Cervicofacial Rhytidectomy without Notorious Scars: Experience of 29 Years

Pedroza, Fernando; Pedroza, Luis Fernando; Desio, Ernesto; Revelli, Velia Elena

doi:10.1055/s-0033-1347007

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…The initial search returned 3479 articles, which was reduced to 229 articles after review of title and abstract for relevant context. Full-text review yielded 65 relevant articles 3–7,11,21–27,29–35,37,41–87 (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

An Evidence-Based and Case-Based Comparison of Modern Face Lift Techniques

Avashia

Stuzin

Cason

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Facial aging is a multifactorial process that affects each component of facial anatomy. The two general groups of face lift techniques are superficial musculoaponeurotic system (SMAS) elevation and SMAS manipulation. The purpose of this article is to describe and compare the advantages, disadvantages, and limitations of face lift techniques. Methods: A systematic review was performed to describe current outcomes evidence for face lift techniques. A subcohort of articles was selected for case-based analysis based on designated facial assessment criteria. Analysis was performed to determine the advantages, disadvantages, and limitations of each respective technique. Results: A total of 65 articles were selected for systematic review, of which 15 met criteria for case-based review. Patient satisfaction was found to be equivocal for various face lift techniques. Specific advantages and disadvantages for each face lift technique were dependent on the techniques’ approach to skin shift vector along with its degree of mobilizing superficial facial fat. Facial fat grafting was universally applicable for restoration of deep malar volume. Facial fat grafting was also used differently depending on the SMAS technique to address its specific limitations. Conclusions: The authors’ review confirms that there are many methods to obtain excellent outcomes in facial rejuvenation. Experienced surgeons are able to obtain consistent results through a variety of techniques based on understanding the aesthetic needs of the individual patient, the quality of the soft tissues being manipulated, and how to vary a specific technique to reach desired aesthetic end points.

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Section: Resultsmentioning

confidence: 99%

An Evidence-Based and Case-Based Comparison of Modern Face Lift Techniques

Avashia

Stuzin

Cason

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…Eighty-four articles were selected for final analysis. Of these 84 studies, 49 (58%) were from the United States or Canada, 10 (12%) were from Latin America, 13 (15%) from the United Kingdom or Europe, 1 (1%) from Australia, 8 (10%) from Asia, and 3 (4%) from the Middle East, representing a wide variety of journals (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Advances in Face-lift Techniques, 2013-2018

Floyd

Sukato

Perkins

2019

JAMA Facial Plast Surg

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IMPORTANCE Rhytidectomy, or face-lift surgery, is the mainstay of facial rejuvenation and is constantly evolving. There is continuous research to improve outcomes and minimize complications of this surgery.OBJECTIVE To synthesize the updated techniques in rhytidectomy published during the past 5 years, including surgical technique, advances in anesthetic technique, minimally invasive techniques, and adjunctive procedures performed at the time of rhytidectomy.EVIDENCE REVIEW On February 8, 2018, a literature search was performed of the PubMed and Cochrane databases using the search terms, face-lift or rhytidectomy and techniques. Articles published from February 8, 2013, to February 8, 2018, that related to techniques of facial rejuvenation in the lower one-third of the face by lifting and supporting tissue with 5 or more patients were included. Systematic reviews and primary literature were considered; narrative reviews, validation studies, and anatomic studies were eliminated. The initial search resulted in 604 articles after duplicates were removed. This was reduced to 84 articles after dual independent review screening.FINDINGS Of the 84 articles included, 51 (61%) regarding techniques of face-lifting in the past 5 years pertained to soft-tissue techniques; 14 (17%) pertained to implants or adjunctive medications, such as tissue sealants; and 12 (14%) related to adjunctive techniques performed in addition to face-lifting, such as fat grafting, resurfacing, and liposuction. All studies found the techniques reported therein to be effective, with similar or fewer complications compared with the literature. However, according to the Oxford Centre for Evidence-Based Medicine criteria, the level of evidence of the studies was generally poor, because 45 of the studies (54%) were case series (level 4 of evidence).CONCLUSIONS AND RELEVANCE Several new techniques have been explored for rhytidectomy or face-lift in the past 5 years, including soft-tissue techniques, introduction of implants or topical medications such as tissue sealants, and concomitant adjunctive techniques to enhance results. The overall quality of the evidence is poor, with most articles using case series with nonvalidated measures to evaluate outcomes. There is considerable room for improvement in the literature if additional studies using cohort designs and validated outcomes are performed to validate the quality of the techniques introduced during the past 5 years.

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“…Our surgical center has chosen to perform a surgical technique with short flaps for the dissection of both the skin on the face and the SMAS flap. The initial surgical technique 13 that was performed included the use of imbricature sutures on the SMAS with traction vectors in a predominally horizontal direction 8 and plication sutures on the neck. 7 Among the changes included in the most recent technique, it has been observed that when using SMAS suspension sutures anchored to the deep temporal fascia, better cosmetic results can be obtained than when using traction vectors in a predominantly vertical direction imbricating the SMAS.…”

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confidence: 99%

Rhytidoplasty: SMAS Imbrication Vector Comparison

Pedroza

Gentry

et al. 2016

Facial plast Surg

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To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study. A 7-point scale was used to grade the improvement of the face and the neck. In the face, SMAS lifting with predominantly oblique-vertical vectors used during the procedure offer statistically better results ( ≤ 0.001) in comparison to predominantly oblique-horizontal vectors in the aesthetical improvement of the malar eminence, melolabial fold and jowls. In the neck, both techniques offer excellent results, but the sutures used for platysmal plication in specific areas offer no statistical differences in aesthetical results from those sutures that are randomly placed in the platysmal muscle. In our study of 107 patients, SMAS lifting using predominantly oblique-vertical vectors seem to have better results than using predominantly oblique-horizontal vectors. For the neck, we do not find statistical differences between randomly placed sutures for platysmal plication versus sutures placed in specific areas of the muscle.

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Cervicofacial Rhytidectomy without Notorious Scars: Experience of 29 Years

Cited by 4 publications

References 24 publications

An Evidence-Based and Case-Based Comparison of Modern Face Lift Techniques

An Evidence-Based and Case-Based Comparison of Modern Face Lift Techniques

Advances in Face-lift Techniques, 2013-2018

Rhytidoplasty: SMAS Imbrication Vector Comparison

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