I am a strong proponent of significant attention to the neck and jowls in facelift surgery. While I find it equally important to elevate the cheek and midface, I believe that many patients are immediately satisfied with the appearance of the neck.
I have found that SMAS flaps used to define the angle of the mandible are very effective. I have found that direct excision of fat to give the greatest control to defat the neck. Anterior platysmaplasty is most effective to reduce platysmal banding.
Upper blepharoplasty with excision of periorbital fat is beneficial to rejuvenate the eyes. I am a proponent of transconjunctival removal of fat for lower blepharoplasty and when indicated "skin pinch" lower blepharoplasty to rejuvenate the lower eyelid.
While I have found many positive aspects to all of the different facelift techniques, my preferred technique involves sub-SMAS dissection and wide subcutaneous undermining.
