Abstract
Considering the fixed points of the face (Fig. 1), and in light of the fact that gravity is one of the main factors involved in aging, a new alternative concept in cosmetic surgery is discussed in this paper. In our approach, rejuvenation of the face and neck involves two completely separate procedures. The whole face must be treated “homothetically”, with an upward (vertical) and deep (subperiosteal) approach, to preserve facial proportions and distances, thus preserving the original facial identity. The facial portion of our rejuvenation surgery becomes a single “en bloc” and “closed” procedure, correcting the sagging tissue in the lateral sector, between the fixed zones which must be preserved. The Malaris portion of the Orbicularis Oculi Muscle, (through its strong connections with the skin and the malar fat) has become the “key tool” of the rejuvenation of the whole face. Then, neck surgery becomes a completely distinct procedure, and is to be performed in an oblique/horizontal direction. We now seek to preserve the very firmly attached neck zones, which are the attachment of the posterior border of the fibrous platysma onto the S.C.M. (Sterno-Cleido-Mastoidien muscle). This will permit a more conservative and less aggressive neck surgery, without any sub-platysmal disection. Over 200 RARE procedures have been performed during almost four years. Improvement in terms of facial rejuvenation is dramatic and the technique is quite safe and predictable. The only possible difficulty involves the patient’s temporary initial concern about early postoperative appearance.
Similar content being viewed by others
References
D Furnas (1989) ArticleTitleThe retaining ligament of the cheek Plast Rec Surg 83 1–16
O Ramirez (2001) ArticleTitleFull face rejuvenation in three dimensions: a “Face-Lifting” for the new millennium Aesth Plast Surg 25 152–164 Occurrence Handle10.1007/s002660010114 Occurrence Handle1:STN:280:DC%2BD3MzmsVymsA%3D%3D
B Mendelson (2001) ArticleTitleFat preservation Technique of lower-lid Blepharoplasty Aesth Surg J 21 450–459 Occurrence Handle10.1067/maj.2001.119405
O Ramirez R Santamarina (2000) ArticleTitleSpatial orientation of motor innervation of the lower orbicularis occuli muscle Aesth Surg J 20 107–113 Occurrence Handle10.1067/maj.2000.106712
C LeLouarn (2001) ArticleTitleBotulinum Toxin A and Facial Lines: The Variable Concentration Aesth Plast Surg 25 73–84 Occurrence Handle10.1007/s002660010100 Occurrence Handle1:STN:280:DC%2BD3M3ltFantA%3D%3D
C Casagrande R Saltz et al. (2000) ArticleTitleDirect needle fixation in endoscopic facial rejuvenation Aesth Surg J 20 361–365 Occurrence Handle10.1067/maj.2000.111019
P Tessier (1990) ArticleTitleLifting facial sous periosté Ann Chir Plast Esthet 34 193–197
J Carraway C Mellow (1990) ArticleTitleThe prevention and treatment of lower lid ectropion following blepharoplasty Plast Reconst Surg 85 971–981 Occurrence Handle1:STN:280:By%2BB2s3otlU%3D Occurrence Handle2349302
JC Dardour T Ktorza (2000) ArticleTitleEndoscopic deep periorbital lifting: Study and results based on 50 consecutive cases Aesth Plast Surg 24 292–298 Occurrence Handle10.1007/s002660010049 Occurrence Handle1:STN:280:DC%2BD3cvosVymug%3D%3D
Badin Casagrande et al. (2001) ArticleTitleMinimally Invasive Facial Rejuvenation Endolaser Midface Lift Aest Plast Surg 25 447–453 Occurrence Handle10.1007/s00266-001-0023-9 Occurrence Handle1:STN:280:DC%2BD3MnosVCjsg%3D%3D
T Hamra Sam (1993) Composite Rhytidectomy QMP Inc. St Louis, Missouri
Author information
Authors and Affiliations
Corresponding author
Additional information
**Homothetia (adj: homothetic): From “homos”: same; and “thesis”: position. A geometric term which means conservation of the relations and distances of different points of a figure, after its displacement (syn: to “act in concert” or in harmony). Homothetia preserves the identity of components during movement, without deformation or change. (Figs. 2A, B, 3A, B).
Rights and permissions
About this article
Cite this article
Besins, T. The “R.A.R.E.” Technique (Reverse and Repositioning Effect): The Renaissance of the Aging Face and Neck. Aesth. Plast. Surg. 28, 127–142 (2004). https://doi.org/10.1007/s00266-004-3002-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-004-3002-0