What is my Plastic Surgeon Going to do?

My plastic surgeon is going to do a face lift revision due to descending jowls and neck banding. This time he said he will "undermine" along my neck and jaw line. What does this mean? Does it include fat removal? Is "undermining" like a deep plane procedure that increases the risk of motor nerve damage?

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26 Doctor Answers | Asked by NHaven in Oklahoma City, Oklahoma

Doctor Answers (26)
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What's involved in a face lift?

Undermining is a term that describes the act of using scissors or another instrument to go through layers of tissue, underneath the skin, in order to gain access so they can be manipulated (tighten and lift SMAS, Platysma). It's a standard part of any variation of a face lift. Underming can occur at different tissue layers, in the face, and hence the terms: skin only, SMAS, Deep Plane and subperiosteal face lifts. These are descriptive phrases that... more

Undermining lower face and neck skin is required to tighten jowls and neck during Facelift

Undermining is simply using surgical Facelift Scissors to separate the overlying skin of the face and neck from the muscles and tissues deep to the skin. Undermining is required to "free up" or loosen the facial and neck skin so that they can be pulled tight at the end of the Facelift and Neck Lift. Typically the surgeon will also use sutures to tighten the muscles (Platysma Muscle) of the neck with a procedure called a Platysmaplasty. The SMAS-a muscle like membrane that... more

How to facelift: 101

Exactly what is to be done and how it is done should be explained by the surgeon. I always do. Undermining refers to the separation of the skin from the deep layers (muscle and fascia). I have an office in Beverly Hills and Rancho Mirage. The desert is resplendent with secondary facelift candidates. In fact, we rarely do a first-timer. So I am used to handling bands, adhesions and contour difficulties from previous facelifts. Never feel that you... more

Ritu Chopra, MD

4 reviews

Beverly Hills Plastic Surgeon

drrituchopra.com

Face Lift Undermining and Why Do II?

Sounds like your surgeon may have been a little conservative the first time. Lifting up the skin (undermining) is a critical and important part of any facelift and must be done to get good results. Conservative mini lifts with little if any undermining produces mini results that do not please. Get a few consults from surgeons certified by the American Board of Plastic Surgery and a Fellow of the Americal College of Surgeons. Get two consultations... more

Like moving a rug, you first have to lift it from the floor

Undermining means to separate the skin from the surface underneath it. This also allows the surgeon to manage the layers under the skin by either shifting them as well (SMAS lift) or adjusting the neck muscle (playsmaplasty) or any one of many other options. Dr. Mayl Fort Lauderdale

Nathan Mayl, MD

7 reviews

Fort Lauderdale Plastic Surgeon

Secondary facelift

Undermining, in surgical terms, means to free up tissue by means of surgical dissection. If you "undermine the cheek area", it means you separate the skin and fat from deeper anatomic structures. How the surgeon treats the tissues after that is open to debate. There are several possibilities - so ask your surgeon to explain which technique he will use to treat the deeper structures (SMAS in the cheek, or platysma muscle in the neck). It's important to... more

What undermining during a facelift means

Undermining refers to lifting the skin off of the underlying tissues. In and of itself undermining doesn't refer to removing any fat, although your surgeon may be planning this.

What does "Undermining" Mean in Facelift Surgery?

Regarding: "What is my Plastic Surgeon Going to do? My plastic surgeon is going to do a face lift revision due to descending jowls and neck banding. This time he said he will "undermine" along my neck and jaw line. What does this mean? Does it include fat removal? Is "undermining" like a deep plane procedure that increases the risk of motor nerve damage?" If you check dictionaries for UNDERMINE you will find preposterous explanations such as : 1. To... more

Explaining undermining with a facelift

Undermining is simply elevation and redraping of the tissues to rearrange them. A simple analogy would be similar to lifting the sheets of your bed down to the foot of the bed ("undermining") and pulling them forward to make them taut and flat.

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Revision Facelift

Although I agree that a more extensive discussion should be held with your Surgeon about technique and anatomic details, it sounds as if he feels that he initial procedure was not aggressive enough to address your aging changes. The term "undermining" simply means to surgically dissect or lift up. If your Surgeon is experienced and technically sound, there should be no greater risk with a more extensive procedure.