The Science Behind Skin Aging
With aging we see a loss of elastin and collagen levels affecting skin quality and structure. Our face, neck, and decollete often demonstrate changes associated with aging including skin laxity, wrinkles, fine lines, and loss of a defined jawline. Some of these factors are due to structural changes in the neck and loss of ligamentous support. Other factors are due to environmental exposure to pollution, sun, and UV radiation as well as broad band light. Because of the increased use of video associated with increased remote and virtual demands due to the pandemic, there has been an increased awareness of face and neck aging. Patients are desiring minimally invasive approaches to restoring neck and jawline contours as well as skin quality to help boost confidence and make them feel refreshed. People are in search of a slimmer, more sculpted, and defined neck and jawline they can feel great about showing off in virtual meetings as well as in person.
There is now a combination of minimally invasive techniques that can address both the neck and jawline in tandem to restore a more youthful appearance.
Our practice is excited to be one of the few to offer the incisionless option to restore the neck and jawline: The Zoom Neck lift. This is a customized approach per patient but results in rapid recovery and a refreshed look. It involves a comprehensive exam to evaluate one’s jaw and neckline including evaluation of the ligaments, glands, fat compartments, skin quality, and structural support to the neck. If the patient meets criteria for the zoom neck lift they will be able to have an incisionless approach to recontouring the jawline and neck under light sedation in the office. This typically involves three modalities: micro liposuction of the jawline and neck, FaceTite RF tightening of the jawline and neck, MyEllevate™ light guided suture suspension system to tighten neck structures and define the jawline, and finally Morpheus 8 to retexture and tighten the skin as well as improve skin quality. We have found that these procedures performed in tandem at one setting restore a youthful neck without large incisions and without the downtime associated with a traditional neck lift.
At Politis Plastic Surgery, Dr. Effie Politis will customize each treatment plan to achieve your unique goals. She will never recommend any procedures that will not help you realize the exact results you are looking for.
Here is what to expect throughout the process.
Pre-procedure Consultation
It is important to get an accurate evaluation of the neck and jawline. This includes a history (review of previous injectables, skin care regimen, weight loss/gain, smoking history, etc) as well as a physical exam to evaluate neck laxity, skin quality, sagging or drooping of any glands or ligamentous structures of the neck and also evaluation of platysmal banding. Photos will be obtained and placed in a HIPAA approved program as part of your medical records. Dr. Politis then discusses a skin care regimen to enhance skin quality as this will ultimately provide long lasting results. It is essential patients optimize their skin envelope with medical grade skin care as well as photoprotection (SPF) to maintain long lasting results. The patients are then provided with a customized beauty plan that includes line item treatment options. This may include injectables (toxin, fillers, regenerative materials such as PRF or Renuva), closed vs mini-incision facelift, energy based modality to achieve tightening, neck/jawline/submental liposuction, and MyEllevate™ suture suspension lift. If the patient decides to proceed, our clinical coordinator will discuss dates as well as review preparation for the procedure. Consent for the procedure including pre-procedure and post-procedure instructions will be reviewed with the patient.
Day of the Procedure
The patient will be brought into the office the morning of the procedure after having a light breakfast 60-90 minutes prior. We will obtain standardized photos and the patient will be given an oral electrolyte drink as well as an antibiotic, anti-nausea medication, and a light oral sedative. The patient will change into a soft and comfortable gown. The patient will be monitored with a pulse oximeter and a blood pressure cuff during the procedure. Next, any injectable treatment is performed in our procedure room with the patient sitting upright. This typically includes toxin to relax lateral platysmal bands, and possibly filler or Renuva if needed to various areas of the face (centrally/midface, vs temples, vs peri-orally).
The patient then has standard markings performed to delineate jawline and submentum as well as any central platysmal bands. The central bands are lysed with the suture suspension system at this time after injecting them with local anesthesia.
The patient is then transferred to our procedure room and laid comfortably on a procedure chair. The patient’s face, neck and chest are prepped and draped. At this time, more local anesthesia is infiltrated through the main access points which are just behind the soft lobe of the ear and in the submental area. At this time the jawline and neck are tumesced with a warmed solution consisting mainly of normal saline as well as lidocaine and epinephrine. This solution ensures comfort and also aids in smooth, painless lipo-contouring of the jaw and neckline. Next, a gentle spatulated cannula is used to separate the skin from the underlying deeper structures including the platysmal muscle and glands. After adequate separation, micro liposuction cannulas are then used to contour and slim the neck and jawline. Liposuction can also be applied to the upper jaw/lower face or cheeks if facial slimming is desired.
FaceTite
Once adequate separation and liposuction is performed for slimming and contouring, the radiofrequency bipolar device (FaceTite) is applied to tighten the ligamentous structures and also contour the skin along the bony jawline as well as promote collagen and elastin remodeling. The Facetite device uses radiofrequency energy that is temperature controlled between two probes. The energy delivered can vary depending on the goal (further fat reduction, skin tightening, etc)and the patient’s skin thickness and texture. The heat from the radio frequency waves will cause your skin to contract and any excess fat that is attached to your skin will liquify. As a result, new collagen and elastin growth will be stimulated in the deep layers of your skin to help with overall rejuvenation. The spatulated microlipusction cannulas are then re-inserted in order to gently remove oils and any excess fat liquified with the facetite probe.
MyEllevate™
The lower face and neck are then cleansed in preparation for the MyEllevate™ light guided suture suspension system.
The MyEllevate™ procedure is an additional option to re-support the structures of the neck. It uses tiny incisions (1mm) to mold and shape the structures underneath your skin. While the FaceTite directly impacts the fat and ligaments attached to your skin, the MyEllevate™ procedure uses a light guided suture system (ICLED) to place a support system around the platysma muscle and glands under the skin. The central platysmal bands are lysed initially and the skin is separated from the underlying structures as explained above. The suture re-suspends the glands/muscles/ and ligaments of the central neck and also elevates the structures to better define and strengthen the jawline. This can be combined with a mini-facelift for a more dramatic result and is called the MyEllevate™ Plus.
Morpheus8
Once the liposuction, Factite, and MyEllevate™ suture suspension system are engaged and completed, Morpheus8 is applied to the lower face/jawline, and neck for transdermal fractionated bulk heating to ultimately shrink wrap the skin envelope over the slimmed neck and jawline. Morpheus8 is a device that combines microneedling with radiofrequency technology for fractional resurfacing that stimulates collagen production. By targeting the deeper layers of the skin, the building blocks will reorganize themselves in a natural anti-aging process. There is little to no damage to the dermis and this procedure provides an extremely uniform effect. Morpheus8 microneedling treatments go above and beyond to help your skin rebuild itself from the inside. This fractional heating aids in skin’s clarity and texture within a few days of your treatment, with the full effect becoming apparent in about three to six weeks. When used in combination with facetite, there is bulk remodeling from both vectors of the skin (epidermal and subdermal) which optimizes contraction and contouring.
Post-Procedure
The patient’s face and neck are cleaned and the patient is placed in a soft head dressing consisting of gauze, fluffs, and a compression bandage. This is removed in 24 hours and a C collar applied. Specific instructions are provided both in written and verbal format. The patients take tylenol or ibuprofen for any post procedure discomfort. No heavy lifting or exercising for 3 weeks. We recommend head elevation for 48 hours (sleep with head on two pillows or in a recliner for the first 24-48 hours). This is a rapid recovery protocol with minimal social downtime of only 72 hours.
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