinoplasty (nose job), fat grafting, brow lift, and eyelid lift involves postop bruising and swelling that may prevent anyone to join social activities for a couple of weeks.
Take note that healing from such procedures takes many forms—e.g., social recovery, physical recuperation, and return of normal sensation.
For many patients, the hardest part of the recovery is not really the postop discomfort, which can be easily controlled by painkillers, but the interruption in their social activities.
The list below explains the length of social recovery after a specific type of facial plastic surgery and what kind of postop symptoms one should expect during the initial healing phase:
- Facelift. Five to seven days after surgery, the swelling and bruising will rapidly improve that most patients can return to their social activities by eight day, although usually with the “assistance” of camouflage make-up and/or fashion accessories such as sunglasses and scarves.
- Rhinoplasty. The postop bruises are the most apparent around the eyes and will take a week to subside to a significant degree. However, social recovery greatly varies from patient to patient, with some people able to look “more acceptable” within a week, while others have to wait for two to three weeks especially if they have a thick nasal skin.
- Fat grafting. This involves injecting a small amount of fat into the area that needs more volume, leading to mild swelling and bruising that can last for seven days, although some patients may have to wait for another week to appear “socially presentable.”
- Eyelid surgery. This involves a rather straightforward recovery with the use of very fine incisions made within the natural upper eyelid crease and close to the lower lash margin. For this reason, most patients can have “dinner with friends” after about five days, although big sunglasses remain helpful to hide any residual swelling and bruising, and to protect the scars from harsh elements.
- Brow lift. With endoscope or small camera probe, the procedure will only need several small incisions that can lead to about a week of social recovery; however, the initial healing phase could take longer with the standard technique in which one continuous incision from ear to ear, behind the hairline, is used.
The number of men having plastic surgery is on the rise, with a recent survey showing that they accounted for 13 percent of all cosmetic surgical enhancements, or about 205,000, last year alone.
The survey, which was conducted by the American Society of Plastic Surgeons, has shown that rhinoplasty or nose surgery, eyelid surgery, and facelift were included on the top five list of the most commonly performed procedures in men.
Celebrity LA plastic surgeon Dr. Tarick Smaili says the growing popularity of male plastic surgeries, particularly those aiming to create a more youthful and more balanced face, is due to the declining stigma on surgical enhancements.
Another contributing factor, according to a recent survey, is the growing job insecurity. In an attempt to look more competitive and youthful, male patients are commonly citing this reason for having cosmetic plastic surgery.
But since there are certain aesthetic characteristics that typify the masculine face—including “heavier” and lower brow, more horizontally-oriented forehead, thinner lips, and bigger nose compared with women’s—Dr. Smaili says facial plastic surgery should always take into consideration one’s gender, in addition to other factors such as the rest of the facial features, ethnicity, and motives and expectations.
When treating male patients who want to have a more youthful visage through facelift, Dr. Smaili warns that excessive tension on the skin can lead to fake results, or worse, a more feminine appearance.
While too much tension on the skin has detrimental effects on both genders, over-correction is particularly detrimental to men because it not only feminizes the face, but also leads to unnatural side burns, hairline, and ear (pixie ear deformity or “stuck-on” appearance).
Compared to women, male facelift generally requires a more conservative jaw line contouring to preserve their masculine appearance. Some “seasoned” plastic surgeons even retain a few wrinkles to create a somewhat mature, but still attractive male face.
By being on a conservative side, the leading LA plastic surgeon says it is easier to achieve more natural results and avoid the dreaded windswept and perennially surprised appearance.
In brow lift surgery, Dr. Smaili says being conservative is also beneficial to men. The idea is to create a more horizontally-oriented, “heavier” brow to preserve the masculine appearance.
A more curved, arched brow, on the other hand, only works for female brow lift surgery.
There is also a stark difference between male rhinoplasty and female nose surgery. According to a recent study, an attractive male nose is a bit bigger and wider, and has an angle of rotation close to 90 degrees to give it a stronger, straighter tip.
On the other hand, creating a more upturned nose has a feminizing effect which must be avoided when performing a male rhinoplasty, explains Dr. Smaili.
One of the most common misconceptions of people is that facial aging is only caused by loose skin or tissue laxity. On the contrary, some variables such as leathery, dry skin and gaunt appearance due to loss of fat or tissue atrophy could have a more detrimental impact.
One important goal of facial rejuvenation surgery is to preserve the youthful plumpness and tighten the loose skin without leading to an overly tight, fake-looking appearance that “screams” facelift. Oftentimes, botched results occur because surgical skin tightening is performed on someone who doesn’t need it in the first place.
If you have little loose skin but still look perennially tired, the culprit could be the loss of facial volume or fat in your cheeks, around your eyes, and temple.
Fat injection, or fat grafting, is growing in popularity nowadays due to its perceived safety and more natural results than soft tissue replacements or dermal fillers such as Restylane and Juvederm. Its intrinsic purpose is to add volume to plump up the face and skin, leading to a more rejuvenated appearance.
The procedure always starts with a gentle way of harvesting (with a use of a special syringe) of fat usually from the tummy and thigh area.
After extraction, the fat cells must be “washed,” sorted, and prepared for re-injection. Celebrity Los Angeles plastic surgeon Dr. Tarick Smaili says it is vital to remove the impurities such as blood prior to re-introduction of fats to encourage high survival rate and more predictable results.
To further increase fat survival rate, Dr. Smaili highlights the importance of injecting the “processed” or purified fat into facial tissue at a varying level, instead of “dumping” it all in one go. The idea is to allow the grafts to form and/or reach the blood supply they need to survive, thus leading to a near permanent result.
Judicious injection of fat grafts also plays an important role in delivering natural results, explains Dr. Smaili.
Aside from the gaunt or hollowed appearance, fat injection might also soften your nasolabial folds, or laugh lines between your mouth and nose. However, some doctors prefer dermal fillers with a thicker consistency than fat (e.g., Juvederm and Restylane), which is believed to be more potent in softening the facial lines.
But when it comes to correcting loss of facial volume, the consensus is that fat graft remains superior over other volumizers because it is as soft as the surrounding tissue. Traditional fillers, meanwhile, are somewhat cohesive that makes it challenging to simulate the natural softness of the face.