An article I wrote for the Sun Post News……
When a Necklift Doesn’t
Extreme Makeover and other “fantasy” plastic surgery television has definitely had an effect on consultation traffic in my office. The notion that more than a few large operations can and should occur in one operative session has become almost commonplace. My own disagreement with the general premise has been the subject of this column more than once.
There are specific situations however in which one procedure can and does contribute to the success of another. Necklift surgery is a prime example. As of late I have seen a few consultations for necklift as well as a patient in whom another surgeon’s necklift left her nonplused.
In the vast majority of cases, a necklift and at least a minimal facelift go together. The reasons for this are practical. A basic facelift includes dissection and repositioning of the “middle” of the face and neck. These structures are in continuity with one another so movement of one affects the other. Patients with more than minimal banding (the famous “turkey gobbler” neck) require repositioning using a facelift approach. It is possible to not do a facelift at the same time, but this affects the ability to reposition the neck without a deformity at the jawline. When the tissue planes are exposed, correcting them both seems logical. My opinion is that the result is potentially more long lasting.
There are those surgeons who have chosen to work from the neck alone. The benefit here is that of less trauma from less surgery. The second opinion consultation patient I mentioned above had had a “neck only” neck lift by her former surgeon. The result by her estimation was less than wonderful. While I cannot comment on her pre-operative appearance (which is very important in judging the result of an operation), lesser surgery in the neck often leads to dissatisfaction.
“But my surgeon was on one of those ‘Extreme Makeover’ television programs. He came well-recommended.”
I’d wager that her case won’t be featured on an upcoming show. Television can be edited. Real life cannot.
Plastic surgery is surgery and there are different methods to obtaining a good result. Any surgical plan is an estimate based upon the experience of the surgeon concerned. Both patient and surgeon need to be on the same page before entering an operating room. If your surgeon offers lesser surgery, ask what you might expect in the way of an outcome. A few consultations are never a bad idea when coming to a decision in this regard.
John Di Saia, MD
Originally posted 2005-07-01 19:47:00.