neck-liftAuthor: Joel J. Feldman, MD
Publisher: Quality Medical Publishing – 532 pages
Book Review by: Nano Khilnani

This book published in 2006 marked the thirtieth year of practice for the author Dr. Joel J. Feldman, as he writes in his Preface.

His unique approach to neck-lifting techniques and the great results he has achieved for numerous patients over the years has attracted the interest of many practicing plastic surgeons, both when listening to him when he speaks from a podium and when observing him in an operating room.

While he laments that there had never been sufficient time available “to convey every technique and conceptual point,” he writes that he is pleased to have done that in detailed print form with photos and text in this uniquely outstanding book in this medical and surgical specialty.

Spanning more than 500 pages, this book is one of the most extensive works available on the market on the subject of neck-lifting plastic surgery.

We typically provide, at the outset of reviews of books, overviews of content. This is because many physicians have expressed their desire for such an approach, Taking into account their scarce free time. Accordingly, below is the list of the titles of chapters in this book:

  1. Central Concepts
  2. Surgical Anatomy of the Neck
  3. Incisions
  4. The Patient in Consultation
  5. Surgery’s Sequence of Events
  6. Neck Flap Dissection and Subcutaneous Lipectomy
  7. Corset Platysmaplasty
  8. Subplatysmal Aesthetic Surgery
  9. Submandibular Salivary Gland Bulges
  10. The Ptotic Chin
  11. Earlobe Shaping
  12. Correcting Problems from a Previous Neck Lift

“The difference between a good result and a great result is usually determined by attention to detail,” Dr. Feldman points out, and “flexibility is what we’re really after: the capability to adapt our approach to suit the specific anatomic characteristics that the individual patient presents, and the flexibility to set forth whatever aesthetic objectives we want to accomplish.”

When doing neck-lifting work, surgeons encounter a wide range and variety of anatomical features of necks that may be:

  • Big and flaccid
  • Firmly oblique, and lacking an angle
  • Having bulging glands
  • Showing prominent bands
  • Marked with hollows and bumps following a prior surgery

Patients desire, and surgeons should aim to achieve, results without detectable alternations in the hairline, without distortions of the earlobe, and without noticeable scars. A good neck lift should be – and can be – achieved without doing a full facelift, if the patient doesn’t want or need one, Dr. Feldman asserts.

Is it possible to get a “Wow!” from a patient after neck-lift surgery? We believe that while Dr. Feldman does not saying explicitly, this is possible.

His standards are certainly high, based on this remark addressed to readers: “I suspect that fundamentally you and I want the same thing: the means to safely transform any neck into a graceful pedestal for a contented face in a way that seems to others to have been done by magic.. That, of course, means having control over every relevant component of neck anatomy in every kind of neck…”

This book can enable you to achieve that magic.

One important element in the effort to achieve a great result is to learn from the patient what a “great result” consists of, for her or him. So let us take a closer look at the topics covered in the 55-pages long chapter 4, The Patient in Consultation.

A critical beginning point to achieving the desired objective is having a conversation with the patient. So Dr. Feldman presents this:

Consultation Sequence

When conducting a consultation with a patient, I

  1. Inquire what he or she hopes to achieve from the surgery
  2. Review the patient’s medical history
  3. Examine the neck and face
  4. Formulate a tentative treatment plan
  5. Discuss potential risks, problems, and complications
  6. Describe how the anesthesia and the surgery will be conducted
  7. Outline the anticipated postoperative course
  8. Formulate a final treatment plan
  9. Detail medications to avoid, that increase bleeding
  10. Conduct appropriate physical examination
  11. Take preoperative photographs
  12. Discuss financial matters, scheduling, and arrangements for pre-operative testing, much of which is done by the office manager

What follows after this list of doctor-patient discussion points is detailed presentations of numerous photos of patients with a variety of anatomical features, along with choices and options of what can be done safely.

Under the critical topic Examining the Neck, the following types of features are shown, with detailed discussions:

  • The Skin
  • The Fat Under the Skin
  • The Chin
  • The Jawline Band
  • The Submental Zone
  • The Midline Strip
  • The Midneck Lowland
  • The Lateral Neck Highland
  • The Musculomandibuar Triangle
  • The Postauricular Hinterland

This is an excellent, comprehensive, detailed, well-illustrated text on neck-lift surgical procedures by an expert plastic surgeon who has over forty years of experience. We highly recommend this work to those who want to enter and /or enhance their skills and insight in this specialty.

 

Author:

Joel J. Feldman, MD is in private practice at Mount Auburn Hospital in Cambridge, Massachusetts. He is Associate Clinical Professor of Plastic Surgery at Harvard Medical School in Boston, Massachusetts.

Illustrator:

Amanda Yarberry Behr, MFA, CMI