Q. I'm a 64-year-old man with a younger girlfriend. I find that I look older because I've have a turkey neck and deep nasolabial fold. Is there an operation that I can do that does not involve a full facelift? I have very little hair and I don't want incisions around my ear. I would appreciate your input.
A. If I didn't have an answer for you, I would not be writing this column! There are solutions to the nasolabial fold that would not include surgery. These fillers would include Juvederm, Restylane, Perlane and Voluma and Radiesse. These fillers can last up to two years.
If you were looking for a more permanent solution, surgery can be done with local anesthesia. Surgery entails removal of the nasolabial fold, that is, the excess skin and fat are removed from the area. The subcutaneous tissue is closed with absorbable sutures that are left inside. The skin is then closed with sutures that are removed approximately four to five days later. The purpose of the external sutures is to orient the skin so that the incision scars are minimized. Soon after your surgery, you may begin shaving. The act of shaving reduces the scarring and makes the incision practically invisible.
If your neck is truly a turkey neck and you have just extra skin and a little bit of fat, there is a direct excision that can be done. The surgery removes fat and skin using local anesthesia with sedation. A Z-plasty closure is undertaken to minimize tension on the skin and to elongate the incision so that the skin moves naturally and the incision becomes less noticeable. You can resume normal activity within seven to 10 days with some restrictions. While these two surgeries are not for everybody, it is important that you be evaluated by a surgeon who is knowledgeable with these procedures. Make sure you ask a lot of questions and that you see before and after pictures of each procedure.
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Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at: Cwolf@miamiplasticsurgery.com