Deep Plane Facelift: An Evaluation of the High-SMAS versus Standard Incision Points

Abstract

In surgery of the aging face, operative adjustments of the superficial musculoaponeurotic system (SMAS) enhance facial contours. The senior author has observed that the standard deep plane face lift entry points on the SMAS do not provide as much tissue movement in a vertical direction as high-SMAS deep plane face lift entry points. In this study, tissue movement was measured comparing the conventional SMAS entry point with a high-SMAS entry point for deep plane face lifts. Institutional review board approval was obtained. Fourteen facelift patients were enrolled, 10 female and 4 male. Average age was 63.4 (50–81) years. Tissue movement at three points along the jaw line was measured intraoperatively. Standard SMAS entry point suspension resulted in average vertical movements of 6.4, 10.3, and 13.8 mm and average horizontal movements of 3.5, 5.7, and 6.5 mm. High-SMAS entry point resulted in average vertical movements of 11.8, 17.9, and 24.1 mm and average horizontal movements of 5.8, 9.8, and 9.9 mm. This resulted in a 77.3% increase (p = 0.03) in vertical movement and a 61.4% increase (p = 0.02) in horizontal movement with a high-SMAS entry compared with standard SMAS entry. The high-SMAS entry point for a deep plane facelift resulted in a significant increase in lift for both the horizontal and vertical vector on the facial skin flap when compared with the conventional entry.

Keywords

facelift - aging face - high-SMAS

Note

This paper was presented at the following meetings.

• European Academy of Facial Plastic Surgery Annual Meeting in Lisbon, Portugal, September 28–30, 2017.

• American Academy of Facial Plastic and Reconstructive Surgery Annual Meeting in Phoenix, AZ, October 26–28, 2017.

• Institutional Review Board Approval was obtained for this study from the University of California, Los Angeles.

Author Contributions

All authors substantially contributed to the design, acquisition, and interpretation of the data. All were involved in drafting the article, providing final approval, and agree to the accuracy and integrity of the work.

Financial Disclosure

None.

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