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Men pose uniquely different challenges than women when it comes to the consideration of facelift surgery. Men age just like women but usually are only concerned with their neck when becomes more of a waddle. As a result, they often are seen in plastic surgery consultation with more advanced facial aging concerns than what one sees in women. Because of their more advanced neck issues and the heaviness of the male skin, minor or more minimally invasive procedures are not going to be effective at making a significant difference in their neck. Only a real facelift procedure will do the trick.

But the typical facelift operation is more difficult in men because of two hair issues….their beard skin and the hairline and quality of hair density (or lack thereof) around their ear area. As the conventional facelift procedure uses incisions in and around the ears, with a subsequent redraping of skin back and over the ear, men will often end up with beard skin behind their ear and potentially even inside their ear after the skin excess is trimmed. For this reason, the male facelift must often use an incision in front of the ear at the junction of the beard and non-hearing skin just in front of the ear to keep hair out of the ear after the operation. Keeping beard skin from ending up behind the ear is difficult and most men should expect that they will have to shave behind their ears after a facelift procedure. ( at least for an inch or behind the ear lobe)

For some men, their sparse hair over the temple areas and around the ear may make a conventional facelift very difficult to do to end up with good camouflaged scars. This is rarely a problem in women. Usually the scar ends up above the ear in the hairline, but with todays’ very short hairstyles particularly in men with thin or little hair,  it may not be very camouflaged and this is a very real consideration and concern. No male wants any area of the facelift scar to be visible so where to end the scar, and how that may affect the outcome of the procedure, must be thoroughly discussed prior to facelift surgery.

Me also will not get as dramatic a change in the neck as women will with a facelift. The heaviness and thickness of male facial skin does not allow it to tightened as much. And the way the facelift must be done in consideration of their hairline will also play a role in the outcome. Men are also prone to more ‘rebound relaxation’ in the jowl and neck area after surgery due to the quality of their skin, another factor that plays into the long-term outcome. Fortunately, men do not usually want a dramatic change anyway from any facial procedure so all of these issues usually add up to a good result that will please most men.

In rare cases of the much older male (usually greater than 65) who has a large neck waddle and does not want or can not undergo a significant operation, the direct neck lift can be an option. Rather than using any incisions around the ears, the loose skin is cut out directly in the neck. This produces a pretty significant change that offers a much more limited recovery. And can be a consideration if the man can accept a scar running vertically down from the chin to the adam’s apple. Surprisingly that scar can heal very nicely due to it being in beard skin which scars less than non-beard skin most of the time. 

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Whether you are young or old, some people end up with that annoying double chin even if they are not overweight. And while there are some ways to camouflage it, like wearing a turtleneck, that often is not practical or desired. Many times, that double chin or extra ‘neck’ is not seen or fully appreciated until one sees themselves in profile in a photograph. I have had many patients tell me that want initiated the consult was that they saw themselves in a school reunion, family picture, etc and they were surprised how they looked. Almost always, the surprise is the appearance of the jowl line and neck.
Double chins or neck waddles are the result of excess fat and hanging loose skin for some. In the younger patient, it may be a lot of extra fat and not so much extra skin although the weight of the fat pulls it down, making it look like there is more extra skin than there is. That distinction is important as it changes the strategy for what will be the most effective treatment.
If extra neck skin is not the dominant problem (usually the younger patient), then a fat-based treatment method shoudl be fairly effective. If the amount of fat or the double chin is small, then office-based Lipodissolve injections could be very effective. This is a slow process that takes months for maximal results to be seen. The biggest issue with Lipodissolve, however, is not the series of treatments but the swelling that will occur after each treatment session. It may only last for 4 or 5 days but the neck will essentially double in size for that time period. The most efficient treatment method for the fat neck would be liposuction. While that is surgery, it is both more efficient and effective and one only has to go through swelling and bruising of the neck one time.
When extra skin is a more significant issue, then a fat treatment alone will not work well and one will likely end up with even more loose sagging neck skin. In these cases, some type of neck lift (aka a facelift) must be done to remove the loose skin by lifting and working it out around the ear area where incisions can be placed more discreetly. In the older man, a direct neck lift can be done which is much simpler and highly effective although one has to be able to accept a fine line scar running from under the chin down to the adam’s apple.
Double chin reduction can be a very gratifying procedure and can be approached with Lipodissolve injections, liposuction, or some form of a facelift. The best procedure is the one that matches the cause of the double chin…too much fat, too much skin, or both.
Dr. Barry Eppley
http://www.eppleyoplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

While facelifts in men are less common in women, men also have concerns about their sagging jowls and in particular about their neck aging waddles. My observation about men and facial aging is that they usually only undergo a procedure when their problem is much more advanced and, as a result, they are usually older than the average woman who undergoes a facelift procedure. For the sake of clarification, many patients and plastic surgeons frequently use the terms facelift and necklift interchangeably. And while that concept is reasonable most of the time as most facelifts have their greatest impact on the neck, a necklift can also be different than a facelift particularly in men.
A facelift, with its incisions in and around the ears, is a powerful procedure for the jowl and neck area. The greatest benefit with a full facelift is in the neck area. In men, the placement and management of the incisions in and around the ear is critical given where the beard line stops and with most men’s shorter hairstyles. For some men, the severe lack of hair around the ears and the amount of neck waddle present poses a challenge for the traditional facelift operation. Plus, some older men simply do not want to undergo the magnitude of a full facelift and don’t want any significant recovery.
For these select few men, a direct neck lift is another option. In this procedure, the skin and fat is cut out directly in the neck, greatly simplifying the operation and recovery. And the result is much better and more long-lasting than a traditional facelift. The trade-off to this benefit is a scar that runs down the middle of the neck, from under the chin down to the lowest horizontal skin crease. While this scar should be given serious consideration, I have always been impressed in my practice here in Indianapolis with how well it does in the bearded neck skin of the male patient. That same scar in a woman does not usually do as well, and for this reason, a direct neck lift is rarely done in necks without beard skin.
For an older male with a significant neck waddle, a direct neck lift can be a very simple and uncomplicated procedure that can quickly get the results that you want. A direct neck lift produces immediate and dramatic results that do not change one’s facial appearance (above the neck) at all. If one can accept a thin discrete scar down the middle of the neck, the direct neck lift may be an option to consider that is not familiar to most patients seeking plastic surgery.

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

My office often gets asked if we perform the ‘LifeStyle Lift’, ‘S-Lift’, and a variety of other names that end in -lift. The callers and patients don’t know, of course, that all these names really refer to the same procedure, otherwise known as a limited facelift. Their interest is peaked by the allure of improvement in sagging jowls or loose neck skin but without the downtime of a full facelift.
The confusion about this procedure stems from general misconceptions about what an actual facelift is. Most patients envision a facelift as a procedure that starts at the top of the head and ends somewhere below the neck. Visions of weeks of seclusion, obscene facial swelling and bruising, and ruinous financial strain make many patients feel that they definitely don’t want a facelift. They don’t understand that a facelift is really a misnamed procedure. A better name which more accurately describes what it is….is a necklift or a jowl-necklift. A facelift, in isolation, does very little above the jawline or for most of the face. It is a procedure that changes the neck and jowl line only. Many patients will have other facial procedures done in conjunction with a facelift, such as the brow, eyes, nose, cheeks, or lips (often referred to as total facial rejuvenation) but these do not constitute a facelift. As a stand-alone procedure, a facelift is really about the neck and jowls and creating a sharper neck angle and a clean jowl line again.
Therefore, a limited facelift is a scaled down version of the full facelift. It has gotten, for a variety of marketing purposes, many catchy names as previously mentioned. Some plastic surgeons even put their own name on it. But, in the end, there are all the same procedure. A limited facelift is…..limited. Meaning the length of the incisions used (in front of the ear), how much skin is undermined and removed, and the amount of subsequent after surgery care and recovery is much less than a full facelift. And an important concept to grasp here is….the result is also less than that of a full facelift. For this reason, the best candidates for a limited facelift is someone younger who has minimal jowling and loose neck skin or someone older, who really needs a full facelift, but prefers a smaller procedure for any number of reasons.
I have found that one-half of the facelifts I do today are of the limited variety. They are very popular due to their quick recovery, lack of pain, and minimal swelling and bruising. They are a great stopgap measure that will substantially delay the need for a facelift is some patients and may, in others, potentiallhy eliminate the long-term need for a full facelift. Whe combined with other small face procedures, such as eye tucks and peels, they really make a nice change with no chance of getting that ‘operated look.’

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

One of the common sequelae in the massive weight loss patient after bariatric surgery is the devlopment of a very saggy neck. What was once a very full neck for some patients becomes a hanging waddle after bariatric surgery for some. Unlike many of the body changes after bariatric surgery, the development of a sagging neck does not occur in everyone. For many, the loose skin in the neck is not a top priority over many other body areas such as the arms, abdomen, buttocks, and thighs. Often addressing the neck problem is done done until a second or third stage bariatric plastic surgery correction.

When it is important, the saggy bariatic neck can be dealt with through a very conventional approach. The typical full facelift (a facelift is a necklift….it does nothing for the face above the jowls unless other procedures are done with it), with the incisions in front and behind the ear, can lift and tighten a large amount of jowl and neck skin. When the excess is considerable, a perfectly sharp neck angle is not possible to obtain. In some rare patients, I have dealt with the neck skin by cutting it out directly (known as a direct neck lift). This is less of a procedure to go through but does leave a scar running down the middle of the neck from the chin to the adam’s apple. While many of these sscar can look quite good, you have to be prepared to bear with the scar as it goes through its maturing phases over many months. This type of scar always looks much better on men than it does in women.

Either way, a facelift or a direct neck lift are relatively easy to go through. There is virtually no pain, and much less swelling and bruising that you would think. I only keep my patients in a neck dressing for one day after surgery. Even with some swelling and bruising, the appearance is less full than before surgery. Do not confuse an isolated facelift or direct necklift with images you have seen on TV or the internet where patients are swollen and bandaged from the top of their heads to the neck. These patients are getting other facial procedures as well as perhaps including eyelifts, browlifts, nosejobs, etc. which causes a lot of mid- and upper facial swelling.

Dr Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

A facelift is one of the most recognized procedures in aesthetic plastic surgery…..but also one of the most misunderstood. The general public’s perception of a facelift….based on TV shows and the internet…is someone after such surgery being bruised from their eyes to their neck and their face wrapped up in a big dressing…like they had been involved in a major accident. And that it will take weeks to even look good enough to go out in public. In reality, this perception is flawed at best and even grossly inaccurate at worst.
The name of the operation, facelift, is misleading. It does not really describe what the surgery actually does or what the objectives of the procedure are. More accurately, a facelift should be called a neck-jowl lift, for this is what it actually helps. It is a great procedure for tightening the neck, getting rid of the that neck waddle, and lifting those sagging jowls. The medical name for a facelift, rhytidectomy (old plastic surgery meaning cutting out wrinkles), should be described as a cervicoplasty. (reshaping of the neck) However, the name facelift persists and always will as it is embedded in our plastic surgery nomenclature.
Therefore, when you realize that only the neck and jowl are affected by the procedure, many of its misconceptions fade away. In isolation as a stand-alone procedure (which half of my ‘facelift’ patients only have), a facelift causes no bruising or swelling from the nose up. While many facelift patients get their eyes, forehead, nose and other facial procedures done at the same time, this is not a requirement and is only done if one wants the ‘total face’ rejuvenated. I find that after an isolated facelift, one can look pretty good in about a week and can easily be out in public in a few days with a little make-up in the neck area.
Remember, the eyes are not swollen at all!
One of the great misconceptions about a facelift is what is actually done in the operation. A facelift operation is all about tissue layers and vectors of lifting. The lifting off of the skin from the underlying tissues over the side of the face (to the cheek area) and across the neck through incisions placed in and around the ears is obvious in any diagram of a facelift operation. And movement of loose skin pulled back and over the ears at about a 45 degree angle to the face probably accounts for about 80% - 90% of the result created by a facelift. And often this is the only tissue moved in a facelift. This is the safest and easiest approach with the least likelihood of complications. Deeper layers have also been raised up and moved in more recent versions of facelift surgery. These deep layer that can be moved independent of the skin, is a special layer of tissue over the muscle. This tissue, known as SMAS, is raised and sutured up in a more vertical direction compared to the direction of the skin pull, closer to 60 degrees usually. The public erroneously believes that it is muscle that is moved which is not possible. The SMAS sits on top of the muscle. There is considerable debate as to whether the ‘deeper’ versions of the facelift produce better long-term results than skin movement only.
The neck-jowl lift, known historically as a facelift, can lift two different layers of sagging facial tissues in two slightly different up and backward directions.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.eppleyfacelift.com
http://www.ologymd.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Facelifts in Indianapolis by Eppley Plastic Surgery - Understanding What A Facelift is

It is quite frequent for me to have a patient come in that wants to improve their signs of facial aging, usually the jowls and neck, but doesn’t want a facelift. Or, quite the reverse, they have lines around their mouth and along the nasolabial folds, and thinks that a facelift will improve that area. Without question, I think the concept of a facelift for most patients is an operation that is not well understood, particularly in appreciating what a facelift can and cannot do to help reverse that aged facial appearance.

First and foremost, a facelift is not well named. What it really ought to be a called is a necklift or neck-jowl lift. Quite frankly, a facelift does nothing for much of the face above the chin and jowl line. It is a powerful operation when it comes to improving the droopy neck and eliminating jowling, but it does nothing for the middle and upper two-thirds of the face. Even the medical name of a facelift, a rhytidectomy, is far from helpful as the term rhytid- refers to wrinkle and -ectomy to removal….so wrinkle removal hardly provides a good concept of what the operation does. When most patients think of a facelift, they see a patient after surgery encased in a complete head wrap, eyes bruised and swollen, and many weeks of recovery. As I point out to patients, what you are seeing is someone who has had a facelift and numerous other procedures done at the same time, usually eyes and forehead procedures. This is much more of a total facial rejuvenation approach which can include many procedures. Quite the contrary, an isolated facelift causes no swelling and bruising much above the jowl line.

While aging of the face occurs throughout the face, certain facial areas will age worse than others. For many, the neck and jowls is what bothers them the most. A facelift, then, is the operation of choice and is far ’simpler’ than what they had envisioned. Usually only a week is needed for ’social’ recovery and the bruising is limited to the neck area. Most patients tell them they have little or no pain after an isolated facelift. When others areas of the aged face bother the patient, such as the eyes and forehead, then a combination of these procedures with a facelift is just what the doctor ordered…..and the patient needs.

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