Face Lift

Abstract

The ability to surgically rejuvenate the aging face has progressed in parallel with plastic surgeons' understanding of facial anatomy. In turn, a more clear explanation now exists for the visible changes seen in the aging face. This article and its associated video content review the current understanding of facial anatomy as it relates to facial aging. The standard face-lift techniques are explained and their various features, both good and bad, are reviewed. The objective is for surgeons to make a better aesthetic diagnosis before embarking on face-lift surgery, and to have the ability to use the appropriate technique depending on the clinical situation.

Overcoming Limitations of Short Scar Minimal Access Cranial Suspension Facelift for Enhanced Rejuvenation

“…Each offers its set of advantages and disadvantages [3][4][5] and each provides good rejuvenation when properly executed; compared side by side, it is in fact difficult to demonstrate superiority of 1 procedure over the other. [4][5][6][7] A study evaluating the midface elevation using the traditional deep plane versus the transtemporal subperiosteal technique demonstrated that the subperiosteal approach could achieve 43.2% greater elevation of the midface. 1,8 It is, however, technically demanding 1 and associated with a prolonged downtime and higher potential complications.…”

Anatomical Evaluation of Facial Nerve Pathways and Dissection of “Premasseter Space” for Rhytidectomy in Asians

“…The ascending buccal trunk ramifications run through the fibers outside the anterior border of the masseter in some patients but within the border in others, about 2-3 cm above the mandibular margin. The PMS has been described as being free of facial nerves [17,29]; therefore, the anatomical landmark of the safe zone was thought to be the anterior sub-SMAS dissection (P-Point) recorded anatomically; the distance from the anterior masseter border to the P-Point (X axis) and the distance from the mandibular margin to the P-Point (Y axis) were measured and recorded Buccal branches of facial nerves…”

“…Mendelson et al [17] focused on the fact that the SMAS is separated with difficulty from the parotid capsule, whereas it is separated with less difficulty from the masseter fascia because there is an areolar tissue layer between the cheek SMAS and the masseter fascia that makes sub-SMAS dissection easier. They named this areolar cleavage plane overlying the lower masseter the ''premasseter space'' (PMS), studied the detailed anatomy of the PMS, and carried out partial sub-SMAS dissection limited to the PMS [17,29]. Their anatomical study demonstrated that because the PMS is free of nerves, dissection of this area can decrease the risk of facial nerve injury in sub-SMAS dissection [17,29].…”

“…They named this areolar cleavage plane overlying the lower masseter the ''premasseter space'' (PMS), studied the detailed anatomy of the PMS, and carried out partial sub-SMAS dissection limited to the PMS [17,29]. Their anatomical study demonstrated that because the PMS is free of nerves, dissection of this area can decrease the risk of facial nerve injury in sub-SMAS dissection [17,29].…”

“…We carried out an anatomical study of the buccal branches of the facial nerves running around the PMS in Japanese cadavers. Particular attention was paid to the ramifications of the buccal trunks, which ascend from beneath the floor of the PMS up to the mimetic muscles along the oral angle and penetrate the plane of sub-SMAS dissection in the vicinity of the PMS [17,29].…”