This information describes the simplest approach to the neck which may or may not be appropriate for you. Sometimes this procedure is called a “weekend facelift” because the recovery is short, but I do not like that expression because I think it is mainly about marketing.
With time, fatty deposits and extra skin will often develop underneath the chin. The skin tends to separate from the jawline and hang down. The muscles of the neck separate and droop giving what are called platysmal bands or a turkey gobbler appearance to the neck. What sub-mental liposuction with plication and facelift have in common is that they both have a small one-inch incision under the chin which is not very noticeable. Through this incision, liposuction of the neck is performed, the muscles of the neck are brought back together in the mid-line, and the skin is re-draped. For a patient whose main problem is fatty tissue and muscle separation, sometimes a facelift can be avoided by performing this neck operation. For patients with significant excess skin under the chin, this simple operation will not work for them since the excess skin will have to be removed through a necklift or a facelift with incisions around the ears in order to prevent unnatural re-draping of the skin folds. In some cases, even though a facelift would be optimal in terms of removing extra skin and improving the contour of the neck, sub-mental liposuction and plication will be performed instead because of patient preference.
Sub-mental liposuction and plication takes about 45-60 minutes whereas a facelift takes about 3 hours. It is an out-patient procedure usually performed in my accredited office surgery suite under sedation. The time out of work is usually less than a week rather than about 2 weeks, and obviously there are no scars around the ears.
Complications of sub-mental liposuction and plication include bleeding. There is occasionally a drain which will be removed the day after surgery. Bruising is minimal, swelling is normal, and the risk of infection is only 1 in 100. Very rarely a patient could have a crooked smile for a few weeks after surgery, but there is no real risk of permanent nerve damage from this operation.
There could be some minor surface irregularities to the skin during the healing process, especially if you had significant skin excess, but these almost always resolve over time and are certainly still an improvement from the contour before the procedure was performed. In addition to this, although the neck line will look much better in the first few weeks, it will feel firm or doughy to the touch for up to 3 months. This is completely normal. There may also be some temporary numbness of the skin, but this will resolve over time.
Smokers heal poorly in terms of infection and wound breakdown, and you are advised not to smoke for at least 1 month before and after surgery. Nicotine screening may be necessary the day of your surgery. IF THE TEST IS POSITIVE, YOUR SURGERY WILL BE CANCELLED.
It is somewhat variable how much the neck skin will shrink after the fatty tissue is removed underneath the skin. This depends on the patient’s age and general condition of the skin in terms of sun damage, smoking and genetics. In some patients, this is the only operation they will have, while in others, it is simply a way of delaying a facelift for a few years.
I hope that this information has not been overwhelming in terms of the possibilities of complications. I have tried to give you as complete information as possible so that you can make an informed decision. Nonetheless, I would like to emphasize that the vast majority of patients have successful and uncomplicated surgery and are quite pleased with their results.
It will be a pleasure to discuss sub-mental liposuction with or without plication with you. Please call my office with any questions you may have (804-320-8545).