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    Lower face and neck lift

    Indications – poorly defined oval of the face sagging jowls, prominent oral commissure (Marionette Lines), loose underlying neck muscles, “turkey neck”. ormal weighing patients may develop minimal skin excess at 40-50 years of age.

    Diagnosis: Aging process of the lower face and neck areas.
    Operative correction included face and neck lift.
    One month postoperatively


    Endoscopic face lift surgery can be used in this facial area. SMAS layer of the face ( the underlying layer of muscle and connective and fatty tissue) is repositioned and secured by sutures avoiding exessive skin removal. In older aged patients with skin excess in the submental, cheek and neck areas, both endoscopic SMAS lift and excessive SMAS and skin removal are performed.

    Surgery.
    Anesthesia - General anesthesia
    Surgery Time: – 2-3 hr
    The incisions are made in front of the ear along the tragus and behind the ear within the hairline area (figure. 1). This way of tightening skin and neck tissue can help to achieve regular, well-defined oval shape of the face.


    Figure. 1. Arrows show the skin lift pull-up vectors.

    Liposuction is used to remove the excessive fat deposits whenever it is necessary. It can also be performed in mid-section and submaxillary areas of the neck. Submental and malar implants placement can successfully balance (restore) soft tissue deficiency (producing the so called volume rejuvenation.)
    The implants are placed under endoscopic control or using intra-oral incision (for example at the gingivo-labial fold). By liposuctioning or placing the sumbental silicon implant the face shape can be changed from round to oval.
    The external incision in the submental area is used in cases when the extensive surgery access is required, for example in order to suture the neck muscle or trim tissue excess (“turkey neck” case). Lower third of the face surgery can be combined with eyebrow and forehead lift and blepharoplasty. In addition, the follow up correction of the prominent nasolabial fold can be performed several months afterwards when necessary. Sometimes the nasolabial problem can be repaired by cosmetic (filler) injections or patient’s own fat tissue (autologous fat, SMAS)

    Diagnosis: Aging process of the lower face and neck areas
    Operative correction included face and neck lift
    One month after

    Recovery period
    he recovery process after the endoscopic assisted surgery goes easier, causing less discomfort than traditional face-lift surgery. Patients do not suffer from acute pain syndrome, large swelling and scarring. The postoperative compression garment is recommended to wear during 24 hours and later replaced by elastic bandage or compression mask. Sutures are removed within 7-10 days. Endoscopic types of surgery drainage is normally not required.

     
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