For younger patients whose usual problem is the neck “band,” liposuction may be effective as a standalone procedure in neck lift surgery.  This is performed by inserting a cannula, a very thin suctioning probe, to an incision made under the chin to remove the excess fats in the neck and jaw line.

According to plastic surgeons, younger individuals usually have a more elastic skin than older patients, which means that their skin can easily shrink and tighten on its own without any problem after the fatty deposits have been removed.

But for older individuals or those 50 years and above, neck lift is usually performed using an excision technique which may be combined with liposuction.  This is because their main problems are the loose, hanging skin and weakened muscle which can only be corrected with the use of incisions.

In this plastic surgery approach, doctors create two discreet incisions under or behind the ears in order to manipulate and remove the excess skin that is causing the sagginess, and another one that is placed under the chin that will allow them to reduce or reshape the weakened muscles.

But instead of creating three incisions, some plastic surgeons prefer to use internal sutures that can support the neck tissue and tighten the sagging skin.

After the necessary alterations are completed, doctors will close the incision sites using tissue glue or sutures and then wrap a pressure dressing around the top of the head to the chin that will support the new contour during the recovery.

As with any plastic surgery, neck lift is associated with certain risks and complications particularly on patients with serious health issues such poor healing, diabetes, and heart problems.  With this consideration, patients will undergo physical examinations and interviews that will determine their health status and overall candidacy for this procedure.

Aside from being physically fit, plastic surgeons also require their patients to perform certain procedures several weeks before the operation; these may include quitting smoking to promote better healing ability, avoiding herbal supplements and medications that contain ibuprofen and aspirin that can increase bleeding, and preparing all the things needed during their recovery.

To remove or at least minimize the signs of aging around the eyes, plastic surgeons use blepharoplasty or what is more commonly known as eyelid surgery.  Depending on the location and amount of excess fats and skin, this procedure may involve the upper or lower eyelid, or sometimes even both.

If the procedure will involve both the upper and lower eyelids, doctors usually work first on the excess, drooping skin in the upper eyelids which in severe cases can even affect the vision of a patient.  This is done by making a discreet horizontal incision along the natural crease of the skin so the scars will not become noticeable.

Through the incisions, plastic surgeons can trim off the excess skin and fats and then tighten the remaining part to eliminate the sagging appearance.  And once the necessary alterations are completed, they will close the surgical wound using tiny sutures.

To remove the fatty deposits and excess skin along the lower eyelid, doctors make a horizontal incision in the lash line.  But if the bulging fats are the only problem, the surgical cut is usually made inside the eyelid that will enable surgeons to remove or redistribute them more evenly.

While the incisions are commonly created by a scalpel or surgical knife, some plastic surgeons use laser beam which is said to be more accurate and safer since it minimizes bleeding.

As a stand-alone procedure, blepharoplasty can make a drastic result, although this is commonly used to complement other facial rejuvenation surgeries such as face lift, neck lift, and forehead lift.

However, patients should remember that this procedure is only designed to remove the excess, loose skin and fats around the eyes but it cannot eliminate or reduce the appearance of wrinkles and furrows.  For this reason, they can ask for complementary treatments such as botox injection, facial fillers, microdermabrasion, and laser resurfacing.

As with any cosmetic surgery, blepharoplasty is associated with recovery and risk of complications, although patients can reduce these by carefully following their doctor’s pre- and post-operative advice which may include avoiding aspirin and other “blood-thinning” medications, quitting smoking, using eye cream to prevent infection, wearing sunglasses to protect the eyes and incision sites, and avoiding activities that may strain their eyes such as reading, using computer, and watching TV.

Because every patient has a varying degree of excess skin and fats, plastic surgeons use different techniques in performing neck lift surgery.  In this way, they can also achieve the most natural result using the least number of incisions as possible.

If the only problem is the excess fats under the chin and along the jawline, liposuction alone is usually enough to create a dramatic change to a person’s appearance.  With this plastic surgery procedure, doctors make a discreet incision under the chin where they can insert the cannula, a slender instrument which can suction out the excess fats.

Some plastic surgeons remove and dislodge the fats by moving the device back and forth while others prefer to use a motorized cannula that is designed to produce accurate, tiny vibrations which are said to collect about 30 percent more fats compared to manual liposuction.  Meanwhile, some doctors collect the fatty cells through laser-assisted liposuction which uses heat energy or ultrasonic-assisted liposuction which uses low ultrasonic waves.

For patients whose only problem is the hanging, excess skin in the area, the neck lift will involve two incisions placed under or behind the ear.  With this plastic surgery approach, doctors can pull the skin tight and trim out the part that is causing the sagging appearance.

In case that the sagging appearance is caused by the weakened, stretched muscles, doctors will reduce and reshape the underlying muscles in the neck and throat area using a small incision placed under the chin.  After the necessary changes are made, they will tighten the skin before closing the incision with sutures or tissue glue.

Meanwhile, some plastic surgeons prefer to use a network of sutures to eliminate the appearance of “turkey” neck or a condition in which there is an excess, loose skin in the area.

Once the neck lift plastic surgery is completed, doctors will suture the incisions and use pressure dressing that is wrapped around the top of the head to the underneath of the chin in order to support the new contour during the recovery period.

Because of the use of incisions, patients should expect permanent scars, although these will fade over time and become almost unnoticeable under the chin and behind the ears.

Perhaps secretary of state Hillary Clinton is the most perfect example of a politician who seems to have had several plastic surgery procedures.  The rumors are hard to ignore as she looks almost 15 years younger today than when she was still the first lady.

Cosmetic surgery expert Dr. Tarick Smaili, who did not treat Clinton, said that she might have undergone eyelid surgery, neck lift, and face lift possibly complemented with Botox injection.  And with her glowing skin, the surgeon added that she had probably resorted to laser skin resurfacing, chemical peel, or dermabrasion.

If you would look Clinton’s previous photos and television appearance, you might notice that she had wrinkles and prominent crow’s feet in the corners of the eyes, and deep creases across her forehead—problems which can be easily treated with soft tissue fillers and Botox injection.

But nowadays, the secretary of state looks more youthful and rejuvenated.  Gone are the sagging skin in her neck and the undefined jaw line, probably due to face and neck lift.

While facial rejuvenation surgeries are enough to erase up to 15 years off your face, skin resurfacing treatments such as laser, chemical peels, and dermabrasion can further make the countenance more youthful by removing or at least minimizing the appearance of sunspots, fine wrinkles, and skin discoloration.  These treatments are also known to correct the leathery, dry skin caused by too much sun exposure and natural aging.

Although good makeup can also do wonders on one’s face, it would be difficult—if not impossible—to achieve the dramatic improvements in Clinton’s appearance.

While some people may think that cosmetic plastic surgery for politicians is superfluous because they are not expected to look just like a celebrity, some may need this “medical enhancement” particularly if their countenance looks haggard or even angry (even if they are not) because of the sagging skin around their eyes and jaw line.

As superficial as it may sound, several studies have proven that our brains judge a person’s traits based on his face—and an angry or tired look caused by sagging skin may not be good to a politician who must appear likeable, competent, and approachable to voters.

Plastic surgeons start this procedure by injecting local or general anesthesia that will provide comfort to their patients during the operation which may be performed in a hospital, doctor’s office, or outpatient surgery center.

If the neck lift requires liposuction to remove the excess fats, this procedure is usually performed first.  This is done by making a small incision below the chin where plastic surgeons can insert a hollow tube to suction out the fatty deposits from the neck area.

After removing the excess fats, plastic surgery specialists perform the excision technique that aims to remove the loose, hanging skin and reshape or manipulate the underlying muscles.  This approach is performed by making a discreet incision behind the ears or under the chin, or possibly in just one these areas.

Through this incision, doctors can cut back and lift the skin which will then be secured with a permanent adhesive glue or suture.  If needed, they will also remove a small portion of muscle or realign it and suture the new contour in place in order to tighten the middle part of the neck.

After the necessary adjustments have been completed, plastic surgeons will close the incision site with sutures and put a bandage and tape across the chin and/or behind the ears to reduce bruising, swelling, and discomfort.

As with any cosmetic plastic surgery, neck lift is associated with risk of complications and of course recovery, which will depend on the extensiveness of the procedure.  For instance, patients who will only receive neck liposuction should expect shorter downtime compared to individuals who will have the excision technique or both.

If the neck lift only requires liposuction, the swelling and bruising in the jaw, ears, and neck will generally subside within 10 days.  Meanwhile, patients will be asked to wear an elastic garment to minimize the appearance of these symptoms and aid for a faster recovery.

But if the procedure will also require excision technique to remove the loose skin and reshape the neck muscles, the swelling and bruising will generally take a longer time to subside, although these symptoms can be minimized by keeping the head and neck elevated at all times for at least 10 days.

As with any plastic surgery, facelift requires recovery that will largely depend on the number and depth of the incisions used, and a person’s healing ability.  For this reason, individuals suffering from serious health conditions such as diabetes, excretory disorder, heart problem, delayed healing, and high blood pressure are typically considered as a bad candidate for the said procedure.

While facelift provides a satisfying result to the right patients, they should realize that this plastic surgery procedure will not change their fundamental appearance and will not stop the aging process, although it can make them look five to 10 years younger.  In general, the surgical approach provides a more dramatic outcome compared to non-invasive procedures such as botox injection, facial fillers, and laser treatment.

If needed, plastic surgeons recommend non-surgical procedures to complement facelift surgery.  Examples of these treatments include chemical peels to improve the skin texture; botox to relax the muscles and prevent wrinkles due to excessive facial movements; facial fillers or volumizers to plump up the skin and “fill in” the small crevices and hollowed areas of the face; and laser treatments to treat photo damage manifested by sun spots, freckles, and other discolorations.

Because every person has a varying degree of skin sagginess and has different locations of lines and wrinkles, plastic surgeons have developed several “isolated” techniques to remove the effects of aging.  And by specifically targeting the “problem area,” there is almost no risk of having a “windswept appearance” caused by overcorrection.

For patients aged 30 to 50, the most popular “isolated” facelift technique targets the mid face, the first area to manifest the signs of aging.  Through this approach, plastic surgeons can remove the mouth-and-nose lines, correct the downturned lips, eliminate the under-eye bags, and lift the sagging cheeks through shorter incisions made discreetly behind the hairline, along the lower lash line, or inside the mouth.

These are the other examples of “isolated” facelift surgeries: brow or forehead lift, neck lift, lower facelift, and eyelid lift.  These procedures may be combined together to create the most desired result.

However, it is important to note that most minimally invasive facelift techniques, especially if performed as a stand alone procedure, are not ideal for patients 50 years and older who will benefit more with a complete facelift.

As with any plastic surgery, facelift involves certain risks particularly to those patients who have serious health conditions such as diabetes, high blood pressure, kidney disorder, and heart problem.  For these reasons, plastic surgeons require physical examination and consultation to determine if a person is a good candidate for this surgery.

During the consultation, plastic surgeons will evaluate the skin’s elasticity, wrinkles and folds, hairline, and facial bone structure so they can determine the best incision placement.  In most cases, they will also take some post-operative photos and ask the expectations and goals of their patients.

If the patients are cleared from any serious health conditions, they may be asked to stop certain medications particularly aspirin, certain anti-inflammatory drugs, blood thinners, and other drugs which can increase the risk of excessive bleeding.  Taking of certain supplements and vitamins should also be stopped especially if these contain green tea, omega-3 fatty acids, vitamin E, and ginko biloba since studies have shown that these may also predispose patients to increased risk of bleeding.

To be on the safe side, patients should tell their plastic surgeons about their past and present medications, medical history, previous surgeries, allergies, and other health issues that may affect the result of facelift surgery.

For patients who are smoking, they may be turned down by their doctors unless they are willing to quit the habit several months before their plastic surgery.  This is because the nicotine and other chemicals found in the cigarettes can significantly postpone the body’s healing ability by preventing the oxygen from effectively reaching the incision.  And with a delayed healing, people are more likely to suffer from skin necrosis (or death of skin tissue) which usually leads to infection and unnecessary scarring.

According to a study, smokers are 1,500 times more likely to suffer from skin necrosis after their surgery compared to non-smokers.

Aside from quitting smoking and stopping certain medications, it is also important for patients to follow their doctor’s pre-operative instructions which may include proper diet and avoidance of alcohol.

• Eyelid lifts
• Hair transplants
• Neck lifts

If  your favorite actress is about the same age, she has most likely had:

• Forehead lift
• Face lift
• Breast augmentation
• Lip augmentation

Somehow, TV film and movie stars, along with other celebrities seem to change appearance from one week to the next – with no hints of surgery like bruising or bandages.

If you haven’t guessed, celebrities go to great lengths to have plastic surgery in secret.
According to the British documentary, Hollywood Knives, film legend Gary Cooper wanted a face lift and checked into a New York City hospital under an assumed name for an operation on a cyst.

The next day, the hospital arranged for Cooper to leave at five in the morning and denied any plastic surgery took place.

Before that, one Beverly Hills plastic surgeon took a famous actor to his own home for recovery. But one of the surgeon’s youngsters let the cat out of the bag when he bragged at school the actor was staying at his house with a bandaged head.

News photographers were soon on the surgeon’s front yard.

But all that was in the mid-1950s, long before rejuvenation surgery became so common.

Today, with so many famous people wanting to keep their plastic surgery under wraps, top plastic surgeons offer the following safeguards from prying eyes:

• Separate waiting rooms
• Private entrances
• Assumed names so that clerks, parking lot attendants and others will be none the wiser
• Procedures taking place at 4 a.m.
• Procedures taking place on weekends
• Staying incognito at recovery centers
• Plastic and cosmetic surgeons will visit the celebrity at home or somewhere private rather than back at the practice.
• Plastic and cosmetic surgeons and their staff are committed to total secrecy

It’s a cat-and-mouse game between the news media – who often station photographers on the sidewalks outside surgeons’ offices – and the actors and actresses who want the public to think they are just blessed with natural good looks.

Which celebrity do you think has had the best plastic surgery? The worst?

Las Vegas plastic surgeon Goesel Anson, M.D., says that many Americans are getting plastic surgery to stay on top their game during a tough economy.

O.K., doctor, but what procedures?

While you may need to update your resume, you also must consider your appearance. A tired, haggard or unrested look does not put your name at the top of the hiring list!

At the same time, budget is a big concern. Just where do you allocate any dollars you can allocate to rejuvenation surgery? Which procedures produce the most noticeable change?

Here are the results of a quick, impromptu and totally unofficial phone survey of board-certified Beverly Hills plastic surgeons who recommend what to do first:

• Fix the neck and jaw line

Aging is most noticeable when the neck becomes loose and jowls sag from your jaw.

• Next, consider eyelid surgery

If the upper eyelids sag, your eyes look hidden. If lower eyelids are baggy, you look unrested.

• Consider your  skin quality

If your facial skin is wrinkled and covered with age spots, you might try dermabrasion or an acid or laser peel as the ticket to a new job. Women usually need skin care first because men tend to have thicker skin.

• Think about facial injectables

More injectables are added to the marketplace as time goes on. For six months to a year, you can correct and plump up sagging facial features with substances like Restylane, Prevelle and Radiesse.

• Perhaps a breast augmentation?

Women with breast enhancements certainly get more attention, but first, consider the field in which you work.

A breast enlargement will probably go over well in the entertainment industry, among marketing and sales professionals and others. But what would happen in a more conservative industry, like banking, accounting or academics?

Think rejuvenation surgery would help your job hunt?

Of course, Madonna can afford any type of surgery she wants.

But for we ordinary mortals who earn less than bazillions of dollars yearly, the more common situation is finding yourself at age 55 and settling for the appearance you had at 40.

There are a few more affordable plastic surgery procedures that can have an impact on making you look younger and more refreshed.

Before plastic surgery, however, take preventive measures like:

• Forsake sun bathing – it ages the skin.
• Ditto for smoking – it ages facial skin while adding lines and wrinkles.
• Always use sun block.

Here are a few cosmetic plastic surgery procedures that may stretch your dollar.

• Ask about the nasolabial fold

The deep creases that run from the corners of your nose to the corners of your mouth, the nasolabial folds, make you look older.  Some surgeons make the mistake of performing a facelift and pulling the facial skin too tight when trying to lessen those lines. A better way: consider using facial fillers like Restylane to fill in and plump up those creases.

• Want to get rid of wrinkles?

If your only complaint is wrinkled facial skin, consider getting a younger look via a chemical peel or a laser peel to resurface the facial skin.

• Consider just an eyelid surgery

Rather than having a whole face lift, consider an upper eyelid lift for sagging eyelids. If your lower eyelids are bagging, surgical correction there can be less costly while making you look younger.

• Think about your neck

Flabby jowls and a drooping neck also add to an aged appearance. A neck lift is often done by using a little liposuction and then tightening the stretched neck muscle that creates a double chin. (Read more about neck surgery on a previous post.)

What features would you change? Leave a comment!