What does breast augmentation improve?

Breast augmentation increases breast volume, improves shape, enhances symmetry, restores fullness after pregnancy or weight loss, and helps balance overall body proportions.

What is the difference between saline and silicone implants?

Saline implants are filled with sterile salt water and deflate visibly if they rupture, but they may feel less natural and show more rippling. Silicone gel implants feel more like natural breast tissue and usually have less rippling, but rupture may be silent and monitored with imaging over time.

Are textured implants used in breast augmentation?

Textured implants are used less frequently due to their association with a rare lymphoma called BIA-ALCL. Dr. Freedland primarily uses smooth implants for most patients.

Should implants go over or under the muscle?

Under-the-muscle placement can reduce rippling and capsular contracture risk and often looks more natural in thinner patients, but recovery may be longer. Over-the-muscle placement can have a faster recovery and stronger cleavage, but may show more rippling in patients with thin tissue.

Where are the incisions placed for breast augmentation?

Common incision options include the breast crease (inframammary), around the areola (periareolar), or in the armpit (transaxillary). Dr. Freedland often prefers the breast crease because it gives the best control and heals discreetly.

How is implant size chosen?

Implant size is selected based on your chest width, breast tissue, skin quality, lifestyle, and aesthetic goals. Sizers in a surgical bra help visualize options, and Dr. Freedland recommends sizes that fit safely within your anatomy.

What is recovery like after breast augmentation?

Most patients wear a support bra for several weeks. Discomfort is normal, especially with under-the-muscle placement. Many patients return to work in about a week and avoid heavy lifting or strenuous exercise for 4 to 6 weeks.

Do breast implants last forever?

Implants are durable but not lifetime devices. Many last 10 to 20 years, but future surgery may be needed for rupture, capsular contracture, or cosmetic changes over time.

Why doesn’t Dr. Freedland recommend cosmetic fat injection to the breast?

Fat grafting to the breast can lead to fat necrosis and calcifications that may resemble or obscure breast cancer findings on mammograms. Because cosmetic augmentation is elective, Dr. Freedland avoids introducing long-term screening risks.

Can I still get mammograms with implants?

Yes. Implants do not prevent mammography. Technicians use special imaging views to visualize breast tissue effectively, and you should always tell your imaging center that you have implants.

What are common risks of breast augmentation?

Risks include capsular contracture, implant rupture or deflation, infection, bleeding or fluid collection, scarring, rippling, sensation changes, implant malposition, and the rare risk of BIA-ALCL. Dr. Freedland takes precautions to minimize these risks.

What does a neck lift treat?

A neck lift treats submental fat, platysmal banding, loose neck skin, blurred jawline definition, and jowls at the face-neck junction.

What is the difference between a full neck lift and a mini neck lift?

A full neck lift addresses fat, muscles, and skin using incisions behind the ears and sometimes under the chin. A mini neck lift is a more limited procedure focused on muscle tightening and fat removal through a smaller incision under the chin and is best for early aging with good skin quality.

Is neck lift often combined with facelift?

Yes. Treating the face and neck together provides a harmonious result and allows one recovery period.

How long is neck lift recovery?

Most patients take about 1 to 2 weeks off work. Bruising improves by 2 to 3 weeks, and final contour appears over 3 to 6 months as swelling fully resolves.

What are the main risks of neck lift surgery?

Risks include swelling, bruising, numbness, hematoma, infection, asymmetry, scarring issues, and rare nerve weakness. Smoking greatly increases complication risk.

Neck Lift Consultation Notes

We had an extensive discussion about neck lift surgery, also known as lower rhytidectomy or platysmaplasty. This procedure addresses aging changes in the neck by removing excess fat, tightening the platysma muscles, and removing excess skin to restore a defined, youthful neckline and jawline. A well-defined neck can dramatically improve the overall facial profile and create a more refreshed appearance.

Understanding Neck Aging

As we age, several changes occur in the neck:

Fat accumulation: Excess fat beneath the chin creates submental fullness and blurs the cervicomental angle.
Platysmal banding: The platysma muscles separate at the midline, leading to visible vertical bands.
Skin laxity: Neck skin loses elasticity, resulting in loose, crepey skin.
Loss of jawline definition: A once sharp jawline becomes softer with jowling and sagging.

These issues can make the neck look older even if the rest of the face has aged less dramatically.

What Neck Lift Surgery Addresses

Submental fullness: Removal of fat under the chin using liposuction or direct excision.
Platysmal bands: Tightening and reuniting the platysma muscles at the midline.
Excess skin: Redraping skin and trimming redundancy for a smoother contour.
Jawline definition: Restoring the crisp angle between chin and neck.
Jowls: Improving the junction where the neck meets the lower face.

The Neck Lift Surgical Procedure

Neck lift surgery is performed under general anesthesia as an outpatient procedure. The exact approach depends on your anatomy.

Step 1: Incision Placement

Behind the ears: Incisions start in the hairline behind each ear, curve around the earlobe, and continue into the crease behind the ear.
Under the chin: A small incision may be placed in the natural crease beneath the chin to access fat and the platysma muscles.

These incisions are designed to heal discreetly and fade over time.

Step 2: Fat Removal

If submental fat is present, it may be treated with:

Liposuction: Small cannulas remove excess fat through tiny access points.
Direct excision: For larger deposits, direct removal can be more complete and controlled.

Step 3: Platysma Muscle Tightening (Platysmaplasty)

This is often the most important part of the procedure. Through the submental incision, the platysma muscles are sutured together at the midline to:

Eliminate vertical bands
Sharpen the cervicomental angle
Create a stable foundation for skin redraping

Step 4: Skin Redraping and Excision

Skin is lifted upward and backward toward the ear incisions.
Excess skin is removed.
Closure is done without tension to optimize healing.

Step 5: Closure and Dressing

Incisions are closed carefully, and a compression garment is placed to reduce swelling and protect results.

Mini Neck Lift

A mini neck lift is a more limited option. It focuses on the neck muscles and submental fat through an incision under the chin and does not remove significant skin. It can be appropriate for early aging with good skin quality.

Recovery From Neck Lift

First 48 hours: Swelling, tightness, and bruising are expected. Head elevation is important.
First week: Swelling peaks around day 2 to 3, then improves. Many return to desk work in 7 to 10 days.
Weeks 2 to 3: Bruising mostly resolves. Light activity resumes.
Weeks 4 to 6: Major swelling improves and definition becomes clearer.
Months 3 to 6: Final results emerge as subtle swelling fully resolves.

Combining Neck Lift With Facelift

Neck lift is commonly paired with facelift for a seamless result. Treating the neck and face together creates harmony and allows one recovery period.

Potential Risks and Complications

Bruising and swelling (expected)
Temporary numbness of the neck or earlobes
Hematoma or seroma requiring drainage
Infection
Temporary or rarely permanent nerve weakness
Asymmetry
Scar visibility issues (uncommon)
Skin healing problems, especially in smokers

Nicotine use significantly increases complication risk and must be stopped fully before and after surgery.

Longevity of Results

Neck lift results typically last 10 to 15 years. Aging continues, but from a younger baseline. Skin quality, weight stability, sun protection, and smoking status influence longevity.

Non-Surgical Options and Limits

We reviewed non-surgical options such as Kybella, ultrasound tightening, radiofrequency, and Botox for platysmal bands. These can provide subtle improvements in minor cases, but they cannot replicate the structural change of surgery.

Making the Decision

Neck lift surgery can provide a dramatic improvement in contour and jawline definition. We will tailor the plan based on the specific causes of your neck aging, your anatomy, and whether combining with facelift would create the best overall result.

Photos were obtained, a quote was given, and the patient will return in a week for further discussions if needed.

Neck Lift Consultation