Operative Procedures

  • Lawrence C. Y. Ho
  • Michael F. Klaassen
  • Kumar Mithraratne


The aged face is graced by sagging skin and soft tissue characterised by a lax neck with bilateral vertical folds in front. The ageing stigmas consist of progressive upper cheek, lower eyelid-cheek sulcus, nasolabial folds, marionette deformity, jowls, anterior platysma bands and obtuse cervical-mental angle as seen in Fig. 4.1a–c.

Supplementary material

Video 4.1

Video of Fig. 4.4 (MP4 8081 kb)

Video 4.2

Video of Fig. 4.5 (MP4 3231 kb)

Video 4.3

Video of Fig. 4.6 (MP4 2848 kb)

Video 4.4

Video of Fig. 4.30 (MP4 2356 kb)

Video 4.5

Video of Fig. 4.31 (MP4 2847 kb)

Video 4.6

Video of Fig. 4.50 (MP4 2794 kb)

Video 4.7

Video of Fig. 4.51a (MP4 5054 kb)

Video 4.8

Video of Fig. 4.51b (MP4 5330 kb)

Video 4.9

Video of Fig. 4.64b (MP4 6817 kb)

Video 4.10

Video of Fig. 4.70a (MP4 5597 kb)

Video 4.11

Caption (MOV 688 kb)

Video 4.12

Caption (MOV 686 kb)


  1. 1.
    Alghoul M, Codner MA (2013) Retaining ligaments of the face. Review of anatomy and clinical applications. Aesthet Surg J 405:1–14Google Scholar
  2. 2.
    Mendelson BC (1997) SMAS fixation to the facial skeleton: rationale and results. Plast Reconstr Surg 100:1834–1842CrossRefPubMedGoogle Scholar
  3. 3.
    Jackson I, Yavuzer R, Beale B (2000) Simultaneous facelift & carbon dioxide laser resurfacing: a safe technique? Aesthetic Plast Surg 24(1):1–10CrossRefPubMedGoogle Scholar
  4. 4.
    Joseph J (1931) Nasenplastik und sonstige Gesichsplastik nebst einem anhang uber mammaplastik. Verlag von Curt Kabitzsch, LeipzigGoogle Scholar
  5. 5.
    Lexer, E; Die gesamte Wiederherstellungschirurgie (Leipzig, Barth), Zugleich 2, Auflage der Wiederherstellungschirurgie, Mit 1910 Abbidungen im Text, Band 11, 1931.Google Scholar
  6. 6.
    Saylan Z (1999) The S-lift. Less is more. Aesth Surg Jour 19(5):406–409Google Scholar
  7. 7.
    Saylan Z (2002) Purse-string-formed plication of SMAS with zygomatic bone fixation. Plast Reconstr Surg 110(2):667–671Google Scholar
  8. 8.
    Tonnard PL, Verpaele A, Monstrey S, Van Landuyt K, Blondeel P, Hamdi M, Matton G (2002) Minimal access cranial suspension lift: a modified S lift. Plast Reconstr Surg 109(6):2074–2086CrossRefPubMedGoogle Scholar
  9. 9.
    Tonnard PL, Verpaele A, Gaia S (2005) Optimising results from minimal access cranial suspension lifting (MACS-lift). Aesthetic Plast Surg 29(4):213–220CrossRefPubMedGoogle Scholar
  10. 10.
    Hoefflin SM (1998) The extended supraplatysmal plane (ESP) face lift. Plast Reconstr Surg 101:494–503CrossRefPubMedGoogle Scholar
  11. 11.
    Gianpapa V, Di Bernado BE (1995) Neck recontouring with suture suspension and liposuction: an alternative for early rhytidectomy candidate. Aesthetic Plast Surg 19(3):217–233CrossRefGoogle Scholar
  12. 12.
    Gianpappa V, Bitzos I, Ramirez O, Granick M (2005) Long term results of suture suspension platysmaplasty for neck rejuvenation: a 13 year follow-up evaluation. Aesthetic Plast Surg 29(5):332–340CrossRefGoogle Scholar
  13. 13.
    Cronin TD, Biggs TM (1971) The T-Z-plasty for the male ‘Turkey Gobbler’ neck. Plast Reconstr Surg 47(6):534–538CrossRefPubMedGoogle Scholar
  14. 14.
    Adamson JE, Toksu AE (1981) Progress in rhytidectomy by platysma-SMAS rotation and elevation. Plast Reconstr Surg 68(1):23–33CrossRefPubMedGoogle Scholar
  15. 15.
    Guerrero-Santos J, Espaillat L, Morales F (1974) Muscular lift in cervical rhytidectomy. Plast Reconstr Surg 54(2):127–131CrossRefPubMedGoogle Scholar
  16. 16.
    Ho LCY (2002) Refinements in rejuvenative facial lipomorphoplasty. Aesthetic Plast Surg 26(5):329–334CrossRefPubMedGoogle Scholar
  17. 17.
    Ho LCY (2011) Facial optimisation. Chin J Aesthetic Plast Surg 11:702–708Google Scholar
  18. 18.
    Ho LCY (2012) Contour and vector congruent facelift. Chin J Aesthetic Plast Surg 11:702–704Google Scholar
  19. 19.
    Ho LCY, Yin Z, Fan J (2014) Visuality. Chin J Aesthetic Plast Surg 9:573–576Google Scholar
  20. 20.
    Gregory RL (1997) Eye and brain: the psychology of seeing, 5th edn. Princeton University Press, Princeton, NJGoogle Scholar
  21. 21.
    Chang L, Tsao D (2017) The code for facial identity in the primate brain. Cell 169(6):1013–1028CrossRefPubMedGoogle Scholar
  22. 22.
    Sulamanidze MA, Shiffman MA, Paikidze TG, Sulamanidze GM, Gavasheli LG (2001) Facial lifting with APTOS threads. Int J Cosmet Surg Aesthetic Dermatol 3:275–281CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Lawrence C. Y. Ho
    • 1
  • Michael F. Klaassen
    • 2
  • Kumar Mithraratne
    • 3
  1. 1.Formerly Repatriation General Hospital ConcordSydneyAustralia
  2. 2.Private PracticeAucklandNew Zealand
  3. 3.The University of AucklandAuckland Bioengineering InstituteAucklandNew Zealand

Personalised recommendations