facelift short or long incision?

Summary: When it comes to choices about your facelift, short or long incisions matter. That is to say, you’ve got options when it comes to your facelift. Choosing the right one will help set you on the path to achieving the results you really want.

When it Comes to Your Facelift, Think About Short or Long Incisions

One of the most innovative facelift incision techniques in the past few years has been to minimize the incision. Rather than making one long incision along the side of the face, as has been traditionally done to achieve results, a few smaller incisions are made so that, combined, achieve a similar result.

The benefit of this technique is that the patient experiences a faster recovery time. And, as always, smaller incisions mean less visible scarring. The skyrocketing popularity of the shorter incision method is well justified by the results that patients experience.

However, it’s worth noting that the decision on whether to get a short or a long incision on your facelift matters. And there’s more to consider than, simply, the amount of recovery you’re looking to experience. In fact, whether you get a short or long incision with your facelift could have a long-term impact on your results.

The Importance of a Neck Lift

It might seem odd to start off our discussion of facelift methods by talking about a neck lift. But neck lift procedures are often paired with facelifts. The reasoning is pretty straightforward: your neck gets wrinkled too. If you were to get a smooth face but left your neck full of wrinkles, the overall look would be… confusing.

The solution, then, is to ensure your neck is also free of wrinkles (or at least has diminished wrinkles). If you were to go about diminishing the wrinkles on your neck as a separate procedure, it would be called a Neck Lift. However, it would not be uncommon for this aspect of the work to be incorporated into a traditional facelift procedure.

In other words, sometimes we have to talk about neck lift and facelift procedures as kind of going hand in hand.

Getting the Best Possible Neck Lift Results

That’s why this research from Derrick E. Antell, M.D., from Lennox Hill Hospital is so very interesting. See, the question for a long time was about whether a traditional facelift or a minimally invasive facelift gave better results in the neck over the long term. This might seem like something that’s pretty simple to measure—but it’s not.

See, the human face is quite complex, something most plastic surgeons easily recognize. If a patient develops some adverse results 10 years after surgery, it’s difficult to know whether that’s due to the surgical techniques or something as simple as genetics. When a lot of time passes, it’s hard to account for all of the variables.

Dr. Antell got around this by looking at twins. It’s a novel study (and probably one that is, admittedly, a little hard to reproduce). But it at least eliminates the variable of genetic variation (mostly). What the study found was this:

  • Short term results for long and short incisions are roughly equivalent
  • Long term results for both incision types saw more variation
  • Patients who had the “shorter” incision type were more likely to develop excess skin around the neck years later

The development of this “turkey neck” in the long term after the using the shorter incision type seems to suggest that longer incisions are the way to go. However, the study was performed on only 8 people—and the results may be difficult to replicate. That said, it’s a great starting place for a conversation between you and your surgeon.

Considerations Other Than the Long Term

When it comes right down to it, there might be considerations other than the long term. There are, in fact, plenty of reasons to choose a shorter incision or a longer incision that have nothing to do with how your neck will look in five or ten years. That’s not to say that a potential “turkey neck” is a concern you should immediately dismiss.

Rather, it’s simply a way of pointing out that there are other considerations as well:

  • How much recovery time does the patient have or want to endure? (That is, how much vacation time the patient has banked could matter.)
  • Does the patient already have a substantially wrinkled neck?
  • Does the patient have enough wrinkles or excess skin to justify a longer incision facelift?
  • Will the patient benefit from the other effects of a shorter incision or a longer incision?
  • How substantially noticeable does the patient want the effects of the procedure to be?
  • Is the patient looking for subtle or bold results?

Sometimes, getting improvements in the short term is just as important as maintaining those results in the long term. Additionally, your neck may not be particularly susceptible to the “turkey neck” phenomenon. Indeed, many people never develop a turkey neck regardless of the plastic surgery they’ve undergone.

An Individual Decision to Make With Your Surgeon

Ultimately, your surgeon is going to have to examine your face. That usually goes without saying—no surgeon is going to operate on someone without a thorough examination first! However, knowing the long term outcomes as well as the short term results can help you balance some of the decisions you have to make.

The research mentioned above is incredibly useful in that sometimes it’s difficult to compare results from different and innovative techniques. Yes, surgeons can compile statistics on patient satisfaction or complication rates. But it’s harder to measure something more subject: is technique A more aesthetically pleasing than technique B?

Dr. Antell has certainly found an interesting way to provide some answers to that, given that identical twins can make a productive foundation to interrogate some of those aesthetic questions. But it’s important not to lose sight of the fact that everyone is different.

Let’s put it this way: you should always select the technique that’s best for your face (or any other part, depending on the procedure). That sounds simple, but there’s a lot of decision-making that goes into it. Your surgeon will have a large role to play in answering those questions.

But only you can decide on what outcome you want.

Minimally Invasive as a Trend

In any case, the smaller incisions of the minimally invasive approach aren’t going anywhere. The ability to help patients achieve bold results with minimal recovery time is always going to be an aim for plastic surgeons. Of course, that shouldn’t stop patients from exploring all options.

Having a frank discussion with your surgeon about what you can expect—both in terms of recovery and in terms of results—can help you temper your expectations and move in a direction that makes the most sense for you. For example, if a long recovery is really out of the question for you, then your choice will be easier.

By the same token, if your neck is really a problem area—and looks to be in the future—then a longer incision might be appropriate. To say that there are many considerations to balance is, of course, an understatement. But that’s why it’s important to meet with a plastic surgeon who can evaluate your face, your needs, and the best way to achieve your results.

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