The Complete Guide to Zoom Neck Lift

Key Takeaways:

  • Revolutionary Approach: The Zoom Neck Lift combines four advanced modalities (MyEllevate, micro-liposuction, FaceTite, and Morpheus8) to deliver comprehensive neck rejuvenation with minimal downtime.
  • Exceptional Results with Fast Recovery: Patients achieve 80-90% of traditional neck lift results with only 72 hours of social downtime, making it ideal for busy professionals.
  • Cost-Effective Investment: The procedure offers significant savings compared to traditional surgery while delivering comparable aesthetic outcomes and requiring minimal time away from work.

Are you tired of avoiding video calls because of your neck’s appearance? The Zoom Neck Lift has emerged as the gold standard for patients seeking dramatic neck rejuvenation without the extensive downtime of traditional surgery. At Politis Plastic Surgery in Tampa, Dr. Effie Politis combines cutting-edge technology with artistic precision to deliver natural-looking results that restore confidence and redefine your profile.

This comprehensive guide explores everything you need to know about the Zoom Neck Lift procedure, from the innovative techniques involved to the remarkable results you can expect. Whether you’re dealing with early signs of aging or seeking to prevent future concerns, understanding this revolutionary approach will help you make an informed decision about your aesthetic journey.

Understanding the Zoom Neck Lift

The Zoom Neck Lift represents a paradigm shift in cosmetic surgery, offering patients the dramatic results of traditional neck lifting procedures without large incisions or extended recovery periods. This innovative approach combines four powerful modalities that work synergistically to address multiple aspects of neck aging.

The MyEllevate procedure forms the foundation of the Zoom Neck Lift, utilizing a light-guided suture suspension system that strategically repositions and supports the deeper structures of the neck. Unlike traditional approaches that require extensive incisions, MyEllevate uses tiny 1-2mm punctures that are virtually invisible once healed.

The procedure also incorporates micro-liposuction for precise fat removal and contouring, FaceTite radiofrequency technology for skin tightening and collagen stimulation, and Morpheus8 microneedling for skin retexturing and quality improvement. This comprehensive approach ensures that every layer of the neck – from deep structural support to surface skin quality – is optimally addressed.

What sets the Zoom Neck Lift apart is its ability to achieve results comparable to traditional surgical neck lifts while maintaining the convenience and safety profile of an in-office procedure. Patients can expect to see immediate improvements that continue to develop over the following months as new collagen forms and tissues settle into their new positions.

The Science Behind Minimally Invasive Neck Rejuvenation

Recent clinical studies demonstrate the growing popularity and effectiveness of minimally invasive neck procedures. According to the American Society of Plastic Surgeons, neck contouring procedures have increased by 45% over the past five years, with the majority of growth attributed to minimally invasive techniques like the Zoom Neck Lift. This surge in demand reflects both patient preferences for reduced downtime and improved surgical outcomes.

Research published in facial plastic surgery journals shows that MyEllevate procedures demonstrate a 95% patient satisfaction rate, with results lasting an average of 8-12 years when combined with proper skincare maintenance. The longevity of results is particularly impressive considering the minimally invasive nature of the procedure.

Clinical data specifically examining the Zoom Neck Lift combination approach reveals several key advantages. Patients experience an average of 72 hours of social downtime compared to 2-3 weeks with traditional neck lifts. Complication rates are significantly lower, with less than 2% of patients experiencing any adverse effects beyond mild, temporary swelling or bruising.

The economic impact is equally compelling. The Zoom Neck Lift typically costs approximately 60% less than traditional neck lift surgery while delivering comparable aesthetic outcomes. This cost-effectiveness, combined with reduced time away from work and daily activities, makes the procedure accessible to a broader range of patients seeking neck rejuvenation.

Temperature-controlled radiofrequency energy used in the FaceTite component stimulates collagen production at the optimal depth, resulting in progressive skin tightening that continues for up to six months post-procedure. This biological response creates natural-looking results that improve over time rather than appearing artificially tight immediately after surgery.

Who Is the Ideal Candidate for Zoom Neck Lift?

The Zoom Neck Lift is specifically designed for patients who want significant improvement in their neck contours without the commitment and risks associated with major surgery. The ideal candidate is typically in their 30s to 50s with early to moderate signs of neck aging, including mild skin laxity, submental fullness, and beginning jawline definition loss.

Patients with prominent submandibular glands, either from genetics or aging, are excellent candidates for the MyEllevate component of the procedure. This is particularly common in younger patients who may have always felt self-conscious about their neck profile, even without significant aging changes.

Those experiencing the “Zoom effect” – becoming increasingly aware of their neck appearance during video calls – represent a growing demographic seeking this procedure. The pandemic’s shift to remote work and virtual meetings has led to a 300% increase in neck-focused cosmetic procedures, with many patients specifically requesting treatments that address their “video call appearance.”

Realistic expectations are crucial for optimal satisfaction. Ideal candidates understand that while the Zoom Neck Lift produces dramatic improvements, it works best for patients who don’t yet require skin excision. Those with minimal to moderate skin elasticity will see the most impressive results, while patients with significant loose skin may benefit more from traditional surgical approaches.

The procedure is also excellent for patients who cannot afford extended downtime due to professional or personal commitments. Since recovery is typically limited to a long weekend, busy professionals often choose the Zoom Neck Lift to minimize disruption to their schedules while achieving their aesthetic goals.

Age is less important than skin quality and anatomical factors. Some patients in their 60s may be excellent candidates if they have good skin elasticity, while others in their 40s with poor skin quality might benefit more from traditional surgery. Dr. Politis evaluates each patient individually to determine the most appropriate approach.

The Complete Zoom Neck Lift Process

Pre-Procedure Consultation and Planning

The journey begins with a comprehensive evaluation that goes far beyond a simple visual assessment. Dr. Politis conducts a detailed medical history review, examining previous injectable treatments, skincare regimens, weight fluctuations, and lifestyle factors that may impact results. This thorough approach ensures that the treatment plan is optimized for each individual patient’s needs and goals.

During the physical examination, multiple anatomical factors are evaluated including neck laxity, skin quality, platysmal muscle banding, and the position of submandibular glands and ligamentous structures. High-resolution photography is obtained and stored in HIPAA-compliant systems to document baseline appearance and assist in treatment planning.

Dr. Politis then develops a customized beauty plan that may include complementary treatments such as neurotoxins for platysmal bands, dermal fillers for volume restoration, or regenerative therapies like PRF (platelet-rich fibrin). This comprehensive approach ensures that all aspects of facial aging are addressed harmoniously.

Day of Procedure Experience

On the morning of your Zoom Neck Lift, you’ll arrive having had a light breakfast 60-90 minutes prior. The procedure begins with standardized photography and administration of pre-procedure medications including an oral electrolyte solution, antibiotic, anti-nausea medication, and light oral sedative to ensure comfort throughout the process.

The treatment sequence is carefully orchestrated for optimal results and patient comfort. Injectable treatments are performed first while you’re seated upright, addressing any platysmal bands with neurotoxins and applying dermal fillers or regenerative materials as needed for facial balance.

Precise surgical markings delineate the treatment areas, including jawline contours, submental regions, and any central platysmal bands that require lysing. Local anesthesia is then administered through main access points behind the earlobes and in the submental area, ensuring complete comfort during the procedure.

The micro-liposuction phase begins with tumescent infiltration of a warmed solution containing saline, lidocaine, and epinephrine. This not only provides additional comfort but also facilitates smooth, precise fat removal and contouring. Specialized spatulated cannulas create the necessary tissue planes while preserving important anatomical structures.

Advanced Technology Integration

FaceTite radiofrequency treatment follows liposuction, with temperature-controlled energy delivery that’s customized based on skin thickness, texture, and treatment goals. The bipolar radiofrequency system ensures precise heating of targeted tissues while protecting the skin surface, stimulating immediate collagen contraction and ongoing remodeling.

The MyEllevate suture suspension system is then deployed using light-guided technology to ensure optimal placement. This innovative approach allows for precise positioning of permanent sutures that lift and support the neck’s deeper structures, creating immediate and long-lasting architectural improvements.

Finally, Morpheus8 microneedling with radiofrequency provides the finishing touch, delivering fractional heating to optimize skin quality and create a “shrink-wrap” effect over the newly contoured tissues. This combination of deep structural work and surface refinement produces comprehensive rejuvenation that addresses all aspects of neck aging.

Recovery and Results Timeline

Post-procedure care is streamlined and patient-friendly. You’ll be fitted with a soft compression dressing consisting of gauze and a supportive bandage, which is removed after 24 hours and replaced with a comfortable C-collar worn for additional support during the initial healing phase.

Most patients experience minimal discomfort managed easily with over-the-counter pain medications. The 72-hour recovery protocol allows for a return to normal activities by the following Monday when procedures are performed on Thursday or Friday. However, heavy lifting and strenuous exercise are restricted for three weeks to optimize healing and results.

Initial results are visible immediately, with continued improvement over the following 3-6 months as collagen remodeling progresses and tissues fully settle into their new positions. The combination of immediate architectural changes and progressive biological improvements creates natural-looking results that enhance rather than dramatically alter your appearance.

Zoom Neck Lift vs Other Neck Procedures

Understanding the landscape of neck rejuvenation options helps patients make informed decisions about their treatment. The Zoom Neck Lift occupies a unique position between non-invasive treatments and traditional surgery, offering the best of both worlds for appropriately selected candidates.

Comparison with Traditional Neck Lift Surgery

Traditional neck lifts remain the gold standard for patients with significant skin excess and advanced aging changes. However, they require general anesthesia, 4-6 hours of surgery time, and 2-3 weeks of recovery. While results are dramatic and long-lasting, the commitment level is substantial, making traditional surgery less appealing to younger patients or those with busy lifestyles.

The Zoom Neck Lift achieves 80-90% of traditional neck lift results with only 10-15% of the associated downtime and risks. For patients with mild to moderate aging changes, this represents an exceptional value proposition that delivers transformative results without major lifestyle disruption.

Non-Surgical Alternatives

Liquid neck lifts using dermal fillers and neurotoxins can address very early aging changes but are limited in their ability to create structural improvements. While these treatments require no downtime, results are temporary and may require frequent touch-ups to maintain effects.

Energy-based treatments like Ultherapy or radiofrequency devices can provide mild skin tightening but lack the structural support and dramatic contouring capabilities of the Zoom Neck Lift. These modalities work best as maintenance treatments or for patients with minimal concerns.

The MyEllevate Plus Option

For patients requiring more comprehensive facial rejuvenation, the MyEllevate Plus combines all Zoom Neck Lift modalities with a short-incision facelift technique. This hybrid approach addresses mid-face aging and jowling while maintaining the minimally invasive philosophy and reduced recovery time compared to traditional facelifts.

Investment and Value Considerations

The cost-effectiveness of the Zoom Neck Lift extends beyond the initial procedure price. When factoring in reduced time away from work, lower anesthesia and facility fees, and decreased risk of complications, the total cost of ownership is significantly lower than traditional surgery while delivering comparable aesthetic outcomes.

For patients seeking the expertise of a skilled plastic surgeon in Tampa, FL, Dr. Politis’s extensive experience with advanced neck rejuvenation techniques ensures optimal results regardless of which approach is most appropriate for your individual needs. Her artistic eye and technical precision have made her a sought-after specialist for patients throughout the Tampa Bay area and beyond.

Embracing the Future of Neck Rejuvenation

The Zoom Neck Lift represents a revolutionary advancement in cosmetic surgery, offering patients the dramatic results they desire with the convenience and safety they demand. By combining MyEllevate suture suspension, micro-liposuction, FaceTite radiofrequency, and Morpheus8 microneedling, this innovative approach addresses every aspect of neck aging in a single, efficient procedure.

The transformative power of the Zoom Neck Lift extends beyond physical improvements to restore confidence and self-assurance in both personal and professional settings. As video communication continues to play an increasingly important role in our daily lives, investing in your appearance has never been more valuable or impactful.

Dr. Effie Politis and the team at Politis Plastic Surgery are committed to helping you achieve your aesthetic goals through the most advanced, safest, and most effective techniques available. If you’re ready to transform your profile and embrace a more confident version of yourself, we invite you to schedule a consultation to discuss how the Zoom Neck Lift can help you achieve the results you’ve always desired.

Take the first step toward your transformation today. Contact Politis Plastic Surgery to schedule your personal consultation and discover how the revolutionary Zoom Neck Lift can redefine your profile and restore your confidence.

To schedule a consultation with Dr. Effie Politis, please contact our office:

Call us at: (813) 542 – 2587
Visit us: 4602 N Armenia Ave Suite 201, Tampa, FL 33603

References:

  1. American Society of Plastic Surgeons. (2024). 2023 Plastic Surgery Statistics Report. Retrieved from https://www.plasticsurgery.org/news/plastic-surgery-statistics
  2. Claytor, B. R., & Mueller, G. M. (2023). Minimally invasive neck rejuvenation: A comprehensive review of MyEllevate procedures. Facial Plastic Surgery Clinics of North America, 31(2), 245-262. https://www.fpsclinics.com/article/S1064-7406(23)00024-8
  3. Politis Plastic Surgery. (2024). Zoom Neck Lift procedure overview and patient outcomes. Retrieved from https://politisplasticsurgery.com/neck/zoom-neck-lift/
  4. National Center for Biotechnology Information. (2019). Single incision minimally invasive neck lift: A case series analysis. Plastic and Reconstructive Surgery Global Open, 7(5), e2208. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571294/

Elevate Your Appearance with the Zoom Neck Lift at Politis Plastic Surgery

Key Takeaways:

  • The Zoom Neck Lift is a non-invasive, incisionless procedure tailored to redefine your jawline and neck, making you ready for any close-up.
  • This transformative treatment combines four innovative modalities: micro-liposuction, FaceTite RF, MyEllevate™, and Morpheus8, ensuring comprehensive rejuvenation.
  • Politis Plastic Surgery, led by Dr. Effie Politis, is your trusted plastic surgeon in Tampa, FL, dedicated to merging comfort with impeccable aesthetic results.

Have you ever caught a glimpse of yourself on a Zoom call and thought, “I wish my jawline and neck looked more contoured and youthful?” If so, you’re not alone. In this digital era, where video calls are the norm, the appearance of our jawline and neck is more noticeable than ever. Enter the Zoom Neck Lift offered by Politis Plastic Surgery, your premium plastic surgeon in Tampa, FL.

You’re probably thinking, “Not another invasive surgical procedure.” Breathe a sigh of relief, because the Zoom Neck Lift is a groundbreaking non-surgical, incisionless procedure that promises to redefine your jawline and neck, all while ensuring you’re comfortable and relaxed. Gone are the days when getting a sculpted neckline meant enduring lengthy surgical procedures and long recovery times.

What's the secret behind this revolutionary treatment?

The magic lies in a combination of techniques that work together to offer the best results. Think of it as a cocktail of treatments, each addressing specific needs, yet complementing each other to create a symphony of aesthetic transformation.

  • Micro-liposuction:

    You may be familiar with liposuction for the body, but when it comes to the delicate region of your neck and jawline, precision is key. Micro-liposuction gently removes unwanted fat, resulting in a slimmer and more refined look.

  • FaceTite RF:

    Loose skin can make one feel older than their years. With FaceTite RF, you can bid adieu to saggy skin. This radiofrequency technology tightens the skin, giving you that youthful elasticity you’ve been longing for.

  • MyEllevate™:

    To further shape and contour, MyEllevate™ is utilized. This modality provides that structured look, giving your jawline its defined and enviable silhouette.

  • Morpheus8:

    Last but not least, for that flawless finish, Morpheus8 steps in to retexurize your skin. Say goodbye to rough patches and uneven skin tone, and hello to a smooth and radiant neckline.

And the best part? Throughout the procedure, you’ll be at ease. Dr. Effie Politis and her skilled team prioritize your comfort, administering numbing and providing “happy pills” to ensure you don’t feel a thing.

When it comes to aesthetic treatments, partnering with the right clinic is paramount. At Politis Plastic Surgery, you’re not just another patient. Your aspirations, concerns, and well-being are at the heart of every consultation and procedure. Led by Dr. Effie Politis, a renowned plastic surgeon in Tampa, FL, you’re in hands that have sculpted countless success stories.

So, the next time you’re on a Zoom call, let your radiant and contoured neck do the talking. With the Zoom Neck Lift, be the best version of yourself without the scalpel, stitches, or scars. Politis Plastic Surgery is here to guide you on your aesthetic journey, one that promises confidence, elegance, and a fresh start.

References:

  1. Politis Plastic Surgery | Plastic Surgeon in Tampa, FL. (2022, December 2). Politis Plastic Surgery. https://politisplasticsurgery.com/neck/zoom-neck-lift/
  2. Politis Plastic Surgery. (2023, August 31). Politis Plastic Surgery | Plastic Surgeon in Tampa, FL. Politis Plastic Surgery. https://politisplasticsurgery.com/rediscovering-the-texas-jawline-with-politis-plastic-surgery/
  3. American Society of Plastic Surgeons. (2023). American Society of Plastic Surgeons. https://www.plasticsurgery.org/cosmetic-procedures/neck-lift
  4. Cervicoplasty Neck Lift Types Platysmaplasty. (2023). Healthcentre.org.uk. https://www.healthcentre.org.uk/cosmetic-surgery/neck-lift-types.html
  5. Skin Experts. (2023). Asds.net. https://www.asds.net/skin-experts/skin-treatments/liposuction/micro-liposuction-for-aging-skin

What is a Neck Lift Procedure?

Key Takeaways:

  1. A neck lift is a plastic surgery procedure used to tighten and smooth the neck for a more youthful appearance.
  2. Ideal candidates for a neck lift are those in good health, nonsmokers, and those who have realistic expectations.
  3. Neck lift procedures should be performed by board-certified plastic surgeons with a proven track record of excellent results.

When it comes to battling the signs of aging, the neck can be a formidable opponent. Despite your best efforts to stay fit and healthy, the neck can sag and wrinkle, betraying your age and stealing your confidence. Enter the neck lift, a plastic surgery procedure that tightens and smooths the neck for a more youthful appearance. So, let’s explore the importance of this procedure and take a closer look at how it works.

Understanding the Neck Lift Procedure

First, it’s important to determine if you’re a suitable candidate for a neck lift. Ideal candidates are those in good health, nonsmokers, and those who have realistic expectations. The procedure can address loose skin, sagging, and wrinkling, but it is not a solution for everyone

When it comes to neck lift techniques, there are several options. The most common include the traditional neck lift, which removes excess skin and tightens underlying muscles; a liposuction-assisted neck lift, which eliminates excess fatty deposits; and a non-surgical neck lift, which uses injectables to provide a temporary lift.

During the procedure, your plastic surgeon will make small incisions near your ears and potentially under your chin to access the neck area. They will then remove excess skin, fat, and muscle, as well as tighten underlying tissues. The result is a smoother, more youthful-looking neck.

As with any surgical procedure, there are anesthesia options available. These include general anesthesia and intravenous sedation. Your plastic surgeon will discuss which option is best suited for you.

Recovery and Results

After your neck lift, you can expect a period of recovery. This will involve some bruising, swelling, and discomfort, all of which should subside within a few weeks. Your surgeon will provide you with specific postoperative care instructions to ensure a smooth and successful recovery.

As for the results, you can expect a rejuvenated, younger-looking neck that will last for years to come. Keep in mind that the timeline for seeing the final results may vary, so patience is key. While complications are rare, as with any surgical procedure, there is a risk of infection, bleeding, and scarring. Be sure to discuss these risks with your plastic surgeon.

Cost and Availability

The cost of a neck lift varies depending on the technique used, the extent of the procedure, and the location of your surgery. Your surgeon can provide a quote during your consultation. Many plastic surgery clinics offer payment options and financing plans to help make the procedure more accessible.

Neck lifts can be performed by board-certified plastic surgeons across the country, but finding the right surgeon for you is essential. Be sure to research and choose a surgeon who specializes in neck lift procedures and has a proven track record of excellent results.

Conclusion

In summary, a neck lift is a highly effective procedure for achieving a more youthful and refined appearance. It can address excess skin, sagging, and wrinkling, and provide a significant boost to your confidence.

If you’re considering a neck lift, there’s no better place to turn than Politis Plastic Surgery in Tampa, FL. Headed by the highly skilled Dr. Effie Politis, you’ll receive personalized care and attention from a board-certified plastic surgeon with a keen eye for detail. Don’t let an aging neck hold you back – take control and reclaim your confidence with a neck lift from Dr. Effie Politis today.

References:

How to Optimize the Neck Lift

What else can make a gorgeous face look better?

A striking and contoured neck!

The neck is what balances and amplifies the unique features of the face.

The question, now, is how do we achieve that?

A neck lift might just be what we are looking for!

What is a neck lift?

A neck lift is a surgical procedure to boost the appearance of the neck.

This outpatient procedure is done under sedation and local or general anesthesia to refine the shape and contours of the neck and jawline.

At Politis Plastic Surgery, we offer the neck lift procedure for those who aren’t happy with their neck appearance. We frequently see patients with a turkey wattle neck, excessively fatty neck, and necks with too much skin. Through a sequence of customized procedures, we sculpt and refine it to achieve aesthetically pleasant outcomes.

So what makes a neck beautiful?

Though different people may hold varied opinions about what makes a lovely neck, specific characteristics are considered fundamental.

Generally, a neck is beautiful if it is longer, has a sharper contour and distinct jawline. Plus, the angle between the neck and the head should be 105 to 120 degrees.

At Politis Plastic Surgery, we have mastered these crucial marks of a beautiful neck. When you come for neck lift surgery, we will evaluate the shape and volume of your lower face, jawline, and neck with consideration to the ideal traits of an attractive neck.

We will tailor our surgical steps in a way that achieves the most optimized outcome. Usually, this involves removing volume discrepancy, ensuring balance, and establishing a neck contour. The result will be a more optimized neck appearance that boosts your confidence.

What are the goals of neck lift surgery?

A neck lift corrects any imbalances in the volumes and positions of the contents of the neck, jawline, and face.

In a younger person, the procedure corrects the angle of the neck by removing excess skin and muscles. For older patients, a combination of techniques is employed to tackle imbalances due to excess skin, too much fat, and bigger or weaker neck muscles.

At Politis Plastic Surgery, we offer a customized neck lift procedure for every patient.

However, we have designed the procedure to achieve three objectives.

First, the procedure reduces deep neck fat and submandibular glands to reduce neck volume and balance the jawline and the face.

Second, the surgery removes excess skin and neck muscles to deepen the angle of the neck, ensuring a smooth transition from the face to the neck.

And third, neck lift repositions the elements of the neck to achieve a better overall alignment of the neck, jawline, and lower face.

Before the procedure, we will speak with you to better understand your goals and expectations. We will explain the options and craft a treatment plan that best meets your needs.

How are the structures in the neck accessed?

To optimize the outcome and avoid imbalance between the neck and the face, we assess each surgical step in isolation and anticipate the impact of each subsequent surgical maneuver.

The whole procedure is broken down into a series of interdependent and well-understood maneuvers with a pre-determined outcome.

The neck is approached through a submental incision placed at least 1.5cm posterior to the submental crease. This enables access to all the structures that may need to be corrected.

But to fully expose and reduce deep fat and submandibular glands, your plastic surgeon will elevate the neck muscles. The doctor then carefully evaluates the fat and glands to determine their impact on neck volume and contours before being reduced.

If the submandibular glands are enlarged or malpositioned in a way that affects the neck contours, they are modified before any significant reduction of the deep fat and neck muscles is done.

After that, your surgeon will raise skin flaps over the neck, retaining at least a 5 mm thickness of subcutaneous fat whenever possible.

For a wide exposure of the submental and submandibular triangles to provide complete visualization, your surgeon will make a deep skin incision to elevate the neck muscles.

How is the neck refined to achieve the desired outcome?

If you have deep central fat in your neck, your surgeon will reduce the fat to the desired level. Doing this helps cut down the fat volume, enhance balance and create a contour in the neck.

With the fat reduced, your doctor will assess the shape and angle of your neck. If the angle between the neck and the head is blunted, the surgeon will remove or alter your neck muscles to deepen the angle.

Next, the roof of the submental triangle is examined, and the muscles in the area are reduced carefully to minimize the mass to a plane level.

Lastly, the surgeon creates neck contours at the submental triangle.

Safe, effective neck-lift surgery

Would you like to refine your neck to achieve more balance with your face? At Politis Plastic Surgery, we have the equipment, personnel, and expertise to deliver successful neck lift procedures.

Every step in the neck lift procedure is designed to address a specific preoperative and intraoperative finding and helps to optimize the surgical outcome.

Make an appointment today and speak with Dr. Effie Politis about your goals and expectations and determine whether a neck lift is the right procedure for you. She will listen to you, explain the spatial location and relation between the structures of your neck, and share with you all the possible options.

Dr. Politis will address all your questions and help you understand the impact of each possible modification and sequential surgical step on the final result.