Overview
Use of the SMAS is a major trend for making facelift results last. The author compared outcomes over 1 year by the amount of tension, measured in newtons with a tensiometer during surgery, applied to the composite flap in deep-plane or composite rhytidectomy. Medical records and photographs were reviewed retrospectively.
Findings
- 70 patients in 2 groups.
- Group 1: 45 patients, composite flap fixed under maximal tension.
- Group 2: 25 patients, composite flap fixed under minimal tension.
- Flap tension was measured during surgery with a tensiometer.
- All patients had photographic assessment.
- In both groups, tension in the lower face and neck was statistically significant (P < 0.05).
- No significant difference between the groups for any measure (P > 0.05).
- No difference in patient satisfaction between groups (P > 0.05).
- The conclusion, which reads "Asian rhinoplasty" in the abstract, states that modest tensile forces gave similar outcomes regardless of force within the range studied.
What it means for a patient
- Pulling the facelift flap tighter did not give better results at 1 year in this study.
- Patient satisfaction was the same with more or less tension.
- Limits: 70 patients, retrospective, unequal groups, and the abstract gives no actual tension values, complication rates or outcome scores.
Why this paper matters
It measured flap tension directly during facelift and found that more tension did not improve outcomes at 1 year. This questions the idea that a tighter pull gives a better result at 1 year, within the range tested.
Terms
- Rhytidectomy: a facelift.
- SMAS: the superficial musculoaponeurotic system, a fibrous and muscle layer under the facial fat.
- Composite flap: skin and SMAS lifted together as one layer.
- Deep-plane rhytidectomy: a facelift that lifts the skin and SMAS together.
- Composite rhytidectomy: a deep plane facelift that also repositions the muscle around the eye.
- Tensiometer: a device that measures pulling force.
- Newton (N): a unit of force.