The lower face includes the lower part of the jowls, the lower jaw line and the neck. The most obvious signs of ageing are hanging jowls, a deep marionette line (from the corners of the mouth to the lower jaw line), Turkey gobbler neck and excessive fat deposits on the neck (bull neck).
The goal of the surgery is to remove excess skin and fat deposits, and tighten the muscle layer beneath, to restore the youthful shape of the face. The methods applied are surgical tightening, liposuction, silhouette lift, chin implants and fat injections.
Frequently asked questions about lower face and neck lift:
Who is a good candidate for this procedure?
Often the procedure is part of a comprehensive face rejuvenation. For persons without problems in the upper and midface, it can be performed alone. Suitable candidates are people in their forties, whose skin begins to sag, and who complain about fat deposits.
How is the procedure performed?
The following methods are applied:
- The face and neck lift usually involve an incision in front and behind the ear; it may be extended into the scalp. Excess skin is excised. If the neck skin can be easily tightened, an incision on the front side may be sufficient. The underlying muscles, including those responsible for facial mimic, are tightened and shaped with suitably placed sutures. If this is not done, the face will soon return to its old shape. Fat deposits on the neck are removed by liposuction. To correct the Turkey gobbler neck, the neck part is opened with an incision under the chin and the muscles are tied together. The result is a better contoured neck. A receding chin can be improved with a chin implant; good results can also be achieved with fat injections. The marionette lines are smoothed with fat injections. Any unwanted fat depots along the jaw line are suctioned off.
- For young patients with good skin elasticity, liposuction may be sufficient to enhance the contours of the neck. The fat obtained in this process can be used for chin contouring and marionette line improvement. (Liposhaping – link)
- A silhouette Lift (Link) is suitable for persons with good skin quality who don’t want any scar traces. In this procedure, special strands are inserted under the neck skin and anchored below the ears. The lift can be complemented by fat injections and a chin implant.
What to do and what not to do before treatment?
Three weeks before an invasive / surgical treatment patient must stop smoking and taking aspirin. In the last week, patients must stop taking any anticoagulant (“blood-thinning”) medicine.
The following substances are also prohibited:
- pain killers such as Apranax, Voltaren and Vermidon (alternative brand names are Minoset and Novalgin)
- multivitamin tablets containing ginseng, ginkgo biloba and coenzyme Q,
- green tea, herbal products containing linseed, sour cherry stalks, tomato seeds
- all diet products.
Does the procedure require anaesthesia?
Liposuction and silhouette lift can be performed in the surgeon’s office under local anaesthesia or under sedation. Face and neck lift are performed in a clinic under general anaesthesia or under strong sedation.
How long does the procedure take?
Neck liposuction takes 30 minutes, silhouette lift 30 minutes, neck and face lift 2-3 hours.
Is the procedure painful?
Liposuction and silhouette lift are not painful. Neck and face life may be accompanied by a feeling of tightness and pressure; overall, the procedure is painless.
What happens after the operation?
Neck liposuction and silhouette lift traumas heal rather quickly. A bandage is applied which must be worn for 3 days. Patients are discharged the same day and can take a bath – except in the neck area. Face and neck lifts are accompanied by swelling and bruising which dissolve within a week. To speed up the skin tightening process, neck massages are recommended in the first 2 months.
After neck and face lifts, patients stay in the hospital overnight. The next day, the drains are removed. They can take a bath 48 hours later. The sutures are removed after 6 days. However, it takes up to 3 months until the face has acquired its final shape. The period depends on the scope of the intervention and skin thickness. Like with all other face operations, patients are strongly advised to avoid direct exposure to sunlight for the next 3 months.
What problems can occur after the operation?
Swelling and bruising are normal side effects and dissolve almost completely within a week; it may, however, take up to 20 days before the last traces have disappeared. Bleedings are a serious complication. For this reason, patient must discontinue any medication that affects blood coagulation. High blood pressure must be reduced with suitable medicine. If all other means fail, postoperative bleeding must be stopped with surgical intervention. Persistent oedema may form on the neck, and it may take longer than expected before the neck is smooth and thin. The process can be supported with lymph drainage massage, radio wave and deep ultrasound treatment. In rare instances, neck and face operations can lead to lower lip paralysis and movement impairment. These side effects are usually temporary and resolve after a few days; sometimes, however, they continue for a couple of weeks.
The most feared complication is difficult scar healing, which affects mainly smokers, and excessive skin excision. Smokers are strongly advised to discontinue smoking at least for 3 weeks prior to the operation.
Are the results of the procedure permanent?
The surgery does not prevent the ageing process. A return to the pre-operation state is, however, impossible. How long the effect lasts depends on the method and the physical condition of the patient. In patients with thick skin, the skin will loosen up faster than in persons with fine skin.