60 results match your criteria Facelift Extended SMAS


Facial Plast Surg 2022 Jun 16. Epub 2022 Jun 16.

Facial Plastic Surgery, FACEISTANBUL, istanbul, Turkey.

Facelift techniques can be classified according to the depth and extent of the dissection applied. Imbrication and plication of the SMAS referred to as "SMAS lifts" or "classical facelifts" are the most commonly used techniques. Plication techniques involve in-folding of the SMAS and suture suspension without any SMAS incision whereas imbrication techniques involve a SMAS incision with a portion of the SMAS either removed or transposed with or without limited subSMAS dissection. Read More

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Facial Plast Surg 2022 May 26. Epub 2022 May 26.

Otorhinolaryngology, Acibadem University, Istanbul, Turkey.

The attenuation of retaining ligaments with aging leads to downward displacement of facial fat compartments, and is responsible for many of the stigmata that occur with aging. The zygomatic cutaneous and masseteric cutaneous ligaments prevent the transmission of adequate traction to the malar portion of the dissection during traditional low SMAS facelift techniques which involve plication or imbrication of the exposed surface of the SMAS because they do not include surgical release of these ligaments. Inadequate release of these ligaments, especially the zygomatic cutaneous ligament may lead to an unbalanced, unnatural appearance with unopposed nasolabial folds. Read More

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Facial Plast Surg 2022 May 11. Epub 2022 May 11.

Private Practice, Meridian Plastic Surgery Center, Indianapolis, United States.

Over the past four decades, the senior author has evolved and perfected his preferred method for face and neck lifting, the extended SMAS deep plane rhytidectomy and submentoplasty. With this procedure, the SMAS layer is addressed both in the face and neck, repositioning the tissues in a superior and posterior vector and creating a sling in the cervicomental area. Outcomes have proven to be both successful and long-lasting. Read More

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Superficial Fascia of the Cheek Shown in P45 Sheet Plastination.

J Craniofac Surg 2021 Mar-Apr 01;32(2):759-761

Department of Plastic Surgery, Inha University School of Medicine, Incheon, South Korea.

Abstract: In this paper, the authors attempted to determine the extent of the superficial fascia of the cheek using P45 sheet plastination.Three head and neck specimens were sliced in horizontal (46 slices), coronal (30 slices), and sagittal (29 slices) sections using P45 sheet plastination (special polyester resin corrosion-resistant method designed to preserve biological sectional specimens in situ). Through slicing, bleaching, dehydration, casting, forced impregnation, curing, cutting, and sanding the molds, P45 plastination sheets provided good light transmission, allowing the internal structures within the sheet to reveal clearly in their intact form. Read More

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Facelift Part II: Surgical Techniques and Complications.

Aesthet Surg J 2021 09;41(10):NP1276-NP1294

Department of Plastic Surgery at Cleveland Clinic Foundation, Cleveland, OH, USA.

Although previous publications have reviewed face and necklift anatomy and technique from different perspectives, seldom were the most relevant anatomical details and widely practiced techniques comprehensively summarized in a single work. As a result, the beginner is left with a plethora of varied publications that require sorting, rearrangement, and critical reading. A recent survey of US plastic surgery residents and program directors disclosed less facility with facelift surgery compared with aesthetic surgery of the breast and trunk. Read More

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September 2021

Facelift Surgery: History, Anatomy, and Recent Innovations.

Facial Plast Surg 2021 Oct 16;37(5):556-563. Epub 2020 Sep 16.

Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Facelift surgery has become a beautifully predictable, safe, and extremely effective operation. Our patients can expect natural and long-lasting results as a direct outcome of our improved understanding and applications of surgical facial anatomy. Rhytidectomy, once an operation of simple well-placed elliptical skin excisions, evolved to include longer skin flaps, skin and platysma flaps with various superficial muscular aponeurotic system (SMAS) manipulations, and various deep plane techniques involving the skin and SMAS as a single unit composite flap. Read More

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October 2021

Short or Minimum Incision Deep Plane/Extended Deep Plane Facelift/Rhytidectomy.

Facial Plast Surg 2020 Aug 31;36(4):376-385. Epub 2020 Aug 31.

Perth Facial Plastic and Cosmetic Surgery, Perth, Western Australia, Australia.

The mini facelift, often referred to as short scar or minimum incision facelift or rhytidectomy, is a facial rejuvenation procedure with limited incisions. It aims to lift and tighten the superficial musculo-aponeurotic system to restore the lower midface and the mandibular contour, thus eliminating undesirable jowls. By performing the deep plane or extended deep plane facelift with short incisions, the midface and upper neck can also be improved without the full face and neck incisions as in the typical rhytidectomy. Read More

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Surgical Anatomy for Extended Facelift Techniques.

Facial Plast Surg 2020 Jun 17;36(3):309-316. Epub 2020 Jun 17.

Department of Otorhinolaryngology, Acibadem University, Istanbul, Turkey.

Preservation of the facial nerve is crucial in any type of facial procedure. This is even more important when performing plastic surgery on the face. An intricate knowledge of the course of the facial nerve is a requisite prior to performing facelifts, regardless of the technique used. Read More

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A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline.

Andrew A Jacono

Facial Plast Surg Clin North Am 2020 Aug;28(3):331-368

NY Center for Facial Plastic & Laser Surgery/JSpa Medical Spa, 630 Park Avenue, New York, NY 10065, USA. Electronic address:

Traditional superficial musculoaponeurotic system (SMAS) facelifting surgery uses a laminar surgical dissection. This approach does not treat areas of facial volume loss, and requires additional volume supplementation with fat grafting or fillers. The novel volumizing extended deep-plane facelift uses a composite approach to the facelift flap. Read More

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Extended Superficial Musculoaponeurotic System Flap Rhytidectomy.

Facial Plast Surg Clin North Am 2020 Aug 6;28(3):303-310. Epub 2020 May 6.

The Piazza Center for Plastic Surgery, 7900 FM Road 1826, Building 2, Suite 206, Austin, TX 78739, USA.

The various rhytidectomy techniques share a common goal of safe repositioning of the facial soft tissues with a lasting effect. This article reviews rhytidectomy approaches and the current methods and practice patterns of the senior author. It includes a discussion of the extended sub-superficial musculoaponeurotic system rhytidectomy technique, which, in the opinion of the senior author, offers the best result with respect to neck rhytids, cervicomental angle and jawline definition, and improvement of jowling. Read More

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The Extended Superficial Musculoaponeurotic System.

Clin Plast Surg 2019 Oct 18;46(4):533-546. Epub 2019 Jul 18.

Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A60, Cleveland, OH 44195, USA. Electronic address:

The extended superficial musculoaponeurotic system (SMAS) facelift targets the 2 cardinal signs of facial aging: (1) descent of the malar fat resulting in deepening of the nasolabial folds as well as accentuation of the palpebral malar groove and tear trough deformity; (2) formation of jowls, which also obscure the definition of the lower mandibular border. In this article the authors describe the concepts behind the extended SMAS operation, importantly the extent of skin dissection and SMAS elevation. They present a brief history of the operation and landmark papers and supplement with fresh cadaver dissections. Read More

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October 2019

Face and Neck Lifting After Weight Loss.

Clin Plast Surg 2019 Jan 23;46(1):105-114. Epub 2018 Oct 23.

Department of Plastic Surgery, Dermatology and Plastic Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A60, Cleveland, OH 44195, USA.

After massive weight loss, deflation of the tissues and loss of skin elasticity in the face and neck can result in the appearance of accelerated facial aging. Surgical facial rejuvenation can be successfully performed with several modifications. Proper preoperative counseling and expectation management regarding staged or ancillary procedures is recommended. Read More

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January 2019

Extended Deep Plane Facelift: Incorporating Facial Retaining Ligament Release and Composite Flap Shifts to Maximize Midface, Jawline and Neck Rejuvenation.

Clin Plast Surg 2018 Oct;45(4):527-554

New York Center for Facial Plastic and Laser Surgery, 630 Park Avenue, New York, NY 10065, USA.

This article describes our extended, deep plane facelift technique. This procedure releases 4 key retaining ligaments in the face and neck, the zygomatic cutaneous, masseteric cutaneous, mandibular cutaneous, and cervical retaining ligaments. Once released, the composite deep plane flap is repositioned to volumize the midface and gonial angle. Read More

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October 2018

The Extended Purse-String Rhytidectomy.

Facial Plast Surg 2018 Oct 18;34(5):539-544. Epub 2018 Sep 18.

Atlanta MediSpa and Surgery Center, L.L.C., Marietta and Atlanta, Georgia.

Facelifts remain a critical part of a facial plastic surgeon's cosmetic practice. Techniques continue to evolve, while at the same time patients demand less invasive procedures with less morbidity. The authors present a facelift plication technique using wide purse-string sutures placed into the superficial musculoaponeurotic system and platysma. Read More

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October 2018

Cervical Branch of Facial Nerve: An Explanation for Recurrent Platysma Bands Following Necklift and Platysmaplasty.

Aesthet Surg J 2019 01;39(1):1-7

Department of Plastic Surgery, Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital, New York, NY.

Background: Recurrent platysma bands remain a common problem in neck rejuvenation.

Objectives: The goals of this cadaver study were to document the course of the cervical branches of the facial nerve and investigate the pattern of platysma muscle innervation before and after various platysmaplasty maneuvers.

Methods: A total of 8 fresh cadaver specimens were dissected for a total of 16 hemifaces/necks. Read More

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January 2019

The Utility of Superficial Musculoaponeurotic System Flaps in Facelift Procedures.

Lynn A Damitz

Ann Plast Surg 2018 06;80(6S Suppl 6):S406-S409

From the Division of Plastic Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC.

Facelift techniques widely vary with known individual surgeon modifications of and preference for particular techniques. This article provides an overview of the history of the superficial musculoaponeurotic system (SMAS), the changes of aging related to the soft tissues of the face, and the history of facelift procedures, including techniques to address the SMAS. In addition, a description of past studies and literature analyzing techniques of facelift procedures, safety of interventions involving the SMAS, low, extended, and high SMAS techniques, and evaluations of patient satisfaction with facelift outcomes including use of the FACE-Q are discussed. Read More

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Asian Facial Rejuvenation by Extended SMAS Facelift Technique.

Joo Heon Lee

Plast Reconstr Surg Glob Open 2017 Feb 24;5(2):e1244. Epub 2017 Feb 24.

April 31 Plastic Surgery Clinic, Seoul, Korea.

Supplemental Digital Content is available in the text. Read More

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February 2017

Long-term Analysis of Lip Augmentation With Superficial Musculoaponeurotic System (SMAS) Tissue Transfer Following Biplanar Extended SMAS Rhytidectomy.

JAMA Facial Plast Surg 2017 Jan;19(1):34-39

Department of Family Medicine, University of Mississippi Medical Center, Jackson.

Importance: To our knowledge, long-term, objective results of lip augmentation using superficial musculoaponeurotic system (SMAS) tissue transfer beyond 1 year have not been previously described.

Objective: To evaluate the efficacy, longevity, and safety of lip augmentation using SMAS tissue transfer.

Design, Setting, And Participants: A retrospective single-blind cohort study was designed to evaluate all patients who underwent surgical lip augmentation using SMAS following rhytidectomy between January 1, 2000, and November, 16, 2015, at a private facial plastic surgery practice in Birmingham, Alabama. Read More

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January 2017

Rhytidectomy Utilizing Bidirectional Self-Retaining Sutures: The Bidirectional Lift and the Extended Bidirectional Lift.

Aesthet Surg J 2015 Aug;35(6):633-43

Dr O'Connell is a Senior Attending Plastic and Reconstructive Surgeon, Bridgeport Hospital, Bridgeport, CT.

This article outlines a new rhytidectomy technique, developed by the author, that utilizes bidirectional self-retaining (barbed) sutures for superficial musculoaponeurotic system (SMAS) plication and, in some instances, skin closures. Short-scar and traditional versions of the procedure are presented, and the history of purse-string SMAS plication and the advantages for using self-retaining sutures in this application are discussed. Read More

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Facelift combined with simultaneous fractional laser resurfacing: Outcomes and complications.

J Plast Reconstr Aesthet Surg 2015 Oct 19;68(10):1332-7. Epub 2015 Jun 19.

Struck Plastic Surgery, 3301 El Camino Real, #200, Atherton, CA 94027, USA. Electronic address:

Background: The combination of simultaneous surgical rhytidectomy with ablative resurfacing has been a controversial procedure due to the concern of postoperative wound healing. Traditional ablative resurfacing lasers are believed to have higher rates of complications, leading to delayed healing and skin flap loss when combined with face rhytidectomy surgeries. With the development of fractionated ablative laser therapy, there has been increased interest in combining these two procedures. Read More

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October 2015

Management of the midface during rhytidectomy.

Facial Plast Surg Clin North Am 2015 May;23(2):195-200

Mittelman Plastic Surgery Center, 810 Altos Oaks Drive, Los Altos, CA 94085, USA.

No nonsurgical technique can come close to rejuvenating the face like a cervicofacial rhytidectomy. However, one of the most difficult areas to improve during a facelift is the midface. The multi-vector high superficial musculoaponeurotic system (SMAS) facelift and extended lower-lid midface lift are important techniques that can adequately address the midface during rhytidectomy. Read More

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Face-Lift Satisfaction Using the FACE-Q.

Plast Reconstr Surg 2015 Aug;136(2):239-242

New York, N.Y. From New York University Institute of Reconstructive Plastic Surgery and Lenox Hill Hospital Plastic Surgery.

Background: Face lifting is one of the most common operative procedures for facial aging and perhaps the procedure most synonymous with plastic surgery in the minds of the lay public, but no verifiable documentation of patient satisfaction exists in the literature. This study is the first to examine face-lift outcomes and patient satisfaction using a validated questionnaire.

Methods: One hundred five patients undergoing a face lift performed by the senior author (C. Read More

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Vertical neck lifting.

Facial Plast Surg Clin North Am 2014 May;22(2):285-316

Facial Plastic Surgery, The New York Center for Facial Plastic and Laser Surgery, 5th Avenue, New York, NY 10075, USA; Facial Plastic Surgery, The Beverly Hills Center for Plastic and Laser Surgery, Beverly Hills, CA 90210, USA.

The authors' vertical neck lifting procedure is an extended deep plane facelift, which elevates the skin and SMAS-platysma complex as a composite unit. The goal is to redrape cervicomental laxity vertically onto the face rather than laterally and postauricularly. The authors consider this an extended technique because it lengthens the deep plane flap from the angle of the mandible into the neck to release the cervical retaining ligaments that limit platysmal redraping. Read More

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The extended SMAS approach to neck rejuvenation.

Facial Plast Surg Clin North Am 2014 May;22(2):253-68

Meridian Plastic Surgery Center, 170 West 106th Street, Indianapolis, IN 46290-0970, USA.

Jowling, submental lipoptosis, and platysmal banding can affect self-image and reduce quality of life, leading one to seek facial and neck rejuvenation. With realistic expectations, a facelift can provide the desired improvement in appearance and sense of well-being. Before any intervention, a detailed history, focused examination, communication of expected outcomes with the assistance of preoperative digital imaging, and discussion of perioperative instructions are of utmost importance. Read More

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Esthetic outcome after soft tissue reconstruction of the face using deep dissection and composite facelift technique.

J Oral Maxillofac Surg 2013 Aug 26;71(8):1415-23. Epub 2013 Mar 26.

Department of Oral, Maxillofacial, and Plastic Facial Surgery, University Hospital RWTH-Aachen, Aachen, Germany.

Purpose: Large defects in the face resulting from the excision of malignant tumors, trauma, and congenital malformation pose a significant challenge to reconstructive surgeons. Achieving good esthetic and functional outcomes is often very demanding.

Patients And Methods: A facelift technique was used in 47 patients (25 female, 22 male; age range, 17. Read More

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Anatomical comparison of platysmal tightening using superficial musculoaponeurotic system plication vs deep-plane rhytidectomy techniques.

Arch Facial Plast Surg 2011 Nov-Dec;13(6):395-7

Division of Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Long Island Jewish Medical Center, New Hyde Park, USA.

Objectives: To quantify the degree of submental platysmal tightening that can be accomplished with superficial musculoaponeurotic system (SMAS) plication vs deep-plane rhytidectomy techniques in a cadaveric anatomical study to help dictate the need for midline platysmal surgery when using different rhytidectomy techniques.

Methods: The lateral distraction of the medial edge of the platysma muscle was measured during tightening of the SMAS-platysmal complex on 5 cadaver heads. The measurements were taken after the following 3 rhytidectomy techniques: SMAS-platysmal plication, deep-plane rhytidectomy, and extended deep-plane rhytidectomy continuing the flap below the angle of the mandible into the neck with release of the platysma and cervical retaining ligaments. Read More

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The minimal access deep plane extended vertical facelift.

Aesthet Surg J 2011 Nov;31(8):874-90

North Shore University Hospital, Manhasset, New York, USA.

Background: Modern facelift techniques have benefited from a "repopularization" of shorter incisions, limited skin elevation, and more limited dissection of the superficial musculoaponeurotic system (SMAS) and platysma in order to shorten postoperative recovery times and reduce surgical risks for patients.

Objectives: The authors describe their minimal access deep plane extended (MADE) vertical vector facelift, which is a hybrid technique combining the optimal features of the deep plane facelift and the short scar, minimal access cranial suspension (MACS) lift.

Methods: The authors retrospectively reviewed the case records of 181 patients who underwent facelift procedures performed by the senior author (AAJ) during a two year period between March 2008 and March 2010. Read More

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November 2011

The S-Plus lift: a short-scar, long-flap rhytidectomy.

Ann R Coll Surg Engl 2010 Oct 29;92(7):577-82. Epub 2010 Jun 29.

Division of Otolaryngology-Head & Neck Surgery, The George Washington University, Washington, DC, USA; Center for Cosmetic Surgery & The Washington Hair Institute, Washington, DC, USA.

Introduction: As rhytidectomy is one of the most elective surgical procedures, there is a strong trend toward less aggressive operative techniques. The authors introduce the S-Plus lift, a 'long flap' superficial musculo-aponeurotic system (SMAS) imbrication technique that diminishes risks, decreases recovery time, and yields long-lasting results.

Patients And Methods: This paper describes a novel approach to mid-facial rejuvenation that combines the limited incision of an S-lift with two SMASectomies, purse-string suture imbrication of the extended supraplatysmal plane (ESP) and SMAS, and malar soft tissue suspension. Read More

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October 2010

Rejuvenation of the aging neck: current principles, techniques, and newer modifications.

Facial Plast Surg Clin North Am 2009 Nov;17(4):589-601, vi-vii

Washington University, St Louis, USA. [corrected]

Aesthetic improvement of the neck and cervicomental angle remains one of the most challenging aspects of surgical facial rejuvenation. Individuals may become dissatisfied with the appearance of their neck because of changes in skin quality, submental fat, and muscle tone or anatomic position related to aging, weight gain, weight loss, sun damage, and other causes. To achieve the patient's desired result, surgeons use various techniques, either in isolation or in combination. Read More

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November 2009