Skip to main content
SpringerLink
Log in

Triple-Anchoring Sub-SMAS Face-lift

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

Abstract

Background

This article presents the senior author’s (ARB) 10-year experience with a rhytidectomy technique that incorporates concepts of modern facial shaping and contour using a sub-SMAS repositioning of volumetric units with partial sub-SMAS elevation (tunnel dissection), periosteal anchoring of SMAS and volumetric units, and limited skin undermining.

Methods

The cases of triple-anchoring sub-SMAS face-lift performed from January 2000 to January 2010 were analyzed retrospectively. Primary and secondary cases were included. All case data and photography were analyzed. Data regarding patient age, sex, and operative time were gathered. Complication rates were also calculated.

Results

A total of 626 patients had a face-lift using the author’s technique in this period. A total of 484 patients had a primary face-lift and 142 had secondary surgery. Experience with 626 rhytidectomies performed over a 10-year period indicates that this operation can be completed safely with satisfactory results and a low incidence of complications. To alter effectively the facial contour, a system that reliably elevates the facial volumetric units is needed. After adequate release of the retaining ligaments, the thick SMAS is used as a load-bearing layer. All the tension is transferred from the SMAS to a fixed periosteal anchor point. Each volumetric unit of the face (mala, lateral, and cervical) should be independently mobilized and fixed.

Conclusion

The author’s technique was shown to be effective in repositioning facial volumes. It was a predictable and reliable technique with few complications over the years.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http://www.springer.com/00266.

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
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Chang S, Pusic A, Rohrich RJ (2011) A systematic review of comparison of efficacy and complication rates among face-lift techniques. Plast Reconstr Surg 127(1):423–433

    Article  PubMed  CAS  Google Scholar 

  2. Berry MG, Davies D (2010) Platysma-SMAS plication facelift. J Plast Reconstr Aesthet Surg 63(5):793–800

    Article  PubMed  CAS  Google Scholar 

  3. Choucair RJ, Hamra ST (2008) Extended superficial musculoaponeurotic system dissection and composite rhytidectomy. Clin Plast Surg 35(4):607–622 vii

    Article  PubMed  Google Scholar 

  4. Baker DC (2008) Lateral SMASectomy, plication and short scar facelifts: indications and techniques. Clin Plast Surg 35(4):533–550 vi

    Article  PubMed  Google Scholar 

  5. Lindsey JT (2009) Five-year retrospective review of the extended SMAS: critical landmarks and technical refinements. Ann Plast Surg 62(5):492–496

    Article  PubMed  CAS  Google Scholar 

  6. Hamra ST (1998) Frequent face lift sequelae: hollow eyes and the lateral sweep: cause and repair. Plast Reconstr Surg 102(5):1658–1666

    Article  PubMed  CAS  Google Scholar 

  7. Hirmand H, Codner MA, McCord CD, Hester TR Jr, Nahai F (2002) Prominent eye: operative management in lower lid and midfacial rejuvenation and the morphologic classification system. Plast Reconstr Surg 110(2):620–628 discussion 629–634

    Article  PubMed  Google Scholar 

  8. Lambros V (2008) Models of facial aging and implications for treatment. Clin Plast Surg 35(3):319–327 discussion 317

    Article  PubMed  Google Scholar 

  9. Lambros V, Stuzin JM (2008) The cross-cheek depression: surgical cause and effect in the development of the “joker line” and its treatment. Plast Reconstr Surg 122(5):1543–1552

    Article  PubMed  CAS  Google Scholar 

  10. Rohrich RJ, Ghavami A, Lemmon JA, Brown SA (2009) The individualized component face lift: developing a systematic approach to facial rejuvenation. Plast Reconstr Surg 123(3):1050–1063

    Article  PubMed  CAS  Google Scholar 

  11. Rohrich RJ, Pessa JE (2007) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg 119(7):2219–2227

    Article  PubMed  CAS  Google Scholar 

  12. Rohrich RJ, Pessa JE (2008) The retaining system of the face: histologic evaluation of the septal boundaries of the subcutaneous fat compartments. Plast Reconstr Surg 121(5):1804–1809

    Article  PubMed  CAS  Google Scholar 

  13. Massiha H (2003) Short-scar face lift with extended SMAS platysma dissection and lifting and limited skin undermining. Plast Reconstr Surg 112(2):663–669

    Article  PubMed  Google Scholar 

  14. Trussler AP, Stephan P, Hatef D, Schaverien M, Meade R, Barton FE (2010) The frontal branch of the facial nerve across the zygomatic arch: anatomical relevance of the high-SMAS technique. Plast Reconstr Surg 125(4):1221–1229

    Article  PubMed  CAS  Google Scholar 

  15. Schaverien MV, Pessa JE, Saint-Cyr M, Rohrich RJ (2009) The arterial and venous anatomies of the lateral face lift flap and the SMAS. Plast Reconstr Surg 123(5):1581–1587

    Article  PubMed  CAS  Google Scholar 

  16. Hamra ST (2002) A study of the long-term effect of malar fat repositioning in face lift surgery: short-term success but long-term failure. Plast Reconstr Surg 110(3):940–951 discussion 952–959

    Article  PubMed  Google Scholar 

  17. Baek R, Lee SW (2009) Face lift with reposition malarplasty. Plast Reconstr Surg 123(2):701–708

    Article  PubMed  CAS  Google Scholar 

  18. Owsley JQ, Zweifler M (2002) Midface lift of the malar fat pad: technical advances. Plast Reconstr Surg 110(2):674–685 discussion 686–687

    Article  PubMed  Google Scholar 

  19. Ferreira LM, Horibe EK (2006) Understanding the finger-assisted malar elevation technique in face lift. Plast Reconstr Surg 118(3):731–740

    Article  PubMed  CAS  Google Scholar 

  20. Stuzin JM, Feldman JJ, Baker DC, Marten TJ (2002) Cervical contouring in face lift. Aesthet Surg J 22(6):541–548

    Article  PubMed  Google Scholar 

  21. Basile AR, Basile FV (2001) Transparent dressing for rhytidectomy. Aesthetic Plast Surg 25(6):454–456

    Article  PubMed  CAS  Google Scholar 

  22. Basile AR, Basile FV (2001) Transparent dressing for rhytidectomy. Plast Reconstr Surg 108(4):1088

    Article  PubMed  CAS  Google Scholar 

  23. Ellenbogen R, Youn A, Yamini D, Svehlak S (2004) The volumetric face lift. Aesthet Surg J 24(6):514–522

    Article  PubMed  Google Scholar 

  24. McCafferty LR (2008) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg 121(3):1061

    Article  PubMed  CAS  Google Scholar 

  25. Lambros V, Stuzin JM (2010) Discussion. Longevity of SMAS facial rejuvenation and support. Plast Reconstr Surg 126(1):238–239

    Article  PubMed  CAS  Google Scholar 

  26. Stuzin JM (2007) Restoring facial shape in face lifting: the role of skeletal support in facial analysis and midface soft-tissue repositioning. Plast Reconstr Surg 119(1):362–376 discussion 377–378

    Article  PubMed  CAS  Google Scholar 

  27. McCord CD, Boswell CB, Hester TR (2003) Lateral canthal anchoring. Plast Reconstr Surg 112(1):222–237

    Article  PubMed  Google Scholar 

  28. Codner MA, Wolfli JN, Anzarut A (2008) Primary transcutaneous lower blepharoplasty with routine lateral canthal support: a comprehensive 10-year review. Plast Reconstr Surg 121(1):241–250

    Article  PubMed  CAS  Google Scholar 

  29. Pina DP (1997) Aesthetic and safety considerations in composite rhytidectomy: a review of 145 patients over a 3-year period. Plast Reconstr Surg 99(3):670–678 discussion 679

    Article  PubMed  CAS  Google Scholar 

  30. Kaye BL, McKinney P, Connel BF, Stuzin JM (1998) Complications of face lift surgery. Aesthet Surg J 18(1):45–49

    Article  PubMed  CAS  Google Scholar 

  31. Moyer JS, Baker SR (2005) Complications of rhytidectomy. Facial Plast Surg Clin North Am 13(3):469–478

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Plastic Surgery Department, Basile Medical Center, Av. Prof Joao Fiusa 2300, Ribeirao Preto, Sao Paulo, 14024-230, Brazil

    Filipe Volpe Basile & Antonio Roberto Basile

  2. Ivo Pitanguy Institute, Rua Dona Mariana, Botafogo, Rio de Janeiro, Brazil

    Vinicius Volpe Basile

Authors
  1. Filipe Volpe Basile
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Roberto Basile
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vinicius Volpe Basile
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Filipe Volpe Basile.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Basile, F.V., Basile, A.R. & Basile, V.V. Triple-Anchoring Sub-SMAS Face-lift. Aesth Plast Surg 36, 526–533 (2012). https://doi.org/10.1007/s00266-012-9872-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-012-9872-7

Keywords

Search

Navigation