爱思英语编者按：脖子不会说谎。脖子上鬆垂的皮肤就像树的年轮一样，泄漏人的年龄。你能够坦然面对你的颈纹吗？

Can We Feel Good About Our Necks?
我们能够坦然面对颈纹吗？

NECKS don’t lie. Sagging there betrays age like the rings on a tree, and now-common Botox and fillers in the face make neck imperfections stand out in stark relief. In her 2006 best-seller, “I Feel Bad About My Neck,” Nora Ephron, by then 65 and a resolved turtleneck wearer, raged against the injustice of having no remedy for her slackening throat skin, short of surgery.
脖子不会说谎。脖子上鬆垂的皮肤就像树的年轮泄漏人的年龄。现在常见的肉毒杆菌和脸部填充物让脖子上的不完美显得格外明显。2006年的畅销书”我不满意我的脖子“裡，Nora Ephron,  一位高领爱好者，在65岁时，对于她脖子上日益松弛的皮肤没有改善的方法，意指缺乏有效的外科手术，感到愤愤不平。

But it turns out that isn’t true. These days, less-invasive options exist to improve the appearance of one’s neck, provided it isn’t a full-blown turkey wattle. Like a romance, a neck can go wrong in many ways. Weight gain or genetics may lead to a double chin. Loose skin can be compounded by underlying lax muscle. A neck-lift (on its own or with a face lift) remains the best bet for a striking, lasting fix.http://www.engbus.cn英语巴士网
然而事实上并非如此。只要皮肤的状况没有严重到像火鸡下巴的肉垂那么夸张，现时是存在有一些低侵入式改善脖子的皮肤外观的美容手术可以选择。如同罗曼史一般，脖子变形也有许多不同的原因。体重增加或基因影响可能会导致双下巴。皮肤下的肌肉松弛也会致使皮肤松弛。颈部提拉手术（在颈部或脸部提拉）的效果最显著，最持久治疗方法。

But careful liposuctioning of excess fat can also help streamline the full necked, especially those who still have relatively youthful elastic skin that can bounce back after the procedure. The trick is not to be suctioned to the point of looking skeletal (one should watch for underlying loose bands of muscle, which become more obvious after).
要注意，虽然抽脂可以修整颈部丰满的线条，但是对于较年轻具弹性的皮肤，手术过后皮肤还是有可能恢复原状。关键在于不要抽到见骨的程度，（应该要注意皮肤下松弛的肌束，在手术后它会变得更明显）。http://www.engbus.cn英语巴士网

If the issue is these isolated bands, injecting Botox into the neck muscle can make them less conspicuous in a patient with great skin tone, said Dr. Rod J. Rohrich, chairman of the plastic surgery department at the University of Texas Southwestern Medical Center in Dallas. But the fix lasts only three to four months.
如果问题是这些单独的肌束，在颈部肌肉注射肉毒杆菌，对于膚色深的病人可以讓手術部位看起來比較不醒目，位於美國達拉斯的德州大學附屬西南醫學中心整形手術部門首席，Rog J. Rohrich醫生表示。但是肉毒杆菌注射手術效果僅能維持3到4個月。http://www.engbus.cn英语巴士网

Promoted during the last year on “The Rachael Ray Show,” Ulthera is a new skin-lifting procedure using focused ultrasound to spur collagen growth deep under the epidermis. A single treatment may improve the contours of under-chin laxity in patients roughly 40 to 55 years old who feel they aren’t ready for surgery or amenable to it, several doctors said, including Dr. Matthew White, a facial plastic surgeon at NYU Langone Medical Center. The Ulthera handpiece pressed to skin allows doctors to see underlying layers on a screen (as with gynecological ultrasounds) before they start treatment, a first for noninvasive dermatological procedures. “We deposit energy to a precise depth below the surface of the skin without affecting the intervening tissue,” said Matthew Likens, chief executive of Ulthera, the Mesa, Ariz., company behind it.
包括纽约大学附属Langone医学中心脸部整形医生Matthew White 医生在内，有数位医生表示：去年在“The Rachael Ray Show”裡推广的Ultera是一种新的皮肤提拉疗程，主要关键在于使用超音波刺激皮肤深层的胶原蛋白增生。对于40至55岁不想动刀处理的病人来说，单一疗程可以改善下巴松弛的问题。在手术治疗前将Ulthera手术机器按压在皮肤上可以让医生在萤幕上看到皮肤下皮层的状况（类似使用妇科超音波）,作为第一个非侵入性程序。“我们把能量传递到皮肤表面下某个精确的深度，不会干扰中介组织。”Ulthera代表法人Mesa, Ariz., 公司的总裁 Matthew Likens 说明。http://www.engbus.cn英语巴士网

Patients may feel pain during treatment. Prospective candidates should also be aware that peer-reviewed published studies have yet to quantify just how much tightening can be expected in the neck and lower face. “That’s true,” Mr. Likens confirmed. (Such research is continuing, he said.)
在疗程中病人可能会感到疼痛。有意进行这项手术的病人应该了解Ulthera紧实颈部和脸部下半部皮肤的效果尚未获得同业公开研究的认可。“那是真实的，” Linken 先生确认。（但类似的研究尚持续进行当中。）http://www.engbus.cn英语巴士网

That didn’t stop Dr. Mehmet Oz, a cardiologist, from proclaiming on his television show last month that Ulthera was a “revolutionary nonsurgical face-lift” and promising to get rid of a viewer’s sagging neck live onstage. In the segment, Dr. Haideh Hirmand, a plastic surgeon in Manhattan, said it was the first time she was “really excited” about a noninvasive technology for tissue-lifting. She emphasized that Ulthera is no substitute for surgery, if neck skin is too loose. (In a later interview, she recommended a pain medication like Percocet and an antianxiety drug like Valium before treatment, which she said was worthwhile for minimal neck looseness.)
这并没有让心脏病专家Mehmet Oz医生放弃上个月在他的电视节目裡宣称Ulthera是“革命性非外科方式的脸部提拉疗程”，保证能够去除观众现实生活中松垮的脖子。在这个部分，在曼哈顿执业的整形外科医生Haideh Hirmand 医生表示，这是她第一个让她真正觉得兴奋的非侵入性组织提拉技术。但她强调若是颈部皮肤太过松弛，Ulthera并非手术的替代方案。（在后来的访问中，她建议颈部松弛状况轻微的病人在手术前可以使用止痛药物如Perconcet和抗焦虑药物如Valium）

“The company will tell you it doesn’t hurt — it does,” said Dr. Tina Alster, a dermatologist in Washington, who has made a pain and an antianxiety drug mandatory for her Ulthera patients. That said, Dr. Alster, who will get a research stipend from Ulthera to study the device’s effect on off-face areas, is seeing results in the eyebrow area, cheeks and necks of middle-aged patients.http://www.engbus.cn英语巴士网
“推销的公司告诉你这不会痛---不，会痛！“位于华盛顿的皮肤科医生，Tina Alster医生说她通常会开给做Ulthera手术的病人疼痛及抗焦虑药物。Alster医生将取得Ulthera的研究津贴进行研究：Ulthera仪器在脸部之外部位的效用，观察使用于眉毛区域，脸颊和中年病人的颈部的效用。

The “Dr. Oz” segment left the impression that the Ulthera device has been cleared by the Food and Drug Administration to be used for the neck and lower face as well as for the eyebrow area.http://www.engbus.cn英语巴士网
Oz医生的宣告给人的印象是”Ulthera仪器已经通过美国食品暨药物管理局的许可，可以使用在颈部，脸部下半部及眉毛部位“。

Not so. “The company can only promote the device for eyebrow-lift,” although the treatment regimen included cheeks and neck, too, Karen Riley, a spokeswoman for the agency, wrote in an e-mail. “But they can make no claims regarding these areas and cannot promote their device for treating specific conditions within these areas.” (As with other procedures, however, doctors can treat other body parts at their discretion.)
事实并非如此。”该公司仅能宣称Ulthera仪器用于眉毛部位提拉。“虽然疗程规划也含括了脸颊和颈部，Ulthera的代理商发言人Karen Riley女士在电子邮件裡写道。”禁止宣称可以使用在这些部位，也不能宣传仪器使用在这些部位的个别治疗情况。“（其他程序也一样，然而，医生可以自行决定是否使用该仪器治疗其他身体部位。）http://www.engbus.cn英语巴士网

Nina Meyerhof, who runs Children of the Earth, a peace organization, was willing to chance it when she met with Dr. White this month for Ulthera to firm up her neck and jawline. “I wanted everything to look fresh and tight,” she said.
Nina Meyerhof女士，她管理一个和平组织”孩童与地球“。她想要冒险试试这项技术，这个月她跟White医生约好进行紧实颈部及下巴轮廓的手术。她说，”我想要看起来清爽紧实。”http://www.engbus.cn英语巴士网

At 68, Ms. Meyerhof, of South Burlington, Vt., is a decade or two older than Dr. White’s typical candidate, someone who is just starting to notice under-chin skin laxity. But Dr. White, who has researched focused ultrasound, felt her skin was still so elastic that it would tighten. (How rapidly skin ages varies with factors like sun exposure, genetics and smoking — which may be why your older pal’s neck skin is taut while yours gave way at 47.)
Nina Meyerhof女士，68岁，南伯林顿人,室性心动过速，比White医生才刚注意到自己颈部皮肤松弛的客群大一轮到两轮。曾经钻研超音波的White医生觉得Meyerhof女士的皮肤仍然具有能恢复紧实的弹性。（皮肤老化的速度会跟着如日晒，基因和抽烟等因素不同而有差异--这可能是比你年长的朋友仍然拥有紧实的脖子，而你的脖子已经泄漏你的年龄的原因。）http://www.engbus.cn英语巴士网

Ulthera’s results take a few months to appear, since creating collagen takes time. But Ms. Meyerhof, who felt discomfort along her jaw during the procedure, said the slight hanging bit under her chin no longer sags, and her face is “tighter around the jawline.” (Heating collagen to a certain temperature can cause immediate contraction, Dr. White explained.)
Ultehra的手术效果要几个月才能看出来，因为产生胶原蛋白需要时间。尽管Meyerhof女士在整个过程当中一直觉得不安，在下巴些微的提拉使得她现在脖子上的皮肤不再下垂，下巴的线条比较紧实了。（刺激胶原蛋白到某个温度会产生立即的紧缩，White医生解释）

Mr. Likens, of Ulthera, said patients can expect results to last “a year or longer.” But the peer-reviewed clinical trial of 35 patients submitted to the F.D.A. tracked patients for only 90 days.
Ulthera的Linkens先生表示手术结果可以维持”一年以上“。 但是同业临床试验提交美国食品药物管理局的35个追踪病例显示维持时间只有90天。

Ms. Meyerhof is thrilled with her results but said she would remain so only if they last. “I feel like I paid a whole lot of money for it,” she said, declining to say how much. (Ulthera can cost $1,000 to $4,000 depending on areas treated.) But she put it this way: “If it only works for a year, I will not be happy. I took that gamble.”
Meyerhof女士对于她的手术结果感到很兴奋，但是她说只有在手术效果期间能保持这个状态。”这是我付了一大笔钱的结果“，她说，拒绝透露确切数字。（Ulthera要价1000到4000美元，视治疗的部位而定。）她这么说；"如果手术效果只有一年，我不会觉得满意。像在赌博一样！“

Many doctors won’t offer Ulthera until more research is done. Dr. Rohrich, the editor of the journal Plastic and Reconstructive Surgery, said he can’t always differentiate between the photographs of the neck taken before and after the Ulthera. The tightening is “very minimal,” he said, adding that long-term multicenter studies are needed. “Hope springs eternal, and hope springs incredible revenue based on hype,” he said.http://www.engbus.cn英语巴士网
许多医生不愿在更多研究结果出炉前提供Ulthera手术。整形及重建手术期刊的编辑，Rohich医生说他无法每次都能区别出Ulthera手术前后颈部照片的差别。该手术紧实的效果是”很微细的“，他说，另外还需要多个医学中心长期的研究。”人人希望青春永驻，而这股青春的期望能带来巨大的收益还是得靠炒作！“，他说。

Many people who “hate” their necks conclude that tightening the neck requires tightening the face, since, as Ms. Ephron put it, “it’s all one big ball of wax.”
许多人讨厌他们颈部的状况，这推论到紧实脖子需要紧实脸部，如同Ephron女士说的，”它是一整套的！“

Not necessarily. Granted, “all necks are difficult,” and it’s the hardest part of a face-lift, said Dr. James Stuzin, a plastic surgeon in Miami.
这也未必，因为”所有的脖子都不一样，”而且颈部提拉是脸部提拉手术中最困难的一项。位于迈阿密的整形医生，James Stuzin医生说。

But he and some other surgeons have long offered a so-called “isolated neck-lift.” Some surgeons don’t do neck-lifts, since patients might return complaining that they cannot live with their imperfect jowls once their neck is tight.
他和其他一些医生长期以来提供一种叫做“单独颈部提拉”手术。由于病人一旦颈部紧实了，他们可能又会抱怨他们的下巴线条不完美，有些外科医生不做颈部提拉手术。http://www.engbus.cn英语巴士网

PERHAPS surprisingly, men get more isolated neck-lifts than women, plastic surgeons say. “Usually with women, they are getting a face- and neck-lift,” said Dr. Felmont Eaves, the president of the American Society for Aesthetic Plastic Surgery, who practices in Charlotte, N.C. “In men, we don’t have exact statistics, but it’s pretty common to see them come in just for the neck.”http://www.engbus.cn英语巴士网
可能让人惊讶的是来做颈部提拉手术的男性多过于女性。“在北卡罗来纳州夏洛特执业的美国美容整形协会会长Felmont Eaves医生说”通常女性会做脸部及颈部提拉手术，而男性，虽然没有确切统计数字但是普遍来说男性只做颈部提拉手术。“

After a 50th reunion for business school made him “very neck-conscious,” Douglas Weil, 74, signed up for an isolated neck-lift in November with Dr. William Y. Hoffman, the chief of the plastic surgery division at the University of California, San Francisco. “It was one of the last things I ever thought I’d do,” Mr. Weil said, adding he hasn’t thought twice about his baldness. But now he’s thrilled with his sleek neckline, he said, and even told his rabbi about the surgery.
Douglas Weil,74岁，在参加过50周年同学会後，变得对自己的脖子外观非常在意。他签字请三藩市加州大学附属整形部门的主任Willian Y. Hoffman医生在11月帮他做单独颈部提拉手术。”这是我过去从来没想过会做的事情。”Weil先生说，他也从来没有在意过他的秃头。现在他对他光滑的颈部线条很满意，他说，甚至跟他的犹太教士谈论这个手术呢！。http://www.engbus.cn英语巴士网

The rabbi’s retort? “What men do to please their women!”
教士的回应说什么呢？“男人做来取悦老婆的事！”

A man’s face may age gracefully, but “there’s no way a man’s neck, with all that tissue hanging down, can be graceful,” said Dr. Phil Haeck, the president of the American Society of Plastic Surgeons, who has done two neck-only-lifts for every three face-lifts in his practice in Seattle this year.
男人的脸老了可能很有味道，“但是男人的脖子可就不是了！松垮的皮垂在脖子上，可不怎么有男人味！”在西雅图执业的美国整形外科医生协会会长，Phil Haeck医生说。今年度他脸部提拉手术和颈部提拉手术比例是3比2。http://www.engbus.cn英语巴士网

“That was the only part that made me look old,” said Walter Dowgiallo, 73, the chief executive of a label-printing company, referring to what he used to call a “rooster thing” under his chin. That was five years ago, before he was operated on by Dr. Joel Feldman, a plastic surgeon in Cambridge, Mass., who wrote a 2006 book, “Neck Lift.”
标签印刷公司的执行长，73岁的Walter Dowgiallo先生说；“那是唯一让我显得老态的地方，”他指的是5年前他的下巴下面他叫做鸡冠的皮肤。是他接受2006畅销书“颈部提拉”作者Joel Feldman医生为他在麻塞诸塞剑桥执行手术之前。http://www.engbus.cn英语巴士网

“You’re out a week, but, boy, I tell you, I’ve got 20 years of looking great,” Mr. Dowgiallo said. Two decades may be an exaggeration, and two-week recovery is more common. But, Dr. Feldman said, “The way I put the muscle together lasts years and years, and usually patients have a better-looking neck for the rest of their life.”
Dowgiallo先生说“出门一个礼拜，但是，小子，年轻20年”。说20年或许是夸张，而且复原时间通常是2个礼拜。但是Feldman医生说“我整形的手法持续了很多年，通常病人的余生都可以保持颈部整形的效果。”