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Mark Domanski, MD
Facelift vs Neck Lift:  The two second test to know for yourself!
Bluemont Plastic Surgery
. https://www.bluemontmd.com/

Facelift vs Neck Lift:  The two second test to know for yourself!

Facelift vs Neck Lift:  The two second test to know for yourself!

One of the most common questions asked by patients is whether they should opt for a facelift or a neck lift. These two procedures are related, hence the confusion.  So, I ask my patients to place their fingers in front of their ears and pull up.  If they like how their skin responds, this is a positive facelift sign.  Then I ask them to place their fingers below their ears and pull back.  If they like how their neck responds, this is the positive neck lift sign.

Precision Tailoring for a Youthful Look

Ultimately, facelift or neck lift surgery is best understood from the perspective of tailoring.  A tailor will remove excess fabric from a loose garment and use a seam for re-stitching.  In a facelift, excess facial skin that has stretched and sags, is removed in front of the ear.  A natural contour line, like a seam, is used to close the incision.  The utilization of natural contour lines is why facelift incisions are practically undetectable.  In a neck lift, excess skin is removed behind the ears, allowing the neck skin to be pulled upwards.  This helps re-establish the natural jawline of youth.  A neck lift incision is hidden in the hairline behind the ear.

Combining Facelift and Neck Lift for Natural-Looking Results

Some patients desire for both facial rejuvenation and neckline improvement.  In this case, a facelift is combined with a neck-lift.  We often recommend this approach as we have seen patients from other providers suffer unnatural results when loose facial skin sags over tightened neck skin.  Ultimately, there is no discrete anatomical boundary between a facelift and a neck lift.  The skin of the face blends with the skin of the neck.  Thus, most neck lifts will include a bit of the face and vice versa. 

Understanding the Many Terms for Face and Neck Lifts

Despite our simple test for knowing the difference between a facelift and a neck lift, there are many terms for face and neck lift procedures.  Some examples include the mini-face lift, short-scar facelift, weekend facelift, SMAS facelift, S-lift, deep plane facelift, full neck lift, and single incision neck lift.  Many of these terms overlap, are anatomically vague, and thus can be intentionally confusing.

The key to understanding the various terms for a facelift or neck lift is that the facial and neck skin sit on top of muscles of facial expression.  This muscular layer, called the ‘SMAS’ in the face or the ‘platysma’ muscle in the neck, are frequently addressed in facial aesthetic surgery.  The platysma muscle can be released to relax turkey gobble neck bands.  The platysma muscle can be tightened laterally to improve neck definition.  The SMAS can be plicated to improve facial skin.  Addressing the platysma or the SMAS is the key to a long-lasting face or neck lift as this decreases the tension on the facial and neck skin.

In conclusion, pull up in front of the ear: facelift.  Pull back just below the ear: neck lift.  And I hope you have an uplifting day!

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