The neck lift and the different operative techniques by Dr. Mitz

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

The reasons for neck deterioration are extremely variable, depending on poorly observed hygiene and dietary rules, inconsiderable weight gain, and deformities in the spinal cord.
The spine is located in the middle of the back, which separates in its left and right sides. It rests on the pelvis, serves as support for the ribs and the skull.
Structure of the spine
The … "data-image =" https://www.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/a/0/c/a0c1b85662_50036178_vertebres-wiki-dp-01.jpg "data- url = "/ health / definitions / medecine-vertebral column-8325 /" data-more = "Read more">spine cervical which, when compressed, causes ptosis of the neck tissues located in front of the tracheal function
The trachea allows oxygen rich air to be passed from the larynx to the lungs, while filtering the air to improve its quality. It is also the way to eliminate carbon dioxide-rich air … "data-image =" https://en.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/3/ a / 0 / 3a05f8a302_50034375_system-respiratory-wikimedia-03.jpg "data-url =" / health / definitions / biology-trachea-2134 / "data-more =" Read more ">trachea. The request for surgery aesthetic at the neck is one of the most frequent and one of the first requirements that patients express as soon as they notice a anomaly at this level.

Fat neck, distended neck, withered neck

For us, cosmetic surgeons, it is imperative to distinguish different deformations in the neck, because they will impose very different repair techniques, but which can be associated in some cases.

The fat neck, or turkey neck, consists of a fat accumulation located in three different layers that overlap in some cases.

  • A layer of subcutaneous fat relatively homogeneous and which can disappear thanks to a well conducted diet.
  • A moderately deep layer of fat, consisting of greasy cells the size of grains of rice, located between the neck muscles of the neck, those that form the vertical ropes when you make a face by lowering the corners of the mouth.
  • A layer of deep cervical fat, which is nestled around the trachea and gland Thyroid function
    The thyroid gland is an endocrine gland that synthesizes and releases into the bloodstream thyroid hormones, thyroxine (T4) and triiodothyronine (T3). These hormones have a role in the basal metabolism, in … "data-image =" https://fr.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/3/b/2/3b290597fa_50034457_thyroide- brooks-cole.jpg "data-url =" / health / definitions / thyroid biology-2858 / "data-more =" Read more ">thyroidfat deposits which can decrease thanks to an appropriate diet.
  • A particular form of fat is constituted by "Cherubinism", or childish round face, which can complex some people wishing to have a better definition at the level of the cheekbones or the chin, or in any case to find some angular aspects of their face, to diminish the "baby face" side that complexes them.

The distended neck has vertical strings under the chin, which is still called baleen. These formations are related to a hyper contraction In mineralogy, a fibrous texture designates aggregates of elongated crystals in the form of fibers (example: asbestos). "Data-image =" https: //fr.cdn.v5.futura-sciences. com / buildsv6 / images / midioriginal / 0/7/2 / 0723e38fb5_50034300_amiante-dr.jpg "data-url =" / planet / definitions / geology-fibrous-1490 / "data-more =" Read the definition ">fibrous contracting neck muscles because of the need to keep the head straight and to compensate for changes in the curvature of the cervical spine. These baleen are temporarily improved by injections of botox in the muscular bands of the cougar of the neck, or platysma.

The withered neck appears in patients who have taken a lot of The Sun is the star closest to the Earth, from which it is distant about 150 million kilometers. The Sun is located at 8.5 kparsecs from the center of the Milky Way. In the classification of stars, the sun is a star of type G2.
The mass … "data-image =" https://www.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/1/d/9/1d9cd1d45f_50034577_eruption.jpg "data-url =" / sciences / definitions / universe-sun-3727 / "data-more =" Read more ">Sun, and whose elastic dermal fibers have more or less dislocated, resulting in horizontal and vertical folds, sometimes more apparent in the neck than the face itself.

These epidermal fractures also extend towards the décolleté inter mammary, complexing people, who are very affected. They dare not wear low-cut clothing anymore.

The balance of deformations at the level of the neck

Certainly, there are cases where the main deformation can be found at the level of the neck; in any case, that's what patients feel and what they complain about first. They hope, moreover, an isolated gesture of surgery on the neck, which may be possible in some cases but which, for the most part, will have to be associated with a more general surgical procedure of the type cervicofacial lift.

Indeed, it is not uncommon for the degradation of dermal elastic fibers to be regional and concerns not only the neck, but also the face. Under these conditions – if there are jowls and an alteration of the appearance of the texture cut on the cheekbones, cheeks, folds in front of the ears – surgery that would remain isolated at the level of the neck would not bring the expected good and the result postoperative spectacular that patients expect these days.

This is why the examination by the surgeon involves not only an evaluation of the degradation in the neck but also the condition of the integument in botany.
In botany, the term integument generally refers to the tissues surrounding and protecting different organs of the plant.
The integument in … "data-image =" https://www.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/a/9/7/a9755c484a_50038865_weta-geant-insecte-mark-moffett- minden-solent.jpg "data-url =" / planet / definitions / geology-tegument-12708 / "data-more =" Read more ">integument of face, and even eyelids to possibly be able to offer a global gesture of rejuvenation, safe and much more important at the surgical level. However, it is also heavier financially, which is not the slightest problem. But, in about 20% of cases, the cervical problem of fat and pasty neck is isolated; it can then be adjusted by a specific operation that is the lipolift.

Lipolift is a careful liposuction of the neck

The lipolift is to realize a duration of the intervention lasts … "data-image =" https://fr.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/7/4/0/ 740a20d4e1_37509_liposuccion.jpg "data-url =" / health / definitions / medecine-liposuction-13488 / "data-more =" Read more ">liposuction regional accumulated deep subcutaneous fat through a cannula very thin metal 3 to 4 mm in diameter. It is introduced by three incisions: a first median under the chin and two lateral under the lobes of the ears. By a gentle but supported and precise liposuction, the surgeon removes subcutaneous fat and fat located between the skin muscles. The region which is thus rid of its fat is below a large surface, below a line which joins the earlobe at the corner of the mouth, and which concerns the whole cervical region anterior and than the lateral parts of the neck to the sternocleidomastoid muscle laterally.

It is a relatively light operation that lasts between 30 and 45 minutes, which can be done under anesthesia local and ambulatory. Some patients, however, prefer to be operated under Surveillance every moment during … "data-image =" https://fr.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/5/0/3/503cd3ce8f_51891_anesthesie -generale-officialusnavyimagery-flickr.jpg "data-url =" / health / definitions / medecine-anesthesia-generale-2972 / "data-more =" Read more ">General anaesthesia but the intervention is nonetheless performed on an outpatient basis.

The small surgical wounds are closed by resorbable wires. A compression elastic is recommended for a period of 3 weeks to prevent postoperative swelling and hematoma that may nevertheless occur in patients whose coagulation is elongated or has unstoppable capillary fragility.

The results of lipolift are excellent and begin to manifest as early as 6e week after, sometimes small retractions that usually disappear on 2e postoperative month.

The result of this lipolift is stable, provided that the patient continues to pay attention to his diet and avoids taking back weightlessly, because not all the fat cells are removed by the lipolift: only those that are dilated and filled are removed. of fat. There is still structure of adipocytes
These cells have a round morphology, up to 150 micrometers in diameter. They are present in adipose tissue (fat). We distinguish :
the white adipocytes, which contain a large drop … "data-image =" https://en.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/c/1/0/c1013582cc_50034148_adipocyte-reytan- gfdl.jpg "data-url =" / health / definitions / medecine-adipocyte-86 / "data-more =" Read more ">adipocytes dishes that have still stored fat and that the lipolift does not empty. These residual cells may restart a storage program requiring surgical retouching after one year, if this occurs. Lipolift also removes fat from the jowls and improves the mandibular bone line.

Because the subcutaneous fat is removed, there is a shrinkage of the integuments of the order of 20%, thus a natural lifting effect without it being necessary to necessarily remove the skin, as in a true facelift. But this effect of spontaneous retention 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 toned skin.

Lipolift and cervicofacial lift

In the case where it associates with the fatty neck, alterations in the face, with the presence of undeniable tissue aging, the lipolift is only the first time of surgical facial rejuvenation. After lipolift, the initial time of the surgical procedure, the surgeon will generally perform a complete cervicofacial lifting, or in some cases, an isolated cervical lift, that is to say it will tighten the tissues of the neck by pulling the teguments behind the ears, according to a vector oriented at 45 degrees upwards and backwards.

Personally I am not a satisfied follower of the use of the threads The tensors are used in differential geometry, in mechanics (tensor of the stresses, tensor of inertia, in relativity).
Math. A tensor is usually a … "data-url =" / sciences / definitions / physics-tensor-2511 / "data-more =" Read more ">tensor, I prefer operations where the excess skin is surgically removed, to obtain a result that will last more than a year, as it happens with the use of tensioning threads which do not allow to tighten the skin and the SMAS.

Treatment of baleen wounds or vertical neck folds

If there are isolated vertical neck folds with skin that remains tonic, or if the folds of the neck reappear after a good head and neck lift, it is possible to use Botulism Injections, the toxin acts. like a muscle paralyzer. Its neurotoxic properties are such that the toxin … "data-image =" https://fr.cdn.v5.futura-sciences.com/buildsv6/images/midioriginal/c/c/a/ccaabbd286_50035305_toxine-botulique-dr .jpg "data-url =" / health / definitions / biology-toxin-botulinum-6476 / "data-more =" Read more ">botox in the platys muscle, to reduce the hyper contraction of the muscles or "platysmas" that are responsible for these vertical baleen. This treatment is easy to do at the doctor's office, but it should be repeated regularly to avoid recidivism which occurs inexorably.

A surgical revision is more complex: the surgeons hesitate between a suture paletot of the neck muscles, or a maximum retention of the skin muscles backwards, by hanging them in the region located behind the ear. The experience of each surgeon is so valuable to be able to advise you at best towards a treatment well adapted to your problem.

Remove the overflow of neck by direct excision?

This operation, rather simple, consists in removing en bloc all that hangs or exceeds at the level of the neck by a excision direct surgery. This interesting operation makes it possible to reshape the skin and muscles of the neck scar vertical sometimes broken by a small Z plasty well located and not very visible. The vertical scar disappears in about 6 to 18 months.

Operation is very popular among men, but also among older women who do not want large operations such as cervico-facial lift and whose suites are heavier, this vertical cervico-plasty is performed as an outpatient. She does not go back, however, the integuments of the face and does not remove the jowls.

Sometimes a implant An oral stent is added to advance the chin a bit, which contributes to a subtle, effective rejuvenation effect that responds to a demand for limited surgery. The good indications are older men with a withered neck who want a quick and easy 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 a aging unpleasant that the patient refuses intuitively.

There are simple and adapted solutions for deformities that are light, lipolift type or small isolated cervical lift. That's why you have to worry about this problem rather quickly, because the longer you wait, the more the degradation becomes regional and extensive, imposing a cervicofacial lift associated with lipolift. Of course, this brings you to a much larger surgical and financial dimension.

Finally, in some cases, a simple resection vertical surpluses can restore a cervico-facial angle appreciated at the cost of a scar finally not very visible after a few months, and especially indicated in men who can hide it in a small temporary beard.

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To learn more about Dr. Vladimir Mitz

Dr. Vladimir Mitz, is a cosmetic surgeon in Paris. It is an author who deals with plastic or aesthetic and restorative surgery through several of his works. He did all his studies of medicine and surgery in France. Former external, then intern and head of the hospital of Paris, he was very interested in surgery. Internal in neurosurgery at the Lariboisière hospital, he had been fascinated by the precision and technical quality of the operations performed on the brain. The human dimension of this surgery had excited him.

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