Cervicofacial Rhytidectomy without Notorious Scars: Experience of 29 Years

Abstract

Objectives Presentation and evaluation of results of the surgical technique of cervicofacial rhytidectomy used by the senior author (F.P.), using the classification of facial aging to determine the stage of pre- and postsurgical age.

Methods The surgical technique was used in 1,181 patients operated on in the past 29 years, starting in 1983. We analyzed retrospectively 318 patients operated on between the years 2001 and 2008, of whom 71 patients met the selection criteria. Postoperative follow-up period was from 6 months to 5 years.

Results All patients in stage I showed clinically visible rejuvenation postoperatively. Significant improvement in facial rejuvenation in stages II and III of aging was shown, with a postoperative change of stage.

Conclusion The technique of cervicofacial rhytidectomy with short flap, facial superficial musculoaponeurotic system (SMAS) imbrication, cervical SMAS plication, inconspicuous incisions, and postauricular z-plasty allows for successful and sustainable results over time, with short recovery time and minimal complications. The classification of facial aging pre- and postsurgery has been useful for the assessment of surgical results.

Keywords

cervicofacial rhytidectomy - facelift

• References

• 1 Wang TD. Patient selection for aging face surgery. Facial Plast Surg Clin North Am 2005; 13: 381-382
• 2 Zager WH, Dyer WK. Minimal incision facelift. Facial Plast Surg 2005; 21: 21-27
• 3 Tonnard P, Verpaele A, Monstrey S , et al. Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 2002; 109: 2074-2086
• 4 Coleman Jr JR. Short incision, short flap face-lift surgery versus deep plane face-lift surgery. Facial Plast Surg 2007; 23: 45-48 , discussion 49
• 5 Adamson PA, Dahiya R, Litner J. Midface effects of the deep-plane vs the superficial musculoaponeurotic system plication face-lift. Arch Facial Plast Surg 2007; 9: 9-11
• 6 Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg 1990; 86: 53-61 , discussion 62–63
• 7 Hamra ST. Composite rhytidectomy. Plast Reconstr Surg 1992; 90: 1-13
• 8 Barton Jr FE. The SMAS and the nasolabial fold. Plast Reconstr Surg 1992; 89: 1054-1057 , discussion 1058–1059
• 9 Ivy EJ, Lorenc ZP, Aston SJ. Is there a difference? A prospective study comparing lateral and standard SMAS face lifts with extended SMAS and composite rhytidectomies. Plast Reconstr Surg 1996; 98: 1135-1143 , discussion 1144–1147
• 10 Becker FF, Bassichis BA. Deep-plane face-lift vs superficial musculoaponeurotic system plication face-lift: a comparative study. Arch Facial Plast Surg 2004; 6: 8-13
• 11 Duminy F, Hudson DA. The mini rhytidectomy. Aesthetic Plast Surg 1997; 21: 280-284
• 12 Brackup AB. Advances and controversies in face lift surgery. Curr Opin Ophthalmol 2003; 14: 253-259
• 13 Quatela VC, Choe KS. Endobrow-midface lift. Facial Plast Surg 2004; 20: 199-206
• 14 Batniji RK, Williams EF. Effects of subperiosteal midfacial elevation via an endoscopic brow-lift incision on lower facial rejuvenation. Facial Plast Surg 2005; 21: 33-37
• 15 Paul MD, Calvert JW, Evans GR. The evolution of the midface lift in aesthetic plastic surgery. Plast Reconstr Surg 2006; 117: 1809-1827
• 16 Renó WT R. Teixeira W. Reinforced orbitotemporal lift: contribution to midface rejuvenation. Plast Reconstr Surg 2003; 111: 869-877 , discussion 878–879
• 17 Cook T, Nakra T, Shorr N, Douglas RS. Facial recontouring with autogenous fat. Facial Plast Surg 2004; 20: 145-147
• 18 Tzikas TL. Lipografting: autologous fat grafting for total facial rejuvenation. Facial Plast Surg 2004; 20: 135-143
• 19 Agarwal A, Dejoseph L, Silver W. Anatomy of the jawline, neck, and perioral area with clinical correlations. Facial Plast Surg 2005; 21: 3-10
• 20 Adamson PA, Litner JA. Surgical management of the aging neck. Facial Plast Surg 2005; 21: 11-20
• 21 Rohrich RJ, Rios JL, Smith PD, Gutowski KA. Neck rejuvenation revisited. Plast Reconstr Surg 2006; 118: 1251-1263
• 22 Sclafani AP, Kwak E. Alternative management of the aging jawline and neck. Facial Plast Surg 2005; 21: 47-54
• 23 Webster RC, Smith RC, Papsidero MJ, Karolow WW, Smith KF. Comparison of SMAS plication with SMAS imbrication in face lifting. Laryngoscope 1982; 92 (8 Pt 1) 901-912
• 24 Webster RC, Davidson TM, White MF, Bush JE, Smith RC. Conservative face lift surgery. Arch Otolaryngol 1976; 102: 657-662
• 25 Wester RC, Beeson WH, McCollough EG. Face-lift. In: Aesthetic Surgery of the Aging Face. St. Louis, MO: Mosby; 1986: 71-128