Neck Lipo and Facelift
Neck Lipo and Facelift NYC
Treatment of the Aging Neck, Neck Liposuction and Platysma
Surgical treatment of the aging face and neck has historically been thought of as going in for a facelift
and coming out with a new look. But the downside to the traditional facelift was always its cost, recovery time, and the risk
of coming out of surgery with a pulled, unnatural look. New therapies in cosmetic surgery have pushed the envelope of minimally
invasive surgery, and nowhere is that more evident than in treating the neck and jaw line. While it is true that some patients
benefit most from a full facelift, many will achieve superb results with treatment of the neck alone, or in combination with
easier and less invasive procedures than a facelift.
The minimally invasive procedure most talked about in medical circles
for treating the aging face and neck is liposuction. Through a series of small incisions, fat can be removed and the neck
and jaw line sculpted to produce a smoother, more natural and youthful appearance. In many cases, tightening of the neck muscles
further refines and shapes the neck, restoring the natural angles and symmetry of this important aesthetic unit. The beauty
of all this is that it is performed as an outpatient procedure with a few small incisions instead of the large, sometimes
unsightly facelift incision.
The neck and jaw line are critically important features of the adult face, and telltale
signs of advancing age are often first noticed in these areas. For this reason, the uniquely elegant procedures discussed
below are targeted to produce a more youthful and natural look with minimally invasive, targeted therapy.
As people age, gravity and time can cause the skin and underlying fat to sag, leading to the
formation of jowls and slack skin around the neck. Neck liposuction can dramatically reduce this prominent sign of aging by
creating a more youthful neck and jaw line. Since skin retains much of its elasticity as we age, the neck and jaw can be reshaped
by removing excess fat from the neck and cheeks through small incisions under the chin. The skin then re-drapes itself along
the jaw line for a more youthful and aesthetically pleasing appearance. In many cases, Thermage is used as an adjunct to neck
liposuction to significantly enhance skin tightening.
particularly women, will develop linear vertical ridges on the neck that are known as platysma bands. The platysma is a thin
muscular sheet located just under the skin of the neck. With time, the fibers of this muscle can weaken, causing prominent
midline bands as well as the appearance of a loose, shapeless neck. Repair of the platysma muscle can dramatically improve
the contour and shape of the neck. At the conclusion of the liposuction procedure, the platysma muscle can be tightened through
a small incision that is hidden under the chin. A few well-placed sutures under the skin help to tighten the muscle, and the
shape of the neck is restored to a more youthful appearance.
The concept of repairing and tightening the platysma muscle
is central to the surgeon's ability to shape and contour the aging neck. There are a variety of muscle repair techniques used
by physicians around the world, but the novel platysma repair procedures performed at SkinCare Physicians are renowned for
producing smooth and eye-pleasing contours of the neck, and refining the jaw line and jowls.
a Combination Approach to Produce the Best Results
These procedures are very effective ways to treat changes
to the lower part of the face caused by aging. Because so many people develop changes to the jaw line as one of the first
signs of aging, neck liposuction and platysma repair can produce dramatic changes in a patient's appearance. Since we target
the source of the problem, the need for a full facelift and its potential complications is eliminated. Ancillary procedures
such as Botox® injections, Contour Threads, Thermage®, or soft tissue augmentation with Collagen, Restylane or fat
transplants can help to enhance the results of neck liposuction and platysma repair.
Your surgeon will help you to
choose the proper procedure, depending on your goals, complexion, skin type, and skin elasticity.
Laboratory tests will be done to ensure you are in good health. Pre- and post-operative antibiotics
are given for infection control, and products containing aspirin are discontinued at least two weeks prior to surgery. Use
of vitamin E must also be discontinued.
Local anesthesia is obtained
with the tumescent technique, which has revolutionized the field of liposuction. We are now able to precisely remove fat cells
without the need for an anesthesiologist in an extremely safe and effective procedure. Several small 3 to 4 millimeter incisions
are made under the chin and along the jaw line to precisely remove the fat contributing to a sagging neck and jowl formation.
Our physicians have helped to pioneer neck liposuction and reshaping techniques, delivered talks at national conventions,
and written books and medical journal articles about the procedures used to perform safe and effective neck contouring.
repair is performed through a small, 1-2 inch incision under the chin. The surgeon carefully brings the muscle back into its
natural position under direct visualization and sutures it into place. The incision heals almost imperceptibly within a few
After the Procedure
You will be asked to continue the antibiotics you began
before surgery. Pain is minimal, as is post-operative discomfort. A compression garment is used continuously for the first
week, then eight to ten hours a day for the next three to four weeks. If sutures are placed (platysma repair), they are removed
one week after surgery.
Patients are able to resume normal activities within a week to ten days of surgery, and the
effects and benefits of surgery are apparent almost immediately.
Contour Thread Facelift
The minimally invasive alternative to a facelift
After years of research
and scientific progress, doctors finally have a minimally invasive way to lift the face with virtually no scars. This new
procedure, the Contour Threadlift, uses tiny incisions and strong sutures to lift and reposition aging skin. This is a remarkable
advance in the treatment of facial aging, and allows many patients who did not want to have a facelift to finally achieve
the results they are looking for.
The quest for the perfect facelift has been going on for decades. Beginning in the
early part of the 20th century, doctors began to seek improvements in technique to lift facial skin back into a more youthful
position. The single greatest limiting factor in traditional facelift surgery, until now, has been the noticeable scarring
that occurs in front of and around the ears. In addition, other factors such as the risk of an over-pulled look, as well as
the inherent risk and recovery of a surgical facelift, have made many patients and doctors reluctant to take the plunge. That
has all changed with the introduction of facelifts using suspension suture, or threads.
Although the general trend in cosmetic surgery has been to move away from more aggressive facelift
surgery, there is still a significant role for the lifting of tissues back into position for many patients. Patients understandably
are reluctant to undergo invasive surgery to achieve this lifting and repositioning of facial tissues, but in many cases this
is exactly what the patient needs.
As we age, tissues of the face including skin, fat, and muscle, begin to sag due
to the effects of gravity. In addition, there is atrophy and loss of supporting structures such as fat. The goal of facelift
surgery is to lift and reposition tissues that have sagged. This simple strategy can be an extremely effective. Many patients
will also benefit from ancillary procedures, such as Botox injections to reduce wrinkles, and soft tissue fillers to replace
the supporting fat that has been lost. But the essential goal of the facelift is to restore tissue to its more natural, youthful
position. Conceptually the facelift is a terrific procedure, but the inherent risks and scarring have limited its utility.
So what is new now?
In a word, what is new are threads. We have used various types
of threads for decades in cosmetic surgery, but until recently none of the threads available provided the strength needed
to predictably lift tissues. The first materials that proved useful, Contour Threads, were approved by the FDA in 2005. These
specially designed threads are made of polypropylene, a suture material we have used in surgery for decades with a superb
and proven safety profile. The threads have tiny "barbs" placed along their length, giving the threads their unique
ability to lift tissue.
What are the advantages of the Contour Threadlift?
are several very important advantages to the Contour Threadlift. They include:
- There are no visible scars after
- The procedure can be performed with only local anesthesia
- Recovery is rapid, with return to
activities within a few days
- The amount of lift is actually adjustable for several months
Threadlift is performed as an outpatient procedure in SkinCare Physician's state-of-the-art procedure rooms. Only local anesthesia
is required. A major advantage of the Contour Threadlift is the ease of recovery afterwards and the absence of risk associated
with general anesthesia. Tiny 3 to 4 millimeter incisions are made in the hairline, and the Contour Threads are gently slid
into place under the skin. Your surgeon will determine just how many threads you will need, and exactly where they should
Once the threads are in place, your surgeon will gently lift and move the tissues to be repositioned. This
part of the procedure is totally painless, and it is remarkable to watch as signs of aging are literally swept away. This
movement of tissue is truly where the artistry of your surgeon helps to create the natural results achieved with Contour Threads.
After the skin has been repositioned, your doctor will have you look in a hand held mirror so that with your input, the threads
can be adjusted to achieve the precise results you were looking for.
Perhaps most amazing, the amount of lift created
by the threads can be adjusted for several months after the procedure. This fine-tuning of the result is achieved in a painless
five minute office visit without the need for any anesthesia.
What is recovery like after the
Recovery is rapid after the procedure. You will need someone to drive you home, but you
will not need any bandages. Pain is minimal after the procedure and usually controlled easily with Tylenol. It takes several
weeks for the threads to "lock" into place, so you will need to be careful with sleeping and certain facial movements
for 3 to 4 weeks after the procedure. Since the threads contain tiny little hooks or barbs that hold your skin in its new
position, your body will take a few weeks to adjust to the presence of the threads. Our staff will give you detailed instructions
as to the proper care of your skin after the procedure. The threads themselves cannot be seen or felt under the skin once
they have settled into position. Patients report that they feel totally natural and comfortable with the threads in place,
and they don't even notice they have them, except for the superb results they have achieved.
Our goal at NYC Dermatology is to be the Tiffanys of Skin
Care. I personally see every new patient who visits our office. I am not just
a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatologic care which I would seek for my own family.
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physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type
of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be
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Dr. Gary Rothfeld is a board-certified dermatologist and dermatologic
surgeon who specializes in aesthetic procedures. Dr. Rothfeld cares for all types of skin conditions with a special emphasis
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office consultation and examination you will be provided with a detailed plan of the treatments that will benefit you
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Sun Protection Ultraviolet radiation is the major cause of skin cancer, including melanoma. It is important
for everyone to be aware of its damaging effects and take measures to avoid overexposure.
Although many people enjoy
the appearance of tanned skin and think it looks "healthy," tanned skin is damaged skin. The ultraviolet radiation
in sunlight penetrates the deepest layers of the skin where it harms the cells. The body responds by making more pigment (melanin)
to try to protect itself, but the damage has already happened and may be permanent. The more exposure you have to the sun,
the more likely you are to develop skin problems later in life.
The damaging part of sunlight
is called ultraviolet radiation, or UV rays. It is categorized into three types:
- UVC rays
(wavelengths = 200 nm to 290 nm) are the shortest and most powerful of the UV rays. UVC is
the most likely to cause cancer if it reaches skin. Fortunately, most of it is absorbed by the ozone layer in our atmosphere.
However, there is concern that a thinning of the ozone layer may be causing more UVC to reach the earth's surface.
rays (wavelengths = 290 nm to 320 nm) are less damaging than UVC, but more of it penetrates to the earth's surface.
It is the most common cause of sunburn and skin cancer. UVB is particularly strong at the equator, at high elevations, and
during the summer.
- UVA rays (wavelengths = 320 nm to 400 nm)
are the least powerful of the UV rays, but they are present all year and can penetrate
windows and clouds.
The first and more effective way to avoid sun damage is
to stay out of tthe sun as much as possible.
If you cannot avoid being exposed to sunlight,
there are five basic defenses that you should keep in mind when you go outdoors:
peak hours of sunlight
Avoid Peak Hours of Sunlight (UV Index)
In general, UV rays are the greatest between 10 a.m. and 4 p.m.
It is best to avoid the outdoors during these hours without protection, particularly during summer, in tropical regions, or
at altitude. During this time, you should pay close attention to the appropriate use of sunscreen, clothing, sunglasses, and
You can obtain an accurate measure of the amount of UV rays in your area by looking
up the Ultraviolet (UV) Index. The UV Index is like a weather forecast. It provides a
report on the amount of damaging UV rays that are expected to affect a region on a particular day. The UV Index changes day
to day according to time of year, cloud cover, atmospheric ozone, and other factors.
The following table is a breakdown
of the UV Index. A high UV Index number means that you are at greater risk of being exposed to ultraviolet radiation. You
should take special care to avoid outdoor exposure to sunlight when the UV Index is moderate or greater.
- 0 to 2
- 3 to 4 = Low
- 5 to 6 = Moderate
- 7 to 9 = High
or more = Very high
The UV Index can be found on our Website or in local
papers, usually in the weather section.
There are several factors to consider when selecting the right
sunscreen. (See the Sunscreens handout for more information.)
actor (SPF) - Sunscreens are rated by the amount of protection they provide from UVB, measured as the "sun
protection factor" or SPF. Sunscreens with higher SPF provide greater protection from the sun. It is best to use sunscreens
that offer a minimum SPF of 15.
Broad-spectrum sunscreens - It is best to use a sunscreen that can
protect you from both UVA and UVB rays. These are called "broad-spectrum" sunscreens.
Most of the original sunscreens blocked only UVB, but increased awareness of the damage caused by UVA has lead to the
development of ingredients that protect against UVA too. Broad-spectrum sunscreens combine ingredients to provide a product
with greater protection.
Common sunscreen ingredients that provide protection
from UVB rays:
- PABA (para-aminobenzoic
- Padimate O and Padimate A (Octyl Dimethyl PABA)
sunscreen ingredients that provide protection from UVA rays:
- Avobenzone (Parsol 1789)
(oxybenzone, dioxybenzone, sulisobenzone)
Sunblocks - "Physical"
sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. They are particularly useful
for people who are sensitive to the ingredients found in other sunscreens. Sunblocks often contain one or more of these ingredients:
- Titanium dioxide
- Iron oxide
Although past formulations
were unsightly (often leaving a white film on the skin), newer "microfine" formulations are invisible after being
applied. Microfine titanium dioxide is effective at protecting from both UVA and UVB rays.
- Sunscreens are classified as "water-resistant" if they maintain their protection after two 20-minute
immersions in water. They are classified as "waterproof" if they maintain their protection after four 20-minute
immersions. You should seek a water-resistant or waterproof sunscreen if you will be participating in water sports, such as
swimming or water skiing, or will be actively sweating.
However, independent testing has shown many products do not
perform well in the real world. So it remains a good idea to apply sunscreen every time you leave the water, or frequently
if you are actively sweating.
Using a Sunscreen
Sunscreen should be applied
evenly and liberally on all sun-exposed skin within 30 minutes before going outside to give sunscreen time to take effect.
(Sunblocks are effective immediately after being applied.) Sunscreens should be reapplied every two hours or following swimming
or sweating. Apply sunscreen generously and reapply frequently at least every two hours.
The chemicals may lose
effectiveness over time, so it is important to throw away sunscreen that is past its expiration date
or is over two years old.
No sunscreen is 100% effective; take additional measures to avoid the
damaging effects of the sun's rays.
Clothing can provide excellent
protection from the sun. However, not all clothing is protective. A thin, wet, white t-shirt will provide almost no protection
from UV rays. When selecting clothes for sun protection, consider the following:
- Cover your head, shoulders, arms,
legs, and feet.
- Use a hat that is broad-brimmed (brim should be at least four
- Wear fabrics that are thicker or with a tight weave; these allow less
sunlight to penetrate the skin.
- Wear darker-colored clothes that absorb more UV rays.
- Wear clothing
made from nylon or Dacron because it is more protective than cotton.
- Avoid remaining
in wet clothes because wet fabric may allow more UV rays to penetrate the skin.
clothing with chemical absorbers to increase their protectiveness.
- Some clothing
comes with a UPF rating that stands for "Ultraviolet Protection Factor." This measures the ability of the fabric
to block UV radiation from penetrating to the skin. A fabric with a UPF 15 allows only 1/15th (6.66%) of the UV radiation
to penetrate your skin as compared to uncovered skin.
Garments fall into 3 categories:
protection: UPF = 15 to 24
- Very good protection: UPF = 25 to 39
protection: UPF = 40 to 50+
Choose clothing with a UPF rating of at least 15. Keep in mind that the UPF of a
garment will decrease over time as the fabric wears.
Overexposure to sunlight can cause cataracts
and macular degeneration, a major cause of blindness. Sunglasses can provide protection. However, not all sunglasses are of
value. A darker lens itself does not guarantee protection. Look at the label to ensure that the glasses provide UV protection.
Sunglasses should be large enough to shield your eyes from many angles. Look for sunglasses that are described as blocking
99% or 100% of UVA and UVB. The glasses may also be described as providing UV absorption up to 400 nm.
possible, remain in the shade when outdoors. Keep in mind that shade does not provide full protection from the sun because
UV rays can bounce off reflective surfaces, such as sand, snow, water, concrete, or even porch decks. In addition, some fabrics
used as shade devices, such as parasols or umbrellas, may not provide sufficient protection. If you seek shade under a cloth,
look for a fabric that is thick, tightly woven, and dark-colored.
Clear window glass provides protection from UVC and
UVB, but not UVA rays. If you are frequently exposed to sunlight while driving, the plastic interleaf of your windshield (which
prevents it from shattering) can help block the light, but side windows have no such protection. Non-drivers can make use
of additional window shade devices. Drivers in some states may be able to use darkly-tinted glass in the side windows, but
this is illegal in some states.
- Avoid the sun when its
UV rays are strongest, between 10 a.m. and 4 p.m.
- Use a broad-spectrum sunscreen with SPF 15 or greater.
Apply it 30 minutes prior to being exposed to the sun and reapply every two hours. Consider using a water-resistant sunscreen
if you will be active (sweating) or in the water.
- Use a sunblock on your lips.
- Wear a broad-brimmed hat
- Wear sunglasses.
- Wear tightly woven, dark clothing to
cover your arms, legs, and feet.
- Stay in the shade when possible.
reflective surfaces, such as water or snow.
- Avoid sunbathing.
be fooled by cloudy days since damaging rays can penetrate clouds.
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NYC Dermatology - Manhattan Dermatology - Skin
Institute of New York - Skin Cancer Doctor- NYC Cosmetic Dermatology- Cosmetic Dermatological Surgery - New
York City - Board Certified Dermatologist
Dr. Gary Rothfeld
NYC Dermatology - Board Certified Dermatologist -
New York, NY
30 E. 60th St. Ste. 805
Manhattan, New York 10022