Download PDF
Facial Plast Surg 2018; 34(05): 539-544
DOI: 10.1055/s-0038-1672176
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Extended Purse-String Rhytidectomy

Chelsea A. Obourn
1   Department of Otolaryngology–Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania
,
John L. Frodel Jr
2   Atlanta MediSpa and Surgery Center, L.L.C., Marietta and Atlanta, Georgia
› Author Affiliations
Further Information

Publication History

Publication Date:
18 September 2018 (online)

Also available at
    Permissions and Reprints

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
 

  • References

  • 1 Baker DC. Minimal incision rhytidectomy (short scar face lift) with lateral SMASectomy: evolution and application. Aesthet Surg J 2001; 21 (01) 14-26
    CrossrefPubMedSearch in Google Scholar
  • 2 Baker D. Short-scar face lift: evolution and applications. In: Tonnard P, Verpaele A. , eds. Short Scar Facelift: Operative Strategies and Techniques. St. Louis, MO: Quality Medical Publishing; 2007: 121-139
    Search in Google Scholar
  • 3 Baker D. Short scar rhytidectomy. In: Nahai F. , ed. The Art of Aesthetic Surgery: Principles and Techniques. Boca Raton, FL: CRC Press; 2012: 1435-1466
    Search in Google Scholar
  • 4 Nahai F. Short scar facelift: Indications and technical considerations. In: Tonnard P, Verpaele A. , eds. Short Scar Facelift: Operative Strategies and Techniques. St. Louis, MO: Quality Medical Publishing; 2007: 35-55
    Search in Google Scholar
  • 5 Nahai F. Clinical decision-making in face and necklift. In: Nahai F. , ed. The Art of Aesthetic Surgery: Principles and Techniques. Boca Raton, FL: CRC Press; 2012: 1347-1376
    Search in Google Scholar
  • 6 Jacono AA, Ransom ER. Patient-specific rhytidectomy: finding the angle of maximal rejuvenation. Aesthet Surg J 2012; 32 (07) 804-813
    CrossrefPubMedSearch in Google Scholar
  • 7 Jacono AA, Rousso JJ. The modern minimally invasive face lift: has it replaced the traditional access approach?. Facial Plast Surg Clin North Am 2013; 21 (02) 171-189
    CrossrefPubMedSearch in Google Scholar
  • 8 Jacono AA, Parikh SS. The minimal access deep plane extended vertical facelift. Aesthet Surg J 2011; 31 (08) 874-890
    CrossrefPubMedSearch in Google Scholar
  • 9 Jacono AA, Malone MH, Talei B. Three-dimensional analysis of long-term midface volume change after vertical vector deep-plane rhytidectomy. Aesthet Surg J 2015; 35 (05) 491-503
    CrossrefPubMedSearch in Google Scholar
  • 10 Salyan Z. The S-lift: less is more. Aesthet Surg J 1999; xx: 406-409
    PubMedSearch in Google Scholar
  • 11 Tonnard P, Verpaele A, Monstrey S. , et al. Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 2002; 109 (06) 2074-2086
    CrossrefPubMedSearch in Google Scholar
  • 12 Tonnard PL, Verpaele A, Gaia S. Optimising results from minimal access cranial suspension lifting (MACS-lift). Aesthetic Plast Surg 2005; 29 (04) 213-220 , discussion 221
    CrossrefPubMedSearch in Google Scholar
  • 13 Tonnard P, Verpaele A. Refining the MACS-lift technique and defining its limits. In: Tonnard P, Verpaele A. , eds. Short Scar Facelift: Operative Strategies and Techniques. St. Louis, MO: Quality Medical Publishing; 2007: 71-91
    Search in Google Scholar
  • 14 Tonnard P, Verpaele A. The short scar MACS-lift rhytidectomy with fat grafting. In: Nahai F. , ed. The Art of Aesthetic Surgery: Principles and Techniques. Boca Raton, FL: CRC Press; 2012: 1377-1434
    Search in Google Scholar
  • 15 Brandy D. The QuickLift: featuring an encircling double purse-string plication technique with blunt neck/jowl undermining and small submental tuck for tightening the sagging SMAS, platysma and skin. Am J Cosmet Surg 2005; 22: 223-232
    CrossrefPubMedSearch in Google Scholar
  • 16 Karam AM, Nayak LM, Lam SM. Short-scar purse-string facelift. Facial Plast Surg Clin North Am 2009; 17 (04) 549-556 , vii
    CrossrefPubMedSearch in Google Scholar
  • 17 Labbé D, Franco RG, Nicolas J. Platysma suspension and platysmaplasty during neck lift: anatomical study and analysis of 30 cases. Plast Reconstr Surg 2006; 117 (06) 2001-2007 , discussion 2008–2010
    CrossrefPubMedSearch in Google Scholar