Repeating Rhytidoplasty with SMAS, Malar Fat Pad, and Labiomandibular Fold Treatment: The NO Primary Procedure

Abstract.

To repeat a rhytidoplasty means to do it again, with the exclusive aim of correcting the consequences on the facial aging. A short historic outline of the SMAS evolution is made. When the rhytidoplasty is repeated, the following aspects have to be taken into consideration:

1. The preoperative study, that includes analyzing previous rhytidoplasties; satisfaction or nonsatisfaction; sideburn, its location; hairline, its location; scars, their location and aspects; irregularities, their characteristics; nerve injuries, their detection; flaccidity, its evolution.

2. The surgical method to be practiced, which consists of skin dissection, subcutaneous fatty tissue treatment; SMAS treatment, and skin treatment. The types of surgical methods are: how the inferior third of the face and neck are corrected through the great mobility of the SMAS in this region, while in the medium third of the face the ``nasolabial fold'' and the midface flaccidity are corrected by treating the ``malar fat pad.''

3. In the chin region, the formation of a ``labiomandibular fold'' and how it is liberated and treated is described.