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

ABSTRACT

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.