Project Description

Dr John Flood specialises in Neck Lift Surgery.  It is important when assessing the neck to understand the underlying anatomy that has contributed to neck ageing. The individual components include skin redundancy, platysmal (neck muscle) separation and laxity, excessive neck fat (either on top of deep to the platysma muscle) and atrophy of the chin bone. The superficial soft-tissue elements must be considered against the backdrop of the underlying bone musculoskeletal architecture, ie, neck length, position of the hyoid bone in relation to the neck muscles and the projection of the chin.

Surgical Approach

In the long, thin neck the characteristic ‘turkey gobbler’ deformity is caused by prominent bands of the platysma muscle and redundant skin. The surgical technique to correct this problem involves a general anaesthetic as an overnight stay procedure. A short incision is placed beneath the chin to allow exposure of the underlying platysma muscle. The skin on the front of the neck is elevated by this incision. A further incision is placed behind the ear and just in front of the hair line of the neck to allow elevation of the skin on the outer part of the neck. Once the dissection has been completed the underlying muscle problem is corrected, this involves suture tightening of the muscle as well as partial division of the muscle to allow the muscle to re-drape appropriately. The skin is then elevated and the redundant skin removed behind the ear. A drain is placed beneath the skin and brought out behind the ear.

The drain is removed the following day prior to the patient going home. Dr Flood usually likes the patient to wear a neck garment for a period of two weeks post-operatively. Thereafter soft-tissue massage is commenced. Most patients only require oral analgesia overnight following the procedure.

This is characterised by a ‘double chin’. The short fat neck deformity is the result of excessive fat in the cervical and sub-chin areas. A detailed assessment must be made of the skin quality as well as the platysma muscle. If the skin quality is good and the muscle tone good then liposuction is an excellent technique to correct the fatty fullness in the neck. At times where there is still skin redundancy and poor muscle tone then a neck lift procedure is required as described above. In association with the neck lift extension de-fatting of the neck is required to help re-define the chin/neck angle and the jaw line. The technique is safe because the facial nerves lie deep to the underlying platysma muscle. The fatty tissue is only removed on top of the muscle thereby avoiding injury to the underlying facial nerve.

 

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