Repeating rhytidoplasty with SMAS, malar fat pad, and labiomandibular fold treatment: the NO primary procedure.

Abstract

To repeat a rhytidoplasty means to do it again, with the exclusive aim of correcting the consequences on the facial aging. A short historic outline of the SMAS evolution is made. When the rhytidoplasty is repeated, the following aspects have to be taken into consideration: 1. The preoperative study, that includes analyzing previous rhytidoplasties; satisfaction or nonsatisfaction; sideburn, its location; hairline, its location; scars, their location and aspects; irregularities, their characteristics; nerve injuries, their detection; flaccidity, its evolution. 2. The surgical method to be practiced, which consists of skin dissection, subcutaneous fatty tissue treatment; SMAS treatment, and skin treatment. The types of surgical methods are: how the inferior third of the face and neck are corrected through the great mobility of the SMAS in this region, while in the medium third of the face the "nasolabial fold" and the midface flaccidity are corrected by treating the "malar fat pad." 3. In the chin region, the formation of a "labiomandibular fold" and how it is liberated and treated is described.