Men, like women, are equally concerned as they age about their sagging neck or, unflattering called, the neck waddle or turkey neck. This is usually more important to men than other facial aging changes such as occurs around the eyes. As men often wear shirts and ties, this problem can even become magnified with any type of constrictive wear around the neck, causing a bunching up of low hanging neck skin and a resultant overhang.For these reasons, men may seek a facelift (necklift) procedure to improve these neck skin issues. For men the improvement in the neck does not have to be dramatic but significant. Dramatic neck and jowl changes in men after a facelift can often make them look peculiar.

One of the most important outcomes of a facelift, and one I would say is how most facelifts are ultimately judged by non-plastic surgeons, is that of the scarring around the ears.The scars should be nearly imperceptable, well hidden in the crevices and grooves of the ear and into the hairline. In men, however, this is much more of a challenge. Unlike women, men have beard skin that poses real issues about scar placement and putting beard skin into areas that have not had hair before. This may create new and undesired shaving challenges after surgery.

The first beard area of concern with a facelift is the tragus. The tragus is that bump in front of the ear canal that one never notices…..unless you put beard skin on it. For this reason, the incision in men is usually placed at the junction of the beard and non-hair bearing skin in front of the ear. This scar is not well camouflaged as in women where the incision dips into the ear behind the tragus and then sneaks out around the earlobe. While this scar in males usually does heal well, and that area is sort of a natural crease, it is somewhat noticeable in the short-term with the scar redness. The other option is to use the typical incisional approach for females and either trim off the hair bulbs underneath the skin prior to closure or do that in a later procedure after it is healed. Laser hair treatment is an option also and can be done within 4 to 6 weeks after a facelift. Which approach is best? I prefer to keep the hair some distance away from the tragus and the ear. It is unnatural to have the beard line right up against the ear and the need to try and remove hair off the tragus later is not always easy or successful.

The other beard skin area of concern is behind the ear. With a facelift, beard skin gets moved up and behind the ear. This skin displacement creates the need to now shave behind the earlobe area in back of the ear. This is certainly not a devastating aesthetic consequence of the procedure and, with some presurgical education, is easily managed by most men. There is no real way to modify the procedure to avoid this problem. Laser hair treatments are worth doing in this area, even if it takes a few of them spaced four to six weeks apart to significantly reduce hair growth.

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis