Face & Neck Lift

What is rhytidectomy surgery?

Rhytidectomy, commonly referred to as a lower face and neck lift, helps reduce the effects of facial aging, giving patients a more youthful, refreshed and rested appearance. It repositions the cheeks to their younger position and restores the sharp contours of the jawline and the neck.  If you are unhappy with how weathered and tired you look around your lower face and neck, a rhytidectomy procedure may be right for you. In some cases, patients present with facial aging, but their neck still appears youthful. In such cases, a mini-facelift (S-lift, short-scar facelift) procedure is usually performed. A mini-facelift is a shorter surgical procedure that uses smaller incisions and has a relatively quicker recovery time. Other times, patients present with the aging of their neck alone and are less preoccupied with the aging of the rest of their face. In such cases, an isolated neck lift procedure can be used. Neck lift surgery requires incisions that are shorter and that are mostly hidden behind the ears. Rejuvenating and defining your appearance without overstretching your skin, Dr. Motakis customizes his rhytidectomy procedure to address your concerns in the most natural way.

Who is a good candidate for a lower face and neck lift procedure?

The ideal candidate for a rhytidectomy procedure is a man or a woman who has facial and neck descend and does not want to look weathered and tired all the time. Frequently, rhytidectomy is performed in patients who are past their forties and can be successfully performed on healthy patients in their seventies and eighties.

The procedure

A commonly performed procedure, a lower face and neck lift (rhytidectomy), lifts the skin and muscles of your face and neck, giving it a firmer, sharper and more attractive appearance.  Dr. Motakis uses a variety of techniques to expertly perform facelifts. Depending on the amount of facial and neck laxity the incisions and technique are modified. Dr. Motakis strives to use the shortest incisions possible (Mini-facelift, short scar facelift, S-lift) to achieve the desired result. However, when necessary the incisions of a full-face lift are used to achieve the optimal outcome.  In all facelift procedures, an incision is made along the anterior contours of the ears, which is extended behind the ear and along the hairline in variable degrees. If the neck is very droopy an incision under the chin may also be necessary to achieve a sharp jawline. Once the skin on the sides of the cheeks and neck is lifted to access the underlying tissue (SMAS), this tissue is repositioned superiorly and posteriorly to where it used to lie earlier in life. The method or repositioning varies from patient to patient and it may involve suturing it at a higher place (SMAS plication), removing a strip of tissue and sewing the tissues tighter together (SMASectomy), or lifting the SMAS and cheek  off its underlying structures and repositioning it at a higher place (SMAS flap, deep plane facelift, composite facelift). Once the tissue is repositioned, excess skin and fat are delicately removed. 

If the neck displays severe bands, excess skin and/or fat, an additional access point is necessary. A one-inch incision is made in the crease under the chin. The structures directly under the jaw are accessed and tightened, allowing for a sharper neck contour. Lastly, particular attention is paid to the incisions using internal dissolving sutures, so that no stitch marks are left behind, no painful suture removal is required and ensuring that the incisions become imperceptible.

There are several other steps that may be necessary to refine the result of a lower face and neck lift. These include a lateral brow lift, fat grafting, skin resurfacing and occasionally buccal fat reduction. If skin excess is present in the upper part of the face around the eyes, and the eyebrows appear low, a lateral brow lift performed with the facelift may be required in order to achieve a smoother and more harmonious result. Through a small one-inch incision within the hair in the temple the lateral brow is lifted and repositioned in a more youthful position. Occasionally, when there is puffiness and excess skin around the eyelids, an upper and lower blepharoplasty (see blepharoplasty) are performed at the same time in order to achieve a more harmoniously rejuvenated facial appearance. An integral part of the modern facelift is the use of “micro-fat” grafts, to replenish the volume that we now understand is lost with age (see facial fat grafting). When necessary, Dr. Motakis ‘volumizes’ the deflated parts of the face in a conservative manner, thus restoring the face to its more youthful state. Areas that are usually fat grafted include the temples, the hollows, and depressions around the eyes, cheeks, jawline, mouth and chin. Furthermore, If the area around the mouth or any other area of the face presents with deep and dense wrinkles due to advance sun damage and aging (smokers lines) the skin is resurfaced in a gentle yet effective manner using a combination of modalities: resurfacing with SmartSkin© fractional CO2 laser, stem-cells harvested from fat (nano-fat grafting) and autologous platelet-rich plasma (PRP) injections.

In the hands of Dr. Motakis facelifts are performed under general anesthetic or under sedation and typically require a one-night stay at our Avenue Road fully accredited on-site surgical facility.

What is the recovery period for rhytidectomy surgery?

On average, it takes 1-3 weeks to recover from a lower face and neck lift. Initially, you should expect a few days of swelling and bruising with minimal discomfort, treated with moderate analgesics. You will likely be able to resume light activities 5-7 days after your surgery. However, it is recommended that any significant physical activity (such as exercise) only be resumed after the second week. You will likely need 1-2 weeks off work. The fine incisions will fade away and become imperceptible over a few months following the procedure. You will receive instructions from Dr. Motakis concerning caring for your incisions while you recover from surgery. Frequently, during the early post-operative period, Dr. Motakis will recommend various lasers and other treatments to further expedite the fading of your incisions.

What are the risk factors of lower face and neck lift surgery?

Dr. Motakis makes every effort to execute the procedure in the most meticulous way, however, as with any surgery, swelling and bruising around the face and neck can’t always be avoided, but resolve over the first few days or weeks. Scarring is invariably imperceptible but may take a few weeks or months to fade. Rarely, bleeding, infection, changes in skin sensation or reaction to a medication or an anesthetic, may occur. Injury to important structures such nerves is extremely rare and usually resolves over time. The list of all possible risks will be discussed in detail during your consult and pre-operative appointment with Dr. Motakis and his team. Smoking can result in serious healing complications, so it is important to stop smoking 4 weeks before this procedure and only resume 2 weeks after.

Are there any alternatives to rhytidectomy surgery?

There is a multitude of non-invasive treatments available at our clinic that can help slow down and restore some of the signs of facial aging. Even though they don’t amount to the dramatic improvement one gets with a facelift, they offer visible improvements and immediate gratification without the downtime. Significant enhancement of the face and neck can be achieved using neuromodulators such as Botox© or Xeomin©, injectable fillers such as Belotero ©, Redensity©, Sculptra© or Radiesse©, and platelet-rich plasma (PRP) injections. The use of various lasers such as the SmartSkin© fractional CO2 laser, Forma and Fractora© RF, Picosure© and IPL that can help brighten one’s complexion and minimize fine lines and wrinkles. Vitamin and hyaluronic acid skin boosters, oxygen therapy and chemical peels can help restore the skins glow and youthful hydrated appearance. Lastly, high grade targeted medical skin care (such as ZO©, SkinMedica©, Neocutis©) can help you maintain these results daily.  Many of these treatments are also ideal after a rhytidectomy procedure to maintain and enhance the surgical result. During consultation, Dr. Motakis will guide you to the right treatment plan in order to accomplish and maintain the most optimal result.

Can rhytidectomy be combined with other procedures?

Many of Dr. Motakis’ patients combine their face and neck lift procedure with other cosmetic procedures offered at our clinic. These procedures frequently include eyelid surgery or a lateral brow lift, fat injections, nano-fat grafting, and platelet-rich plasma (PRP) injections, buccal fat reduction, skin resurfacing with the SmartSkin© fractional CO2 laser or the Fractora© fractional radiofrequency device or hyaluronic acid injectable fillers such as Belotero ©, among many others.

Is it possible to have just an isolated Neck Lift?

The neck is often an area of primary concern for some patients. There might be excess fat and excess skin under the chin as well as ‘cord like’ vertical bands known as platysma bands, creating what is known in layman terms as a “turkey neck”. Even though an isolated neck lift may address some of these concerns, often, the best way to achieve a significantly sharper jawline is through a lower face and neck lift. During consultation, Dr. Motakis will discuss with you all options for neck rejuvenation and help you decide what is the best-suited procedure for you. The incisions used in a neck lift procedure are like those in a lower face and neck lift, although they are more limited and mostly behind the ear. Dr. Motakis expertly removes excess skin and fat in the neck and jaw area, giving them a sharper and more defined appearance. Through a small incision under the chin, the neck muscles are often tightened to further define the neck contour. Typically, the neck lift procedure is performed under general anesthesia although IV sedation may occasionally be used. An overnight stay at the surgical facility is usually required for observation and comfort. A neck lift can be performed alone or in conjunction with another facial procedure such as eyelid surgery.

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