Neck lift and different operating techniques by Dr Mitz

The neck is a region of the face which is often the first to deteriorate due to inevitable aging and an uncontrollable genetic program.We all look like one of our parents somewhere, sometimes distant.The neck translates this inexorable resemblance.

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The reasons for the degradation of the neck are extremely variable, depending on both poorly observed hygieno-dietetic rules, reckless weight gain, and deformations at the level of the cervical spine which, by tiling, leads to a ptose ofCourt fabrics located in front of the trachea.The demand for cosmetic surgery at the level of the neck is one of the most frequent and one of the first requirements that patients express, as soon as they see an anomaly at this level.

Gras, distended neck, wilted neck

For us, aesthetic surgeons, it is imperative to distinguish different deformations at the level of the neck, because they will impose very different restorative operating techniques, but which can be associated in some cases.

Improving the appearance of the neck most often requires a passage through the surgery box.© Solarisys, Fotolia

The fat neck, or neck neck, is made up of an accumulation of fat located in three different layers which are superimposed in some cases.

The distended neck has vertical ropes under the chin, which are still called balens.These training courses are linked to a hyper fibrous contraction of the skin's skin muscles which contract because it is necessary to maintain the head at rectitude and compensate for the changes of curvature of the cervical spine.We improve these baleen, temporarily, by botox injections in the muscle bands of the skin of the neck, or Platysma.

The distribution of fat in yellow and muscle Platysma in purple.© Dr Mitz, all rights reserved

The wilted neck appears in patients who have taken a lot of sun, and whose derontic elastic fibers have more or less dislocated, causing horizontal and vertical folds, sometimes more apparent at the level of the neck than of the face itself.

These epidermal fractures also extend to the inter -breast neckline, complexing people, who are very affected.They no longer dare to wear outrageous clothes.

The balance of deformations at the level of the neck

Admittedly, there are cases where the main deformation can be found at the neck;In any case, this is what patients feel and what they complain about first.They also hope for an isolated gesture of surgery at the neck, which may be possible in some cases but which, for the most part, will have to associate with a more global surgical gesture of the Cervico-Facial Lifting type type.

Indeed, it is not uncommon for the degradation of dermal elastic fibers to be regional and interests not only the neck, but also the face.Under these conditions -if there are covers and an alteration of the appearance of the skin texture in the cheekbones, cheeks, folds in front of the ears -, surgery that would remain isolated at the level of the neck would not bringnot the expected property and the spectacular postoperative result that patients are waiting for today.

This is why the examination by the surgeon not only includes an evaluation of degradation at the level of the neck but also the state of the face of the face, and even of the eyelids to, possibly, be able to propose a gesture of global, safe andmuch more important at the surgical level.However, it is also heavier on the financial level, which is not the slightest deal.But, in around 20 % of cases, the cervical and fatal neck problem is isolated;It can then be set by a specific operation which is lipolift.

Lipolift is a careful liposuction of the neck

Le lifting du cou et les différentes techniques opératoires par le Dr Mitz

The lipolift consists in carrying out a regional liposuction of the deep-subcutaneous accumulated fats thanks to a very fine metal cannula from 3 to 4 mm in diameter.It is introduced by three incisions: a median first under the chin and two side under the ears lobes.By a gentle but precise and precise liposuction, the surgeon removes subcutaneous fat and fats located between the skin muscles.The region which is thus rid of its fats is below a large surface, below a line which joins the lobe of the ear at the corner of the mouth, and which interests the entire anterior cervical region as well asthat the side parts of the neck, to the muscle sterno-cléido-mastoid laterally.

Lipolifting principles by liposuction (in 3 incisions).© Dr Mitz, all rights reserved

It is a relatively light operation that lasts between 30 and 45 minutes, which can be carried out under local anesthesia and on an outpatient.However, some patients prefer to be operated under general anesthesia, but the intervention is nevertheless carried out on an outpatient.

Patient before and after lipolift.© Dr Mitz, all rights reserved

Small operating wounds are closed by absorbable wires.Elastic compression is recommended for a period of 3 weeks to avoid swelling and post-operative hematomas which nevertheless can occur in patients whose coagulation time is elongated or who have unstoppable hair frail.

Les résultats du lipolift sont excellents et commencent à se manifester dès la 6e semaine après, parfois, de petites rétractions qui en général disparaissent au 2e mois postopératoire.

The result of this lipolift is stable, provided that the patient continues to pay attention to his diet and avoids recklessly resuming weight, because all fatty cells are not removed by lipolift: only those who are dilated and filled are removedfat.There are still flat adipocytes that have still stored fat and that the lipolift does not empty.These residual cells can restart a storage program imposing surgical retouching after a year, if this phenomenon occurs.The lipolift also makes it possible to remove the grease which is at the level of the covers and thus to obtain an improvement of the bone bone line line.

Because we remove the subcutaneous fat, there is a retraction of the integuments of the order of 20 %, therefore a natural lifting effect without it being necessary to necessarily remove the skin, as in atruly.But this spontaneous retention effect of the integuments only occurs in cases where the dermis is thick, young, with elastic fibers in good condition, which is the case in young patients with tonic skin.

Lipolift and Cervico-Facial LIFTING

In the event that it associates with the fatty neck, alterations in the face, with the presence of undeniable tissue aging, lipolift only constitutes the first time of facial surgical rejuvenation.After the lipolift, the initial time of the surgical procedure, the surgeon will generally practice a complete cervico-facial lifting, or in some cases, an isolated cervical lift, that is to say that he will reap the tissues of the neckBy pulling the integuments behind the ears, according to a vector oriented at 45 degrees up and back.

Patient before and after a cervico-facial facelift.© Dr Mitz, all rights reserved

Personally I am not a follower satisfied with the use of tensor wires, I prefer operations where the excess skin is surgically remove, to obtain a result which will last more than a year, as it occurs with the usetensor threads that do not allow you to tighten the skin and SMAS.

Treatment of vertical blanks or necks

If there are insulated vertical neck folds with a skin that remains toned, or if the neck folds reappear after a well-done cervico-facial facelift, it is possible to use Botox injections in the Muscle Skincier, in order toto reduce the hyper contraction of muscles or "platysmas" which are responsible for these vertical baleen.This treatment is easy to do in the medical office, but it must be repeated regularly to avoid recurrence which occurs inexorably.

A surgical recovery is more complex: the surgeons hesitate between a paletot suture of the skin muscles of the neck, or a maximum retention of the skin muscles back, hooking them at the region behind the ear.The experience of each surgeon is thus precious to be able to advise you as best as possible to a treatment well suited to your problem.

Remove the too full of neck by direct excision?

This rather simple operation consists in removing everything that hangs or exceeds in the neck by direct surgical excision.This interesting operation allows a stroke to recover the skin and the neck muscles by a vertical scar sometimes broken by a small plasty in well located and not very visible.The vertical scar disappears in about 6 to 18 months.

Principles of vertical cervico-plasty.© Dr Mitz, all rights reserved

Very appreciated operation in men, but also in elderly women who do not wish large operations of the large cervico-facial lifting type and whose consequences are heavier, this vertical cervico-plasty is carried out on an outpatient basis.However, it does not go up the seeds of the face and does not remove the bays.

Preoperative aspect of a patient's profile with Cervico-Plastie and, on the right, post-operative result after 6 months.© Dr Mitz, all rights reserved

Sometimes, an endoobluccal chin implant is added to advance a little chin, which contributes to a subtle, effective rejuvenation effect that responds to a limited surgery request.The right indications concern men from a certain age to the withered neck, who want a simple and fast solution to a problem that has annoyed them for years!

Conclusion

A neck lift is an operation very often requested by patients who focus on this region where the degradation that occurs is the witness of an unpleasant aging that the patient refuses intuitively.

There are simple and suitable solutions for deformations that are light, of the lipolift type or small cervical lifting isolated.This is why you have to quickly worry about this problem because the more you wait, the more regional and extended the degradation, then imposing a cervico-facial lift associated with Lipolift.Obviously, this brings you to a surgical and financial dimension otherwise more important.

Finally, in some cases, a simple vertical resection of surpluses makes it possible to restore a cervico-facial angle appreciated at the cost of a scar ultimately not very visible after a few months, and above all indicated in men who can hide it in a smallprovisional beard.

Pour en savoir plus sur le Dr Vladimir Mitz

Doctor Vladimir Mitz, is a cosmetic surgeon in Paris.He is an author who deals with plastic or aesthetic and restorative surgery through several of his works.He did all his medical and surgery studies in France.Former external, then internal and chief of the Paris hospitals, he quickly interested surgery.Internal in neurosurgery at Lariboisière hospital, it had been fascinated by the precision and technical quality of the operations carried out on the brain.The human dimension of this surgery had enthusiastic it.

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