Research

Short-Scar Face Lift With Extended SMAS Platysma Dissection and Lifting and Limited Skin Undermining
Massiha H (Louisiana State Univ, Metairie)
Plast Reconstr Surg 112:663-669, 2003

Background

Short-scar rhytidectomy is a procedure with the capacity to meet the high standards of minimal scars and deformities without any noticeable signs of manipulation. In the short-scar cervicofacial rhytidoplasty (also known as the S-lift), extended dissections with maximal correction are combined with short scar and decreased signs of manipulation. Over the past 8 years this technique has been used with great success and a high level of patient satisfaction. Described are the S-lift and the devolution of this technique from its more complex form, which is reserved for patients with severe aging damage and redundant neck skin to a simpler technique that is adequate for most younger patients with moderate aging-related changes.


Overview

The initial incisions in this procedure are limited incisions in the sideburn and periauricular areas, extending just around the fold of the ear lobule (Fig 1). Extensive undermining of the superficial musculoaponeurotic system (SMAS)/platysma is performed, and lifting of the face and neck is performed primarily at this level. Minimal skin undermining is performed, which eliminates the need for extended incisions for reduction of dog ears. The preservation of fibrous bands between the skin and the SMAS/platysma unit is an important factor in making an operation such as this one practical, and the preservation of these fibrous bands facilitates the use of short skin incisions (Fig 6). Dissection of large areas of skin and the separation of the skin from the underlying SMAS will require larger incisions.

Conclusions

The S-lift has been shown to be safe, speedy, less traumatic, and well tolerated among patients at high risk for complications, such as smokers. This procedure also reduced the risk of complications.