Overview
Facelift techniques range from SMAS plication and SMASectomy to extended SMAS and deep plane approaches, and the authors state no single procedure suits every patient. This article reviews current concepts and indications and details the senior author's preferred technique. The abstract reports no patient numbers or measured outcomes.
Findings
- Current techniques include SMAS plication, SMASectomy, extended SMAS and deep plane approaches.
- Modern facial rejuvenation repositions descended soft tissue and replaces volume lost with age, not only skin excision.
- The preferred approach was refined over more than 4 decades of high-volume experience.
- Key parts: an anatomy-based algorithm for neck rejuvenation, inverted "L" SMAS plication, and surgical pearls.
- The senior author reports durable restoration of face and neck contour, natural-appearing results, better jawline definition and a well-defined cervicomental angle.
- The extent of neck surgery is tailored to each patient's pattern of aging to limit unnecessary dissection and morbidity.
- The abstract gives no patient counts, follow-up length or complication rates.
What it means for a patient
- There is no single best facelift. A surgeon should match the technique to your anatomy and goals.
- The neck may need more or less surgery depending on how it has aged; this approach tries to do only what is needed.
- SMAS plication, a tightening method that does not cut under the SMAS, is central to this surgeon's approach.
- Limits: this is one experienced surgeon's method and opinion. Claims of durable, natural results are not backed by numbers in the abstract.
Why this paper matters
It sets out a plication-based facelift and neck algorithm from long practice and states that individualized assessment, not one fixed technique, should guide surgery.
Terms
- SMAS: the superficial musculoaponeurotic system, a fibrous and muscle layer under the facial fat.
- SMAS plication: folding and stitching the SMAS to tighten it.
- SMASectomy: removing a strip of SMAS and closing the gap to tighten it.
- Extended SMAS: freeing the SMAS farther forward in the face.
- Deep plane facelift: lifting the skin and the SMAS together as one layer.
- Cervicomental angle: the angle between the neck and the underside of the chin.
- Inverted "L" plication: a plication stitched in the shape of an upside-down L.