Neck Lift Technique

There are many surgical solutions for the aging neck, from closed liposuction, closed or minimal access thread suspension, to open minimally and moderately aggressive approaches with oral sedation and analgesia or with general anesthesia. However, procedures performed under local anesthesia with oral sedation and analgesia can provide a safe, efficient, reproducible, necklift that addresses all the components of the aging neck from the cutaneous envelope to the deep fat compartments.

Key points

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A full range of facial aesthetic surgical procedures can be performed safely and quickly with Level 1 anesthesia, avoiding the risks associated with general anesthesia.
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More than 95% of all of the varieties of aging neck pathology require an open submental approach for evaluation and treatment of fat deposits and varying patterns of platysma muscle bands.
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Draining all necklifts seems to reduce the incidence of small blood and serum collections.
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Sequelae and complications with facelifts performed under Level 1 anesthesia are acceptable and can be managed based upon the clinical findings.

Editor Commentary: This chapter describes the author’s current techniqeue for rejuvenating the aging neck using only oral sedation, oral analgesia, and local infiltrative anesthesia. All of the anatomic findings in aging necks from simple submental mild lipodystrophy without skin excell to obtuse cervical/mental angles with excessive fat in all of the compartments of the neck can be safely managed with this technique. Patient risks are minimized by avoiding general anesthesia with its’ possible sequelae and complications including, but not limited to: emergence related hypertension, respiratory compromise, DVTs, and pulmonary emboli. Not having to work around a nasal or oral tube is an added advantage. The author has safely utilized this approach in patients aged 45–95, and, contrary to the comments of the critics of the Lifestyle Lift, the range of procedures offered and the results obtained by Lifestyle Lift surgeons nationwide are as good as any I have seen in viewing techniques and results worldwide for over 38 years.

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