SMAS-flap transposition in Lower Face-lift

Abstract

The superficial musculoaponeurotic system is of fundamental importance in facial anatomy. One of its primary functions is to harmoniously integrate the facial mimic muscles by coordinating their movements with each other. The continuity of the superficial musculoaponeurotic system with the platysma also creates an effective unitary connection with the mandibular and cervical areas. For these areas, where the signs of aging are first shown with soft tissue ptosis and cervical bands, we propose our lower face-lift technique with SMAS-flap transposition. This technique is not characterized by the section of the aponeurosis at the earlobe or lower level and by its rotation, but it is characterized by an higher SMAS section at tragus level with transposition of the mobilized pre-parotid and platysma aponeurosis to the high mastoid area. This manoeuvrer allows us for an effective platysma extension-lift and for his secure fixation to the upper mastoid area, resulting in greater stability and duration of the treatment.