Is it possible for any kind of procedure to only make incisions behind the ear & under chin? (Photos)

Question

Lower face/neck lift incision options. I've recently posted a question and photos re: neck skin laxity and other issues. I would like to ask some further questions of the experts. I would consider a surgery which involves an incision below my chin, and also a z plasty, but I am concerned about any incision in front of my ear. Is it possible for any kind of procedure to only make incisions behind the ear and under my chin? Also, I have a very light growth of facial hair/stubble. Would that be an issue: re a z plasty?

Jacob Tower, MD · Answer

Hello, hope you are well. No matter what direction you proceed in, treating your neck will require skin removal. Removing skin requires incisions somewhere--around the ears, under the chin, etc. You can certainly trade incisions around the ears for a longer (vertically oriented) incision under the chin. That would be a matter of personal preference. The disadvantages are that the scar would likely be more conspicuous, it could be inconvenient to shave over a long scar in the central neck, and the hair density may not be sufficient to provide good camouflage even if grown a little longer. That's why most patients in my practice prefer the incisions around the ears. (The majority of the incision goes behind the ear, but it does need to extend in front of the ear at least a little). Good luck!
Best,Dr. Tower

Zoran Potparic, MD · Answer

It is very difficult to evaluate your condition from these photos. In well selected patient who need skin excision it is possible to perform a neck lift using submental incision for platismoplasty, deep fat excision and, if needed, resection of SM glands. Posterior incision placed behind the ear will allow full transaction of platysma muscle, shaping of lateral neck and jawline and excision of neck skin. Hope this helps. Good luck.

Connie Hiers, MD, FACS · Answer

No, not really.  Avoiding the incisions in front of the ear tends to bunch the excess skin pulled back below and in front of the ear. The incisions are needed to remove the excess skin.  If you do not want incisions, go with a non or minimally invasive treatment like Secret, Morpheus, or Renuvion.

Barry M. Weintraub, MD, FACS · Answer

Like many men, you have jowl formation and excess skin laxity at the jowl level and below the jawline. When performing a neck lift, it is much more effective to re-drape the excessive unwanted neck skin if a lower-facelift is included. However, I have good news for you:  particularly in men, one can undermine and red drape the neck skin below the jawline with incisions only behind the ear and under the chin. Sometimes a small vertical incision is made under the chin, leaving a very fine line which is near invisible amongst the hair from the beard. On other occasions  a z-plasty, or series of z-plasties, may be employed to tuck up the excess hanging skin without wandering up in front of the ear. I have employed this technique in my practice many times and helped many male patients.  In summary, the answer is yes, jowl formation can be liposuctioned away from behind the ears and excess skin can be removed from behind the ears in conjunction with possibly a small anterior incision under the chin.

William Portuese, MD · Answer

In our practice and neck lift procedure does not remove any skin since those three incisions are rather limited. A next lift only removes excess fat compartments in the neck above and below the platysma muscle and a platysma plasty. When there is significant laxity in the neck, a lower face and neck lift is going to be required to remove that significant amount of skin. A large Z-plasty across the front of your neck Will because cosmedically unacceptable

Is it possible for any kind of procedure to only make incisions behind the ear & under chin? (Photos)

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