15876? Tthanks :)

PREOPERATIVE DIAGNOSIS(ES):

Recurrent laxity of skin in the neck, post neck lift

POSTOPERATIVE DIAGNOSIS(ES):

Laxity of skin in the neck,

PROCEDURE(S)/OPERATION(S) PERFORMED:

Scar/ lift revision with intraoperative use of liposuction for excess fatty

tissue of the neck.

SPECIMENS TO LABORATORY:

None.

ESTIMATED BLOOD LOSS:

Minimal.

DRAINS PLACED:

None.

COMPLICATIONS:

None.

CONDITION:

Satisfactory.

SUMMARY:

With the patient in the preoperative area, the operative site was

verified. The operative plan was reviewed with the patient. The

patient had an opportunity of all questions regarding the

procedure answered and the operative plan, location of the

incisions, intraoperative use of liposuction for areas of excess

fat of the central neck, submental was discussed. Perioperative

wound care including use of the wrap and compression was also

discussed. The patient had an opportunity of all questions

answered. Preoperative photographs were obtained. The patient

was taken to the operating following a time-out verification,

sterile prep and drape, administration of general anesthesia with

PCD DVT prophylaxis, and prophylactic antibiotics, the procedure

was commenced. 1% lidocaine with epinephrine diluted 50:50

mixture was injected with a spinal 25-gauge needle for local

infiltration and hemostasis. The dissection was performed in a

subcutaneous plane using a face lift scissor dissection following

the incision through the previous scar Care was taken

to avoid subfascial plane of dissection and maintaining a

subcutaneous plane to the area of the mid cheek and area of

bilateral jawline. This was also extended following lipoplasty

through the submental incision yielding small volume aspirate . Scissor

dissection was then used to reach the area of lipo creating a

cutaneous undermining to the neck maintaining discontinuous

undermining to the midline. The wounds were copiously irrigated

and inspected for hemostasis with the loupe magnification. The

dissection showed good plane of dissection and hemostasis, the

initial sutures were placed and staples to achieve symmetric

tightening of the neck flaps, was then a permanent 2-0 Prolene

suture was then placed in the posterior auricular surface of the

scalp on both sides, and a second permanent suture was placed

near the hairline in the anterior surface of the ear. These are

2-0 interrupted Prolenes, and we will plan on removal in the

office in 2 weeks. The patient was assessed for symmetry, and

both neutral position and was turned to the left and right showed

evidence of good contour with the flaps and no evidence of

banding or pinching or folding. This was then converted to the

final closure with trimming of excess skin by scissor dissection

in a stepwise fashion and buried 5-0 Vicryl and running 6-0

Prolene. The posterior hairline incision was closed with a

running 4-0 Prolene. The patient showed good symmetry and shape

and good cervical mental angle. The submental incision was

closed with a single interrupted 6-0 nylon suture, also a bulky

wrap was applied. The patient tolerated the procedure without

complications.

15876? Tthanks :)