To the average person, a facelift probably means a full rejuvenation of the face, eyes, forehead, and neck. It may also include skin rejuvenation as well. However, to a Plastic Surgeon, a facelift is a completely different and separate procedure from the forehead, brow, eyes, and neck.
A facelift means that the area of the face is rejuvenated, usually with some type of SMAS (superficial musculo-aponeurotic system) tightening. The incision is typically in front of the ears, and the area of tightening is the cheek and facial areas. However, a facelift does NOT include the neck or the jowl area. For that, you need a neck lift.
A neck lift is when the muscles of the neck and skin are tightened and rejuvenated. The incision can be made in front of or behind the ear. To perform just a neck lift by itself, the neck skin would have to be draped around the ear, behind the ear, and possibly in front of the ear. If you have a significant amount of neck skin and muscle to tighten, then you have to either make a compromise and not tighten all of the neck skin, or you will have to undergo a facelift.
Most people need a facelift and a neck lift because that is the only way the jowl, chin line, and earlobe will look normal. If only a facelift is done, then the loose skin around the neck will detract from the overall result. If only a neck lift is done, an average patient will not have significant tightening of the loose skin of the cheek and jowl area, again detracting from the overall holistic result from facial rejuvenation. Finally, depending on your facial structures, you may need a brow lift, eyelid lift, fat grafting , or smaller procedures along with a facelift and neck lift to get the best and most natural results possible.
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