Short Scar Face Lift Research Articles

Short scar facelift approach for temporomandibular joint replacement surgery

Short scar facelift approach for temporomandibular joint replacement surgery

Advances in Face-Lift Surgical Techniques: 2016-2021.

Face-lift surgery is the most crucial and constantly evolving technique of facial rejuvenation. Periodic reviews synthesizing the latest face-lift techniques may help surgeons sharpen their surgical procedures. A literature search was conducted of the PubMed databases using the search term "face lift" and "rhytidectomy." Articles reporting rhytidectomy of the forehead/brow, midface, lower face, and neck were included. Sixty-nine articles were selected after independent screening by three of the authors. The Oxford Centre for Evidence-based Medicine scale was used for evaluating evidence level. Of the 69 candidate articles, 10 studies (15%) reported techniques of neck lifting; 10 studies (15%) introduced techniques of endoscopic brow lifting; 7 studies (10%) pertained to brow lifting without endoscopic techniques. The most frequently reported locations of rhytidectomy were the brow/forehead (20%), neck (19%), and face-neck (17%). Additionally, articles regarding Asian face-lifts (14%) have been increasing. The evidence level of the articles was generally low, with only 10 articles assessed as level 1-3 with 59 articles as level 4-5. Face-lift articles with high-level evidence are still lacking. Prominently, forehead lifting and neck lifting have become upward trends of rhytidectomy in recent years, and the techniques of short-scar face-lift have been more valued. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Short-Facelift Approach in Temporal Artery Biopsy: Is It Safe?

Giant cell arteritis (GCA) is a quite common panarteritis of the elderly that affects medium- and large-size arteries. Despite the increasing role of imaging with advancing technology, the gold standard for the diagnosis of GCA is still the temporal artery biopsy. A described complication of superficial temporal artery biopsy (STAB), for which incidence is not clear, is the accidental damage of the frontal branch of the facial nerve. In this paper, we described the short-scar facelift surgical approach for STAB on 23 consecutive patients who underwent unilateral superficial temporal artery biopsy for GCA suspicion. We collected data in terms of postoperative complications, biopsy specimen length, biopsy result and cosmetic appearance of the scar. In our experience, this surgical approach combines the advantage of avoiding incisions within the dangerous anatomical area, minimizing the risk of facial nerve damage, with an acceptable complication rate and a good final aesthetic result which avoids visible scarring.

Extending the “Reach” of the Short-Scar Facelift with Energy Devices—An Early Report

Facial rejuvenation has become more popular. A wider breadth of the patient population is seeking procedures to preserve their youthful facial attributes and to remedy age-related deleterious changes. Along with this increasing interest in facial rejuvenation is also the expressed desire for any interventions to be relatively low risk, with limited recovery, and with achievable positive results. Many new technologies have become available in an attempt to improve age-related facial changes. The radiofrequency (RF)-based technologies are largely directed toward skin tightening and toward reducing and remodeling subcutaneous fat. It can be contemplated that the combination of RF-based technology with limited surgical procedures may extend the patient selection for less invasive procedures while improving potential results. This is a report of the combination of radiofrequency technologies-percutaneous and transcutaneous-with short scar face techniques in facial rejuvenation.

Erratum: Extending the "Reach" of the Short-Scar Facelift with Energy Devices-An Early Report.

Erratum: Extending the "Reach" of the Short-Scar Facelift with Energy Devices-An Early Report.

Overcoming limitations of short scar minimal access cranial suspension facelift for enhanced rejuvenation.

The minimal access cranial suspension lift, a short-scar facelift, has been described to correct sagging and laxity of the lower and middle third of the face. It does not, however, fully address the neck or the lateral periorbital area frequently needing rejuvenation in most patients. Another shortcoming of the minimal access cranial suspension lift technique is visible scarring anterior to the temporal hairline that usually occurs despite the suggested surgical maneuvers consisting in zigzag beveled incisions. We describe modifications of the standard subcutaneous musculoaponeurotic system lift technique, increasing its indications for full-face and neck rejuvenation (excluding the forehead) and improving final aesthetic outcome.

Modified Short-Scar Face-Lift: Technique, Pearls, and Outcomes

Introduction: The modified small-incision face-lift is a safe, effective, minimally invasive way to treat facial rhytidosis in carefully selected patients. The purpose of this study is to describe a modified small-incision face-lift technique. Materials and Methods: Institutional review board– approved retrospective case series. Results: Twenty-six patients underwent a modified small-incision face-lift. The average age of the patients was 62.1 years. Two patients developed hypertrophic scarring requiring surgical revision. There were no other complications, including infection, wound dehiscence, or flap necrosis. Patient satisfaction with the procedure was high. Conclusions: The modified short-scar face-lift is a safe and effective procedure that can be done in the office with or without sedation and requires less recovery time than traditional face-lift techniques.

Short-scar facelift without temporal flap: a 10-year experience.

The understanding of facial anatomy and its changes through aging has led to the development of several different facelift techniques that focus on being less invasive and traumatic and, at the same time, providing natural long-lasting results. In this article we describe step by step our facelift technique as it has been done over the past 10 years by the senior author. This is a retrospective, descriptive, transversal study in which all patients who underwent a rhytidectomy using our technique from January 2002 to September 2012 were included. All patients were operated on under local anesthesia and superficial conscious sedation. All surgeries were performed by the same surgeon. A complete step-by-step description of the surgical technique can be found in the main article. Between January 2002 and September 2012, a total of 113 patients underwent facelift surgery. Of these, 88.9 % were women and 11.1 % were men. The mean age was 55.3 (± 8.66) years. Primary surgeries represented 80.3 % (n = 94), secondary 18.8 % (n = 22), and tertiary 0.85 % (n = 1). Only one major complication, representing 0.8 %, consisting of a right-sided temporal paresis with 2 months complete recovery was seen. The minor complications rate was 23.1 %. The most common minor complication was hypertrophic/keloid scars which made up 77.8 % of all minor complications. The technique described provides good and long-lasting aesthetic results with shorter scars, smaller areas of dissection (without temporal and postauricular flaps), and a shorter recovery period. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Comparison of the Short and Full Incision Face Lift on Five Sets of Identical Twins

INTRODUCTION: To compare results of a short scar face lift to a full incision lift in multiple sets of identical twins. There are no prior studies comparing these incisions in identical twins. Here we offer a comparison of the short scar and full incision as performed on four consecutive identical twins and one set of identical triplets, by the same surgeon. METHODS: After obtaining IRB approval, four sets of identical twins and one set of identical triplets (n=11) underwent rhytidectomy between December 2005 and August 2006. Full scar vs. short scar techniques were performed with identical SMAS techniques when appropriate. In the triplets, one patient received a MACS lift while the other two sisters were given SMAS plications. Skin incision length with corresponding SMAS technique selection was determined for each set of twins by the birth order. First born had a full incision lift. Photographic and chart records were reviewed independently at one and five years to compare early and late results. RESULTS: Both the short term and long term results were comparable between the short and long incision techniques used in these identical twins (Figure 1). Total operative times were similar whether the long or short incision was used. While the long incision technique may allow better access to the SMAS, it requires more time to close.Figure 1: Row A depicts the triplets' pre-operative photographs. Row B depicts the triplets' 1 year post-operative photographs. Column 1: Full Incision with SMAS Plication. Column 2: Short Scar Incision with SMAS Plication. Column 3: Short Scar Incision with MACSCONCLUSION: These results suggest that plastic surgeons should possibly consider the benefits of the shorter incision more frequently when formulating a treatment plan. Particularly as the shorter incision seems to yield equivalent results, at least in certain patient populations. The most obvious benefit is avoiding retroauricular scars and not disturbing the hairline behind the ear. Minimal incision surgery also offers less bleeding, is less invasive, and avoids dissection of the thin post auricular skin flap which can be prone to necrosis during the postoperative period. Although there are individuals who benefit from larger long scar incisions, this study supports the use of more conservative, limited incision techniques based on the degree of facial laxity present in each patient.

Rhytidectomy

To evaluate the current evidence-based medicine for rhytidectomy. Specific techniques and their scientific rationale are explored. The authors' practice modifications based on this evidence will be reviewed. The utilities of short scar facelift techniques are validated. Specific indications for the deep plane technique are also discussed. The reader will understand the rationale for choosing specific rhytidectomy techniques for young patients, older patients and specific anatomic findings.

Managing the Neck in the Era of the Short Scar Face-Lift

A recent trend in rhytidectomy has included the introduction of various short incision techniques, particularly the S-lift, the minimal access cranial suspension lift, and other short scar methods. However, this trend has not been without a criticism that these minimally invasive techniques might be limited in what might be achievable by such surgery. As with more traditional face-lift surgery, the management of the neck often presents as the most challenging aspect of the procedure when using short scar techniques. This article will present a brief history of cervical rhytidectomy and relevant surgical anatomy, as well as the authors' algorithmic approach to surgical assessment and management of the neck, the short incision operative techniques, and potential complications. In the authors' experience, attention to both the selection criteria and operative modifications in the execution of short scar techniques are critical to optimizing outcomes in cervical rejuvenation.

The Double “C” Plication Technique: A Reliable Technique for Lower Facial Rejuvenation: Review of 1500 Cases

Introduction: Facial rejuvenation procedures have evolved significantly since they were first performed at the beginning of the 20th century. Modern SMAS lifting techniques focus on providing natural facial rejuvenation, durable results, fewer complications, and reduced morbidity. Many techniques exist, each proposing different methods to attain a common goal, resuspension of the SMAS. A simple new technique for SMAS plication of lower face and neck is introduced, called double “C” plication. This technique is reproducible and simple, creating lasting results for a natural look with a low complication rate. Materials and Methods: In over 1500 face-lifts in the last 4 years, the author has evolved a simple technique with a natural look. All cases were done with oral sedation and local anesthesia. Patients were ambulatory immediately following surgery and had a rapid recovery with little edema or ecchymosis. Nerve injuries were avoided, and the temple hairline and earlobe clefts were preserved. There are no ridges, dimples, or “joker lines.” Revision rate was less than 0.7%. This technique utilizes double running plication sutures in a “C” shape pattern for SMAS suspension, which can be placed via traditional or short-scar face-lift incisions. This technique provides an evenly distributed multi vector radial traction on the SMAS and lateral platysma, allowing for a more uniform suspension compared to traditional single plication and purse string sutures, which provide point specific tension. This SMAS plication technique tightens up the face just like lacing a shoe, making the entire lower face firm and youthful. The neck plication pulls the platysma up behind the ear to maintain the earlobe up in its normal anatomical position. Results: Over a 4-year period, 1532 procedures were performed utilizing the aforementioned double “C” lift technique with average follow-up of 18 months. This is a retrospective chart review of a single surgeon's rhytidectomy practice. Of the 1532 patients, 110 had undergone previous rhytidectomy by a different surgeon. Complications included in the evaluation process were major hematoma 1.3%, minor hematoma 5%, infection 0.5%, facial nerve injury 0%, greater auricular nerve injury 0.1%, post auricular skin necrosis (>2 cm) 0.8%, and revision rate 0.7%. Conclusions: The double “C” plication technique is a reliable, simple, and reproducible technique with natural results and low complications. This technique involves a double running plication suturing of SMAS and lateral platysma in a “C” shape pattern.

The Purse-String Reinforced SMASectomy Short Scar Facelift

Over the last two decades, short scar facelifts, often referred to as "mini" facelifts, have gained popularity. We use a purse-string reinforced (PRS) superficial musculoaponeurotic system rhytidectomy (SMASectomy) shortscar facelift that combines a SMASectomy in the vertical direction and suspension sutures in order to improve structural facial support. In the case of visible platysma bands and/or local fat deposition, liposuction (frequently followed by an anterior plastysmaplasty procedure) was added to correct features that are not consistently correctable using only a short scar facelift. This study retrospectively analyzes our experience with a new type of short scar facelift technique that combines both a superficial musculoaponeurotic system rhytidectomy (SMAS-ectomy) and suspension sutures with a thorough approach to the anterior surface of the neck. Over a period of three years, the PRS short scar facelift was performed in 137 patients with a mean age of 55 years (range 23-79 years). In almost half of the patients, the PRS short scar facelift was preceded by a separate treatment of the anterior neck contour by liposuction (67/137 patients; 49%). In two-thirds of these patients (42/67 patients), this liposuction was followed by an anterior plastymaplasty. Most patients (129/137; 94%) were satisfied or very satisfied with their results at the end of the follow-up period. Eight patients were not satisfied: five because of higher expectations, two because of insufficient improvement of the plastysma bands (which had not been treated by a plastysmaplasty procedure), and one because of the improper recognition of midface sagging (which had not been treated and was not properly discussed preoperatively). In the case of plastysma bands, platysmaplasty (n = 42) did improve the presence of these bands. There were no major complications in this series: 1 case had temporary neuropraxia of a buccal branch, which resolved after two months; two cases had hematoma, requiring evacuation on the outpatient clinic after one week; two cases with traction dimpling in the neck over the sternocleidomastoid region required late surgical revision; and one case had hypertrophic scarring in the preauricular area. The PRS technique is a short scar facelift technique that is both simple and safe. Complications are uncommon and usually minor. However, in the presence of platysma bands and/or local fat deposition, an anterior neck procedure-liposuction and/or anterior platysmaplasty-should be incorporated in order to optimize the results.

Against the “visible” short scar face lift

According to the author, the short scar face lift seeks to eliminate the retroauricular scar by exerting a vertical pull on the cheek, but residual excess skin frequently remains below the ear lobe. More importantly, this vertical elevation of the cheek creates significant skin excess at the temporal level. To eliminate this excess, a precapillary temporal skin excision is usually performed. A potentially obvious temporal scar is thus created in a very visible part of the face. In this article, the author outlines his views on the drawbacks of the short scar face lift and advocates a different technique, using a vertical retroauricular incision, with the goal of avoiding the disadvantages of the short scar approach.

Shortscar Face-Lift with the RoundBlock SMAS Treatment: A Younger Face for All

Performing a face-lift for smokers, bald people, and those looking for a quick recovery is always a challenge. The submucosal aponeurotic system (SMAS) plication technique with limited undermining provides great suspension and has proved to be a safe and fast way to perform a face-lift surgery. The procedure is a suspension technique for face-lifting based on a purse-string suture around the ear that allows all the soft tissues of the face and neck to be elevated and anchored in the strong structures of the cranial muscles and aponeurosis. This allows a harmonic volumetric repositioning and results in almost no dead space because the circular plication diminishes the surgical undermining when stretched. A total of 225 face-lifts were performed. Because this procedure offers quick recovery and long-lasting results with minimal complications, patients become fearless about face-lift surgery. The RoundBlock SMAS treatment is a suspension method for face-lifts that is safe and fast, results in reduced scars and no dead space, requires no drains, and has a quick recovery time.

The MACS-lift short scar rhytidectomy

The minimal access cranial suspension (MACS) lift, a short scar face lift for the lower and middle third of the face, uses a pure vertical vector, involves no lateral tension, and may be performed with the patient under local anesthesia in 2 to 2.5 hours. According to the authors, the procedure reduces recovery time and morbidity, and results are as stable as more classic, extended face lift techniques.

Facial rejuvenation in patients of medium complexion

Gustavo Colon, MD Portia Chiou, MD Onelio Garcia, Jr., MD Volney Pitombo, MD Dr. Colon: I would like to start by posing a general question. Is there any approach that you take differently in a patient of medium complexion—whether Latino/Hispanic, Mediterranean, or another ethnicity with generally thicker skin—with regard to the incisions used for facial rejuvenation procedures? Because one of the things you must warn these patients about is that their scars may be hypertrophic. Dr. Garcia: About 50% of my current practice is Hispanic. I am in south Florida. In the very thick, darker, or olive skinned patients that I see, I do not use hairline incisions. I always keep them behind the hairline, and I shorten the postauricular incision significantly, whenever possible. But when I cannot, because of significant extra skin, I always keep it within the hair. The problems I have seen with hypertrophic scars in these patients have been in the postauricular area. Dr. Colon: Dr. Pitombo, what is your approach? Dr. Pitombo: I limit the problem by limiting the incisions. In other words, I do a short scar face lift. Dr. Colon: And Dr. Chiou? Dr. Chiou: For my patients who have medium complexion skin, I place the scar within the hairline, if possible. Postoperatively, I start patients on active scar massage the week after their sutures are removed. In some instances, I recommend using a particular product, such as Mederma (Merz Pharmaeuticals, Greensboro, NC), which when coupled with scar massage seems to help keep scars flat. Dr. Colon: Is there any difference in your approach to Asian patients? Dr. Chiou: I approach Asian patients in the same way as I approach anyone with a medium complexion. Scarring is a concern, especially in the very early postoperative period. For patients at risk for hypertrophic scarring, …

The MACS-Lift Short-Scar Rhytidectomy

The minimal access cranial suspension (MACS) lift, a short scar face lift for the lower and middle third of the face, uses a pure vertical vector, involves no lateral tension, and may be performed with the patient under local anesthesia in 2 to 2.5 hours. According to the authors, the procedure reduces recovery time and morbidity, and results are as stable as more classic, extended face lift techniques.

Short scar face lift

Daniel C. Baker, MD Foad Nahai, MD Hamid Massiha, MD Patrick Tonnard, MD Dr. Baker: The first patient is a 48-year-old fashion consultant who wants to correct her neck and jowl laxity (Figure 1). Although her hair is quite short, she is planning to let it grow and wear it up off her face. Many of her friends and clients have undergone face lift surgery and have significant scars behind their ears; she would like to avoid this. Dr. Massiha, how would you treat this patient? Figure 1 This 48-year-old fashion consultant is requesting correction of her neck and jowl laxity. Dr. Massiha: She has some asymmetry, and the right side of her face is smaller than the left. The asymmetry may require another procedure, such as fat grafting. She has a type 1 or 2 deformity1 and would be an ideal candidate for a short scar face lift. Dr. Baker: Would you do a SMAS flap, plication, or some type of suspension technique? Dr. Massiha: I would dissect the SMAS and platysma as one unit and pull it up. Whatever SMAS is in excess, I would remove. I would treat the left side more aggressively than the right, and maybe that would improve the asymmetry. I like using a SMAS platysma unit, but if I could not dissect the cheek part of the SMAS because it was too thin or too thick, I would create a skin flap in the upper part of the face and blend it with the SMAS platysma flap of the lower face, namely below the level of the lips inferiorly. Dr. Baker: Dr. Nahai, the submental area seems a little full. How would you address that? Dr. Nahai: I agree with Dr. Massiha that this woman would be a good candidate for a short scar …

Serial Notching of the Platysma Bands, Updated

Introduction: A traditional platysmaplasty almost always results in hardening and scarring at the submental region. In an attempt to avoid these complications, the author has developed a technique for serially notching the platysma bands. Materials and Methods: Patients demonstrate their platysma bands so that they can be marked with a distance of 3–4 cm between every incision. After injecting local anesthesia with epinephrine 1 mL to each incision site, a stab incision is made with a number 11 blade horizontal to the platysma band. Multiple incisions are necessary for a better result. The skin must be pinched together with the muscle between the thumb and index finger. The notching is done with an electrocautery and needle and repeated at the sites marked along the muscle. The wounds are covered with sterile dressings. Results: Serial notching of platysma bands was performed on 102 patients (10 men [9.8%] and 92 women [90.2%]). Only 5 hematomas (5%) were observed. Apart from the cases of hematoma, the other 97 cases were satisfactory (98%). In 78 cases (76.5%), the doctors also performed an S-lift or a facelift and witnessed better results. In most of the cases (80 cases, 81%), a submental liposuction was also necessary. Discussion: This technique alone, or combined with liposuction of the neck and with surgeries of the mid to lower face such as posterior necklift, S-lift, short scar facelift, or a conventional facelift, will eliminate platysma bands, especially in older patients. Since using this technique, we have not been required to perform platysma plication (platysmaplasty). This kind of notching of the platysmal bands is mainly done with liposuction. No special and expensive instruments are required, recovery time is very short, scarring is minimal and the sutures can be removed after a few days. If multiple and serial incisions and notching are done, no depressions and retracted muscles will be palpable or visible. It causes no major swelling and bruising of the neck. Also, only 1 case of hematoma was observed and there were no other complications. This technique is a very good adjuvant to a neck or lower facelift in older patients and in some younger patients Type I, II, and III).