Facelift Part I: History, Anatomy, and Clinical Assessment

Hashem, Ahmed M.; Couto, Rafael A.; Duraes, Eliana; Çakmakoğlu, Çağrı; Swanson, Marco; Surek, Chris

doi:10.1093/asj/sjy326

Cited by 20 publications

(13 citation statements)

References 122 publications

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“…Although conventional facelift procedures may provide excellent and long-lasting results [4], demand is growing for less invasive procedures because of the relatively high cost of facelift procedures, the long downtime, and fear of facelift-related complications [5]. Because patients expect excellent outcomes from procedures that avoid the disadvantages of a facelift, it is challenging to satisfy their needs through a single method; therefore, various techniques should be combined and individualized for each patient.…”

Section: Discussionmentioning

confidence: 99%

Multi-modal treatment strategy for achieving an aesthetic lower face

2020

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Background Most women consider an oval-shaped face to be youthful and beautiful. In recent years, demand has grown for surgical procedures with a shorter downtime and fewer complications. These minimally invasive procedures include botulinum toxin type A (BoNTA) injection, filler injection, suction-assisted liposuction (SAL), laser-assisted lipolysis (LAL), thread lifting, and fat grafting. This study aims to introduce an effective method for creating an aesthetically pleasing lower face using a combination of minimally invasive procedures.Methods From March 2017 to March 2019, 94 patients simultaneously underwent LAL, SAL, and thread lifting. Ancillary procedures such as BoNTA injections, hyaluronic acid filler injections, and removal of the buccal fat pad (BFP) were selectively performed according to the patient’s condition.Results Patients rated their postoperative satisfaction as very satisfied, satisfied, dissatisfied, or very dissatisfied. Approximately 83% of all respondents were satisfied with the results, whereas the remaining respondents had complaints regarding the outcomes. The most common reasons for dissatisfaction were a longer-than-expected recovery time and undercorrection, and the most severe complaint was skin depression as a result of overcorrection.Conclusions Our method of simultaneously performing LAL, SAL, and thread lifting, while adding BoNTA, filler injections, and BFP removal as needed, was capable of producing consistent and reliable aesthetic outcomes for the lower face.

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Section: Discussionmentioning

confidence: 99%

Multi-modal treatment strategy for achieving an aesthetic lower face

2020

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“…The added risk of venous thromboembolism (VTE) in the setting of facelift surgery has recently been documented and discussed in the literature. 3 , 29 , 31 , 36 In our series of patients, we found that a reduction in operative time and anesthesia time may entirely eliminate this added risk, even with a mean Caprini score representing moderate risk among most of the patients in our study. Other than compression stockings and serial compression devices, no other prophylactic measures were taken.…”

Section: Discussionmentioning

confidence: 56%

“… 29 Published statistics since this time have continued to underscore the DVT risk in facelift procedure; however, many of these are derived from surveys of members of the American Society of Plastic Surgeons (ASPS), which suffers from response bias and low reliability of self-reported data. 3 , 30 , 31 …”

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confidence: 99%

Evaluating Facelift Complications and the Effectiveness of the SMASectomy Technique: A Single Center’s 15-Year Experience

Shauly¹,

Stone²,

Shin³

et al. 2021

Aesthetic Surgery Journal Open Forum

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Background Facelift continues to be one of the most common aesthetic procedures performed in the United States. Although there exist many techniques and variations, superficial musculoaponeurotic system (SMAS) manipulation, by way of plication, overlap, or SMASectomy, is common and has been shown to result in favorable cosmesis and durability. However, there is a lack of current complications data in the discussion of this technique. Objectives To assess the benefits and risks of the SMASectomy technique. Methods The records of all patients who underwent a facelift procedure between December 2004 and March 2019 were reviewed for this study. All procedures were performed at an American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)-accredited outpatient facility in Marina Del Rey, California. This represents data on 241 total patients. Retrospective chart review was performed to include data on patient characteristics, operative technique, and complications. Results Average operative time of 152.68 ± 51.50 minutes and anesthesia time of 175.00 ± 54.07 minutes were observed among those patients who underwent SMASectomy. This was significantly lower (P < 0.000001) than those who did not undergo SMASectomy (average operative time of 265.25 ± 85.25 minutes and anesthesia time of 294.22 ± 85.31 minutes). There were no observed facial nerve injuries among patients who underwent SMASectomy. No deep vein thrombosis (DVT) events were observed in this patient population. Conclusions In the hands of an experienced surgeon, the SMASectomy facelift technique offers the unique advantage of significantly reducing operating time and anesthesia time and can provide extremely favorable and long-lasting aesthetic results. Level of Evidence: 3

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“…31 The most critical areas of resuspension are around the lower eyelid, malar eminence and pterygomasseteric sling, as sagging in these areas can cause tear trough deformities, deepening of the nasolabial folds and marionette lines, and jowling, respectively. 32 Periosteum around the orbital rim should be reapproximated if possible. If not, the superficial muscular aponeurotic system (SMAS) should be resuspended with heavy, absorbable sutures secured to the bone or plates in the area.…”

Section: Closure Soft Tissue Management and Recoverymentioning

confidence: 99%

Management of Panfacial Trauma: Sequencing and Pitfalls

Massenburg

Lang

2021

Semin Plast Surg

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Panfacial trauma refers to high-energy mechanism injuries involving two or more areas of the craniofacial skeleton, the frontal bone, the midface, and the occlusal unit. These can be distracting injuries in an unstable patient and, as in any trauma, Advanced Trauma Life Support (ATLS) protocols should be followed. The airway should be secured, bleeding controlled, and sequential examinations should take place to avoid overlooking injuries. When indicated, neurosurgery and ophthalmology should be consulted as preservation of brain, vision, and hearing function should be prioritized. Once the patient is stabilized, reconstruction aims to reduce panfacial fractures, restore the horizontal and vertical facial buttresses, and resuspend the soft tissue to avoid the appearance of premature aging. Lost or comminuted bone can be replaced with bone grafts, although adequate reduction should be ensured prior to any grafting. Operative sequencing can be performed from top-down and outside-in or from bottom-up and inside-out depending on patient presentation. All protocols can successfully manage panfacial injuries, and the emphasis should be placed on a systematic approach that works from known areas to unknown areas.

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Facelift Part I: History, Anatomy, and Clinical Assessment

Cited by 20 publications

References 122 publications

Multi-modal treatment strategy for achieving an aesthetic lower face

Multi-modal treatment strategy for achieving an aesthetic lower face

Evaluating Facelift Complications and the Effectiveness of the SMASectomy Technique: A Single Center’s 15-Year Experience

Management of Panfacial Trauma: Sequencing and Pitfalls

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