Facial lifting effect of SMAS multi-vector suspension / 中华医学美学美容杂志

Objective:To explore the rejuvenation effect of SMAS (Superficial musculoaponeurotic system) multi-vector suspension in the face and neck.Methods:From December 2019 to March 2023, the Plastic Surgery Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences implemented 34 cases of cheek rhytidectomy and 10 cases of cheek andneck rhytidectomy. Following general anaesthesia, liposuction is performed on the cheek and mandibular margins, and incisions are made anterior and posterior to the ear. At the end of the subcutaneous dissection, the SMAS in the region of the parotid gland is separated, and the SMAS is then secured by purse string multi-vector suture suspension. Intheend, excess skin is removed and the incision is reduced in tension.Results:All patients underwent successful surgeries and were satisfied with the postoperative follow-up results. The sagging soft tissues were effectively repositioned, resulting in natural facial and neck lift. There were no serious complications such as facial nerve injury, subcutaneous hematoma, incision infection, or skin flap necrosis.Conclusions:The utilization of MAS multi-vector suspension can significantly improve the relaxation of cheek and neck tissue, with fewer complications and satisfactory rejuvenation effect.

Lower Face-Neck Lift by Periauricular Minimal Invasion & Suspension Suture

To reverse the wrinkling & sagging of the skin on lower face and neck, there are various surgical methods such as suspension suture method, classical cervicofacial lift, SMAS-platysmal facelift, deep-plane facelift and composite facelift. Aging of lower face and neck present not only with sagging skin, but also is aggravated due to loss of elasticity of the SMAS and platysmal muscle. Successful surgical outcome is expected when tugging of the SMAS and platysma is performed with proper skin excision of lower face. Practically, deep-plane facelift methods present more satisfying outcome than the subcutaneous dissection, but takes longer recovery period and higher risk of postoperative complication. The authors would like to present a new method of lower face and neck lift, with periauricular minimally invasive suspension suture method, which does not required hospitalization, and gives higher patient satisfaction. In this study, 30 patients(26 females, 4 males) were operated from December of 2004 to February of 2007. Minimal periauricular subcutaneous dissection was performed. While measuring the sagging of the soft tissue on lower face and neck, suspension suture was performed anchoring platysma muscle from the submandibular slit incision site to the fascia of the mastoid process and stretched SMAS of the lower face was suspended to the fascia of the mastoid process with PDS 3-0 sutures. Most of the patients were satisfied without specific problems. The procedure carries advantages of simple operative method, easier access under intravenous sedation, much lesser risk of hematoma formation or facial nerve injury, shorter recovery period, improvement on the cervicomental angle and jaw line, and minimal postoperative scar.

Combined Approach for Rejuvenation of the Lower Third of the Face and the Neck in the Male Patient

Most men develop deep crease in the nasolabial area and visible redundant tissue in the anterior neck with aging. The ideal operation for those patients seeking facial rejuvenation because of prominent nasolabial folds and neck soft-tissue laxity is the cervicofacial rhytidectomy. If the patient doesn't wish to have a conventional face/neck lift under general anesthesia, a combined approach based on summation of partially effective modalities is a good option. We present our experience with combined subcutaneous neck lift, platysmaplasty, mentoplasty, and platysma graft in the treatment of the lower third of the face and the neck, and obtained good results without complications using this comprehensive approach. In terms of morbidity, the procedure left inconspicuous scars. The platysma grafts remained in place and were not palpable and/or perceptible after insertion. Finally, postoperative recovery occurred uneventfully and no patients presented complications or the need for complementary treatment modalities. The incorporation of this innovative technique will provide us with more choices for addressing this controversial issue with a combined approach. The combination of proven methods may have better results than each one alone. It is a simple, safe, and inexpensive procedure that leaves no visible scars and has long-term adequate outcome. In conclusion, the presented procedure offers an additional technique of rejuvenating the lower third of the face and the neck with excellent results in the male patients.