ASOPRSFall Scientific SymposiumSyllabus
68
Neck andFacial RejuvenationSession
Moderator: Robert G. Fante,MD, FACS
3:30pm
Direct SubmentoplastyCombinedwith Limited-IncisionFacelift forMale
Lower Facial Rejuvenation
Tanuj Nakra
1
, Brett Kotlus
2
, Robert Schwarcz
3
, JonathanHoenig
4
.
1
TexasOculoplasticConsultants/ ToccareMedical Spa, Austin, TX,
UnitedStates,
2
AllureMedical Spa, Shelby Township,MI, UnitedStates,
3
PrivatePractice, NewYork, NY, UnitedStates,
4
JulesSteinEye Institute/UCLA, LosAngeles, CA, UnitedStates
Introduction:
Rejuvenation of the lower face formen by standard faclifting techniques is limited by the potential unwantedmigration
of hair bearing skin, in contrast to female patients. In patientswith significant skin laxity of the neck, the need for neck skin redraping
into the postauricular space can be dramatic.There is another procedure that has historically been useful for submental skin excess:
the direct necklift. In this study,we present a previously undescribed approach tomale lower facial rejuvenation: limited facelifting
plus direct necklifting
Methods:
This is a retrospective review of consecutive combined limited faceliftswith direct necklifts performed in 4 private
practices over 5 years. Pre and postoperative photographic resultswere reviewed by blinded observers and compared.The overall
aesthetic outcome, the location of hair bearing skin, and appearance of the skin scarswere reviewed. In addition, the chartswere
reviewed for complications, subjective satisfaction, and safety of the procedure.
Results:
A total of 18 patientsmet the inclusion criteria.Theminimum follow up timewas 4months. 18 out of 18 patientswere
judged to have excellent to very good overall results. 3 out of 18 patientswere judged to have hair bearing skin posterior to the
lobule. 16 out of 18 patientswere judged to have excellent to very good healing of the incisions- the remaining 2 patients underwent
additional scar revision to achieve optimal final results.Therewere no serious complications encountered in the series. 2 patients had
suture granulomas that were addressedwith simple excision. 1 patient had a same day postoperative hematoma that was evacuated;
he undewent a normal postoperative healing phase thereafter.
Conclusions:
The combined direct neck lift and limited lower facelift is a safe and effective procedure for achieving lower facial
rejuvenation inmale patients.This combined procedure has a strong ability to limit themigration of the hair bearing skin.The long
term healing of the direct necklift is excellent due to its location and the ability of routine shavingmanoevers in remodeling the scar
over the long run.
References:
Bitner JB1, FriedmanO, Farrior RT, CookTA. Direct submentoplasty for neck rejuvenation.Arch Facial Plast Surg. 2007
May-Jun;9(3):194-200.
Perkins SW1, Gibson FB. Use of submentoplasty to enhance cervical recontouring in face-lift surgery.ArchOtolaryngol HeadNeck
Surg. 1993 Feb;119(2):179-83.
DetailedProgram
—Thursday,October 16, 2014
