Face and Neck Contouring

Face and neck lifting in the massive weight loss population poses a significant challenge because of the high rate of recurrent skin laxity. With regards to the face, the neck is usually the area of most concern for patients after weight loss. Despite open neck procedures and substantial skin removal, the risk of recurrent laxity is high and occurs early on. The face after weight loss is usually depleted of fat, so fat grafting procedures and SMAS plication are important adjuncts to improving overall contour. Lower eyelid procedures should consider lid fat removal, repositioning, and lid tightening to prevent ectropion due to poor lower lid tone and a propensity to negative vectors in this population.