Advances and controversies in face lift surgery

Abstract

There is no single ideal technique for each patient. The procedure used must be individualized for each patient's unique anatomy and goal for surgical restoration.

Cervicofacial Rhytidectomy without Notorious Scars: Experience of 29 Years

“…He thinks that it is not necessary to make the incision at the pretrichial temporal area, as described in the MACS-lift technique, 3 because it could produce noticeable scars. 11,12 Complementary surgical techniques could be used to improve other facial areas. Those include an endobrow midface-lift approach, 13,14 lower blepharoplasty to improve midface, 15,16 facial lipografting, 17,18 fillers, and/or facial implants.…”

Management of the Neck in Thick-Skinned Patients

“…This results in a longer period of reaccommodation to the new shape achieved with surgery. 2,9,10,12 Fat superficial to the platysma may be the only cause of the double chin appearance in a patient and may be removed by liposuction or treated with scissors under direct vision. Patients are usually satisfied with this procedure, unless one of the deeper structures such as the platysma muscle, the fat deep to the platysma, the hyoid bone, or the submaxillary gland is modified.…”

“…6). 2,6,17,18 The next step is the double chin liposuction, using a 3-mm cannula in a fan pattern to cover all the areas of the neck that are to be treated. A mistake that is frequently made is to remove only the fat in the midline without treating the lateral region of the neck, creating a deformity known as the cobra neck.…”

“…The main problem for some of these patients is not actually the face but the neck, requiring a procedure to correct the double chin to obtain the desired result. 2,3 Most overweight patients accumulate fat under the mandible, developing a heavy, aging appearance. Management of the neck in these patients is used to restore a youthful, slender appearance.…”