Abstract
Rhytidectomy techniques have evolved significantly since the procedure's introduction
in the early 20th century. Significant advancements in rhytidectomy techniques occurred
in the 1960s and 1970s with the description of the subfascial rhytidectomy, the identification
of the superficial musculoaponeurotic system (SMAS), and development of the SMAS flap.
The incorporation of fascial undermining and suspension techniques have significantly
improved the longevity and natural appearance of the facelift operation. More aggressive
techniques including subperiosteal, composite, and deep plane techniques have been
developed in the pursuit of the perfect facelift procedure. On the basis of over 25
years of clinical and surgical experience, a biplane SMAS imbrication rhytidectomy
provides a natural, unstretched, and refreshed appearance resulting in high patient
satisfaction. This article will present a detailed description of the rationale, technique,
and nuances of the biplanar SMAS imbrication rhytidectomy. While the management of
the platysma may vary depending on individual patient characteristics, the extent
of subcutaneous, sub-SMAS, and neck dissection employed using the biplanar SMAS imbrication
rhytidectomy minimizes patient complications and allows a relatively rapid recovery.
Keywords
rhytidectomy - facelift - SMAS - biplanar facelift - Superficial Musculoaponeurotic
System Suspension Rhytidectomy
