Abstract
Facelifts remain a critical part of a facial plastic surgeon's cosmetic practice.
Techniques continue to evolve, while at the same time patients demand less invasive
procedures with less morbidity. The authors present a facelift plication technique
using wide purse-string sutures placed into the superficial musculoaponeurotic system
and platysma. This is a retrospective review with a level of evidence 3 set at a medical
spa and tertiary referral center designed to assess a purse-string suture technique
using an inner followed by an outer purse-string, with refinements being made during
the timeframe of the review. One hundred and eighteen patients were reviewed and 95
were included in the study given the inclusion criteria of a minimum of 1-year follow-up.
Based on the subjective judgment of the primary surgeon, 37 patients were found to
have excellent results, while 43 patients were judged as having good results. The
judgment was based on the physical exam improvement of the aging aspects of the patient,
and patient satisfaction. Ten patients displayed fair results (the patients were marginally
happy), and five patients were noted to have poor results (they were notably unhappy).
Complications included eight hematomas, five patients with prominent scars, and one
patient with skin loss in the temple region. There were no cases of facial nerve injury.
The extended purse-string rhytidectomy is a good alternative to traditional facelift
techniques. This offers a plication method that results in the vertical vector that
is now considered of paramount importance with all facelifts. The authors feel that
it is a valuable tool that can be considered in most patients presenting for aging
face surgery.
Keywords
facelift - rhytidectomy - purse-string rhytidectomy - aging face surgery - neck lift
