Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
High SMAS Face Lift
The Clinical Problem ( Fig. 11.1 )
The patient looks in the mirror and at recent photographs and thinks that he or she looks old and tired. She or he comments, “how I feel is much younger then how I look” and may state that the work environment is competitive and many cohorts look much younger. An associated loss of self-confidence may be claimed.
Synopsis
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Changes of facial aging of the cheeks, jowls, and neck are characterized by anterior and inferior descent of soft tissues over the facial skeleton.
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The challenge is to restore a natural youthful appearance by moving the descended soft tissues in a superior and posterior vector without distortion of the patient's original appearance (i.e., looking pulled, stretched, or different.)
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A high superficial musculoaponeurotic system (SMAS) platysmal flap is used as the primary vehicle for restoring soft tissues to a youthful position.
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Neck defatting, combined with a full-width platysma transection, is effective for girth reduction of the neck.
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A sub–SMAS-platysma dissection extends until easy movement of the overlying skin and subcutaneous tissues, from cheeks to neck, is obtained by traction on the flap.
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The skin is redraped in a custom fashion for the individual's face and closed without tension.
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A great majority of patients are comfortable in public after 2 weeks. The procedure entails extremely low morbidity and high patient and surgeon satisfaction.
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