Description

Findings: Minimal incision deep elevation face and necklift with anterior digastric reduction reduction and left medial submandibular gland reduction.INDICATIONS: Aging face, neck liposityDESCRIPTION OF PROCEDURE: Pre-operative diagnosis:

1. Facial aging
2. Neck liposity

Post-operative diagnosis:
1. Facial aging
2. Neck liposity

Procedures:
1. Minimal incision deep elevation (MIDE) face and neck rhytidectomy

Complications:
None

Procedure:
The patient was brought to the OR and identified by name and date of birth. IV anesthesia was given and oxygen administered via oral cannula.

We then proceeded with the MIDE face and necklift. Incisions for the facelift and necklift were previously marked out in the preoperative area. The preauricular portion of the incision was carried inferior to the tragus and the postauricular portion of the incision was carried on to the posterior auricle without extending into the hairline. These areas were locally anesthetized with tumescent mixture of 1% lidocaine, bupivacaine, epinephrine, normal saline, and tranexemic acid.

We then proceeded with the MIDE facelift and necklift. A submental incision made and a subcutaneous flap was developed extending from the inferior border of the mandible down to the thyroid cartilage and laterally to the angle of the mandible. Excess subcutaneous fat was sharply excised and the platysma was identified. The medial aspect of the left and right submandibular glands were reduced with care to stay intracapsular sparing marginal mandibular gland.
Next anterior digastric was partially reduced. Opposing platysmal flaps were identified and dissected medially. A horizontal myotomy was made at the level of the hyoid. The platysma was then reapproximated using 4-0 PDS suture the in infra hyoid region. The suprahyoid platysma was the imbricated in the submental region with a running 4-0 PDS.