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Dr. Michael D. Yates: So if we're leaning more towards surgical options, I think the number one thing I see people for is really their eyelids. So if people have loose skin of their upper and lower eyelids and that puffiness and the tired appearance from the lower eyelids, eyelid surgery and a cheek lift work great to kind of freshen up that part of the face. And if you freshen up the eyelid area, you only freshen up the entire facial area.
The second thing I see that really is common would be looseness in the neck area perhaps some looseness along the jaw line with those dreaded jowls. And so that's a common complaint and I think that if we're talking about surgery and non-surgery, there's really nothing good non-surgery that tightens the skin significantly. We have some things that will make modest improvements of the neck such as ultherapy and fraxel, but if people have a lot of looseness, then I really try to talk them about an actual surgical correction.
So people might request a neck lift and that's where they're concerned about loose skin, some extra fatty tissue in the neck area. So in the process of educating my patients I talk to them about the fact that we can receive very nice improvements with the neck lift, but we also would want to consider tightening the jaw line and the cheeks to some extent. It's almost impossible to just tighten the neck and get a good result without also tightening the jaw line and the jowl area. So you're really concentrating on the area that gives you the most improvement, but you can line one with the other.
So typically the incisions are going to be somewhere in front of the ear, behind the ear, and sort of up in the hair behind the ear. Then I might go size the side burn area and there'll be a little incision in the natural crease line underneath the chin. So through those incisions we kind of elevate the skin of the face and that's a start. What's most important is to kind of set the foundation. So when we're down there deep and we're looking at the muscles, and what we call the fascia which is the tough tissue to the face.
Number one, we remove fat to kind of provide sculpting for the jaw line and the chin area, but then we tighten the muscles in the fascia and set a very firm foundation. Tighten the muscles here and also bring the muscles back and tighten even the cheek and even up behind the ear. Once that's done then we tighten the skin and we've completed the sculpting of the jaw line and the neck area. So we really concentrate on trying to give the patient the maximum improvement for the area of concern.
Now, here's a patient of mine, a lady, she came in to see me. She's a delightful lady in this stressful life. She just felt like she was looking a bit older than she wanted to and she was mostly concerned about her jaw line and her neck, really equally. So we talked with her about a face and neck lift, and you can see the really nice improvement we've had with the contour of her neck area with those techniques I've talked about. Now, she happened to also want some more improvement up here. So we did what we call full facial rejuvenation and that gave her a nice overall improvement.
Now, this is a gentleman. We do see lots of guys for plastic surgery these days. He came to me concerned with his neck area. You can see he has a tremendous amount of excess skin and fullness in the neck area. This is a family characteristic, the dad kind of had the same configuration. So you might say, well, just liposuction that fat out, he's a pretty young guy, and it should work okay. But in fact, if you do that, what you're going to end up with is some loose skin in the neck area, it would tend to sag now, wouldn't be a very good result.
So again, in the process of educating him, I really steered him toward a neck lift, but really a face and neck lift because I want to do some longer jowling as well. Same techniques, same incisions, but very meticulous removal of the fat both underneath the skin but also underneath the muscle of the neck area, tighten the muscles, redrape the skin, and you can see we've been able to achieve a really nice improved masculine appearance for him.
The second thing I see that really is common would be looseness in the neck area perhaps some looseness along the jaw line with those dreaded jowls. And so that's a common complaint and I think that if we're talking about surgery and non-surgery, there's really nothing good non-surgery that tightens the skin significantly. We have some things that will make modest improvements of the neck such as ultherapy and fraxel, but if people have a lot of looseness, then I really try to talk them about an actual surgical correction.
So people might request a neck lift and that's where they're concerned about loose skin, some extra fatty tissue in the neck area. So in the process of educating my patients I talk to them about the fact that we can receive very nice improvements with the neck lift, but we also would want to consider tightening the jaw line and the cheeks to some extent. It's almost impossible to just tighten the neck and get a good result without also tightening the jaw line and the jowl area. So you're really concentrating on the area that gives you the most improvement, but you can line one with the other.
So typically the incisions are going to be somewhere in front of the ear, behind the ear, and sort of up in the hair behind the ear. Then I might go size the side burn area and there'll be a little incision in the natural crease line underneath the chin. So through those incisions we kind of elevate the skin of the face and that's a start. What's most important is to kind of set the foundation. So when we're down there deep and we're looking at the muscles, and what we call the fascia which is the tough tissue to the face.
Number one, we remove fat to kind of provide sculpting for the jaw line and the chin area, but then we tighten the muscles in the fascia and set a very firm foundation. Tighten the muscles here and also bring the muscles back and tighten even the cheek and even up behind the ear. Once that's done then we tighten the skin and we've completed the sculpting of the jaw line and the neck area. So we really concentrate on trying to give the patient the maximum improvement for the area of concern.
Now, here's a patient of mine, a lady, she came in to see me. She's a delightful lady in this stressful life. She just felt like she was looking a bit older than she wanted to and she was mostly concerned about her jaw line and her neck, really equally. So we talked with her about a face and neck lift, and you can see the really nice improvement we've had with the contour of her neck area with those techniques I've talked about. Now, she happened to also want some more improvement up here. So we did what we call full facial rejuvenation and that gave her a nice overall improvement.
Now, this is a gentleman. We do see lots of guys for plastic surgery these days. He came to me concerned with his neck area. You can see he has a tremendous amount of excess skin and fullness in the neck area. This is a family characteristic, the dad kind of had the same configuration. So you might say, well, just liposuction that fat out, he's a pretty young guy, and it should work okay. But in fact, if you do that, what you're going to end up with is some loose skin in the neck area, it would tend to sag now, wouldn't be a very good result.
So again, in the process of educating him, I really steered him toward a neck lift, but really a face and neck lift because I want to do some longer jowling as well. Same techniques, same incisions, but very meticulous removal of the fat both underneath the skin but also underneath the muscle of the neck area, tighten the muscles, redrape the skin, and you can see we've been able to achieve a really nice improved masculine appearance for him.
Eyelid Surgery and Neck Lift
Doctor Michael Yates discusses surgical options to tighten loose eyelid and neck skin.
