Short-Scar Face Lift With Extended SMAS Platysma Dissection and Lifting and Limited Skin Undermining

Facelift, or rhytidectomy, is a surgical procedure to improve visible signs of aging on the face and neck. As individuals age, the skin and muscles of the face region begin to lose tone. The facelift cannot stop the process of aging. It can improve the most visible signs of aging by tightening deeper structures, re-draping the skin of face and neck, and removing selected areas of fat. A facelift can be performed alone, or in conjunction with other procedures, such as a browlift, liposuction, eyelid surgery, or nasal surgery.

Facelift surgery is individualized for each patient. The best candidates for facelift surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined.

Background

Short-scar rhytidectomy is a procedure with the capacity to meet the high standards of minimal scars and deformities without any noticeable signs of manipulation. In the short-scar cervicofacial rhytidoplasty (also known as the S-lift), extended dissections with maximal correction are combined with short scar and decreased signs of manipulation. Over the past 8 years this technique has been used with great success and a high level of patient satisfaction. Described are the S-lift and the devolution of this technique from its more complex form, which is reserved for patients with severe aging damage and redundant neck skin to a simpler technique that is adequate for most younger patients with moderate aging-related changes.

Overview

The initial incisions in this procedure are limited incisions in the sideburn and periauricular areas, extending just around the fold of the ear lobule. Extensive undermining of the superficial musculoaponeurotic system (SMAS)/platysma is performed, and lifting of the face and neck is performed primarily at this level. Minimal skin undermining is performed, which eliminates the need for extended incisions for reduction of dog ears. The preservation of fibrous bands between the skin and the SMAS/platysma unit is an important factor in making an operation such as this one practical, and the preservation of these fibrous bands facilitates the use of short skin incisions. Dissection of large areas of skin and the separation of the skin from the underlying SMAS will require larger incisions.

Conclusions

The S-lift has been shown to be safe, speedy, less traumatic, and well tolerated among patients at high risk for complications, such as smokers. This procedure also reduced the risk of complications.