Skip to main content
SpringerLink
Log in

Temporoparietal Fascia Plication in Rhytidectomy

  • Original Articles
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The temporal region has a complex subcutaneous fascial structure known as the temporoparietal fascia, which is part of the subcutaneous musculoaponeurotic system. The temporoparietal fascia is continuous with the superficial musculoaponeurotic system (SMAS) of the face in the inferior border, the frontalis muscle, and the orbicularis oculi muscle in the anterior border. Therefore, a properly planned temporoparietal fascia plication can increase the tightness of the SMAS. In addition, plication of the temporoparietal fascia can provide lifting to decrease lateral canthal wrinkles with elevation of the lateral brows in rhytidectomy. Furthermore, plication of the temporoparietal fascia can yield deep tissue support, which prevents alopecia and visible scar formation in the temporal region by decreasing the tension along the skin incision.

Methods

Plication of the temporoparietal fascia was performed for 16 patients who had undergone face-lifts over the previous 10 years. Careful subcutaneous dissection, performed immediately under the hair follicles to avoid frontal nerve injury, provides excellent exposure of the temporoparietal fascia for plication in rhytidectomy and protects the auriculotemporal nerve and the superficial temporal vessels.

Results

There were no complications such as hematoma, facial nerve injury, alopecia, or visible scar formation attributable to the temporoparietal fascia plication.

Conclusion

Temporoparietal fascia plication can be performed simply during rhytidectomy as an additional procedure. It not only augments the effects of the rhytidectomy, especially in the lateral brows, the lateral canthal, and the temporal regions, but also decreases the risk of possible complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Abul-Hassan HS, Ascher GVD, Acland RD: Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 77:17–24, 1986

    CAS  PubMed  Google Scholar 

  2. Baker DC: Lateral SMASectomy. Plast Recontr Surg 100:509–513, 1997

    CAS  Google Scholar 

  3. Barton FE: The periorbital dissection in rhytidectomy. Clin Plast Surg 19:455–459, 1992

    PubMed  Google Scholar 

  4. Connell BF, Semlacher RA: Contemporary deep layer fascial rejuvenation. Plast Reconstr Surg 100:513–523, 1997

    Google Scholar 

  5. David SK, Cheney ML: An anatomic study of the temporoparietal flap. Arch Otolaryngol Head Neck Surg 121:1153–1156, 1995

    CAS  PubMed  Google Scholar 

  6. Forrest CR, Phillips JH, Bell TAB, Gruss JS, Chir B: The biomechanical effects of deep tissue support as related to brow and face-lift procedures. Plast Reconstr Surg 88:427–432, 1991

    CAS  PubMed  Google Scholar 

  7. Gamble WB, Manson PN, Smith GE, Hamra ST: Comparison of skin tissue tensions using the composite and subcutaneous rhytidectomy techniques. Ann Plast Surg 35:447–453, 1995

    CAS  PubMed  Google Scholar 

  8. Goldwyn RM: Late bleeding after rhytidectomy from injury to the superficial temporal vessels. Plast Reconstr Surg 88:443–445, 1991

    CAS  PubMed  Google Scholar 

  9. Gosain AK, Sewall SR, Yousif NJ: The temporal branch of the facial nerve: How reliably can we predict its path? Plast Recontr Surg 99:1224–1233, 1997

    CAS  Google Scholar 

  10. Hamra ST: The deep plane rhytidectomy. Plast Reconstr Surg 86:53–61, 1992

    Google Scholar 

  11. Jost G, Levent Y: Parotid fascia and face-lifting: A critical evolution of the SMAS concept. Plast Reconstr Surg 74:42–51, 1984

    CAS  PubMed  Google Scholar 

  12. Knize DM: An anatomically based study of the mechanism of eyebrow ptosis. Plast Reconstr Surg 97:1321–1333, 1996

    CAS  PubMed  Google Scholar 

  13. Mitz V, Peyronie M: The superficial musculoaponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 58:80–88, 1976

    CAS  PubMed  Google Scholar 

  14. Owsley JQ: SMAS: Platysma face-lift. Plast Reconstr Surg 71:573–576, 1983

    PubMed  Google Scholar 

  15. Pitanguy I, Ramus AS: The frontal branch of the facial nerve: The importance of its variations in face-lifting. Plast Reconstr Surg 38:352–356, 1966

    CAS  PubMed  Google Scholar 

  16. Sherris DA, Larrabe WF: Anatomic considerations in rhytidectomy. Fascial Plast Surg 12:215–222, 1996

    CAS  Google Scholar 

  17. Stuzin JM, Baker TJ, Gordon HL: The relationship of the superficial and deep facial fascias: Relevance to rhytidectomy and aging. Plast Reconstr Surg 89:441–449, 1992

    CAS  PubMed  Google Scholar 

  18. Stuzin JM, Baker TJ, Gordon HL, Baker TM: Extended SMAS dissection as an approach to midface rejuvenation. Clin Plast Surg 22:295–311, 1995

    CAS  PubMed  Google Scholar 

  19. Sullivan CA, Masin J , Maniglia AJ, Stepnick DW: Complications of rhytidectomy in an otolaryngology training program. Laryngoscope 109:198–203, 1999

    CAS  PubMed  Google Scholar 

  20. Tardy ME, Thomas JR, Brown RJ: The face-lift operation principles and techniques. Mosby: St. Louis

  21. Teimorain B, Delia S, Wahrman A: The multiplane face-lift. Plast Reconstr Surg 93:78–85, 1995

    Google Scholar 

  22. Tellioglu AT, Tekdemir I, Erdemli E, Tüccar E, Ulusoy G: Temporoparietal fascia an anatomic and histologic reinvestigation with new potential clinical applications. Plast Reconstr Surg 105:40–45, 2000

    CAS  PubMed  Google Scholar 

  23. Thaller SR, Kim S, Patterson H: The subcutaneous aponeurotic system (SMAS): A histologic and comparative anatomy evolution. Plast Reconstr Surg 86:690–696, 1990

    CAS  PubMed  Google Scholar 

  24. Thorne CHM, Aston SJ: Aesthetic surgery of the aging face. In: Aston SJ, Beasley RW, Thorne CHM (eds) Grabb and Smith’s plastic surgery. 5th ed. Lippincott-Raven Publishers: Philadelphia, pp 633–649, 1997

    Google Scholar 

  25. Turpin IM: The modern rhytidectomy. Clin Plast Surg 19:383–400, 1992

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ali Teoman Tellioglu, Kenedi Cad 61/8, Kavaklıdere, Ankara, 06660, Türkiye

    Ali Teoman Tellioglu M.D.

  2. Yoshiaki Hosaka, Tokyo, Japan

    Yoshiaki Hosaka M.D.

Authors
  1. Ali Teoman Tellioglu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshiaki Hosaka M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali Teoman Tellioglu M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tellioglu, A.T., Hosaka, Y. Temporoparietal Fascia Plication in Rhytidectomy. Aesth Plast Surg 30, 175–180 (2006). https://doi.org/10.1007/s00266-005-0038-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-005-0038-8

Keywords

Search

Navigation