Face and Neck Lift Article 3
What are jowls and how can they be remedied?
Jowls are fatty deposits that accumulate along the inferior border of the mid-mandible. The jowl formation is the result of masseteric cutaneous ligament laxity, which develops in the cleavage plane between the superficial and deep fascia of the face. These jowls are best addressed with a facelift. Direct excision of jowl fat can be performed. If a face lift is not planned, suction-assisted lipectomy with a small blunt cannula can be performed. There are many face lift techniques that can address sagging jowls, but all successful techniques have in common ligamentous release and resuspension or fixation. This release can be sub-SMAS or supra-SMAS, but in both, the masseteric cutaneous ligaments are released in one plane. SMAS elevation with concomitant delivery of jowl fat into the face and associated platysma tightening is the preferred procedure for addressing the jowls.
How to fix a fat, saggy neck?
Mild to moderate skin laxity can be treated with minimal or no skin excision, whereas significant laxity requires skin excision. The amount of subcutaneous tissue and its location in the submental or subplatysmal space are determined. Laxity and banding of the platysma muscle and prominence or thickening of the digastric muscle as well as ptosis of the submandibular gland should be noted. Vertical and sagittal microgenia must also be recognized – both hasten facial aging, and their correction may dramatically improve the surgical result.
For patients interested in rejuvenation of the neck only, one should generally adhere to the following treatment strategies: in the young patient (40 years or younger), liposuction alone will yield the best results most of the time.
In the middle-aged patient (40 to 55 years), submental lipectomy combined with anterior platysmaplasty (tightening of the muscles in the neck) can be performed.
In the elderly patient or patients with significant skin excess and laxity, submental lipectomy and direct excision of anterior neck skin can be performed.
Click on the Additional Face and Neck Lift Article Links Below to Learn More about Facelifts:
Article 1: Lip and Marionette Line Improvement in Facelifts
Article 2: Laser Resurfacing and Treatment of Nasolabial Folds in Facelifts
Article 3: Jowl and Neck improvement in Facelifts
Article 4: Skin Only Facelifts
Article 5: Deep Plane Facelifts and Extended SMAS Flap Facelifts
Article 6: SMASectomy, SMAS imbrication, and MACS Facelifts
Article 7: Complications of Facelifts: Hematomas
Article 8: Complications of Facelifts: Infection, Skin Loss, and Nerve Injury
Article 9: Optimal Scar Placement in Facelifts
Article 10: Secondary Facelifts
Or View Before and After Photo Galleries of Dr. Hughes’s Face and Neck Lifts Below: