Lamellar Arrangement in Facelift Procedures | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 21, Volume 44, Issue 2, April 2020, Page 397-399 PDF (6.81 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2020.113509 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Karima T. Ismail* ; Mariam T. Ismail | ||||
| The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Introduction: The aging process of the face involves: Skin elastosis, lipodystrophy, gravitational effect and atrophy. For decades while planning facelift procedures, the face was divided into regions (upper, middle, lower face). Reflecting on the etiology of aging it seems logic to plan facelift procedures in horizontal fashion rather than traditional vertical planning. In this study we are addressing the face in 3 lamellas: Skin, subcutaneous fat and SMAS where we are combining the advantages of both techniques: Traditional supra-SMAS and deep composite facelift. Material and Methods: Retrospective study from 2014 to 2017 included 52 cases. Procedures were done using sedation and local anesthesia. Incisions followed by skin undermining (1st lamella) and ligament release from superficial fat compartments and SMAS. Thus, allowing repositioning of superficial fat compartments (2nd lamella, e.g. malar pad of fat) and SMAS plication in upward vector; in which composite facelift lacks. Followed by sub-SMAS and sub-platysma dissection (3rd lamella) giving advantage of platysma redraping over the neck, enabling good pull and mobilization of SMAS (re-enhancing our previous fat repositioning and plication) and allowing SMAS excision (preventing lateral cheek bulge). Plication, excision and SMAS anchoring. Skin and SMAS pull in upward and lateral vector. Ancillary procedures as chin augmentation and fat injection were used when needed. Results: Follow-up from 6 months to 2 years. 84.6% complied to follow-up, 90.9% were satisfied, chin implant in 9%, lipo-injection in 22.7%. Complications 13.6%, early: 6.8% had tenderness and redness managed by antibiotic ointment, 2.2% had hematoma collection which was surgically evacuated and coagulation of bleeding vessels, 2.2% had mandibular neuropraxia for 3 weeks; late: 6.8% hypertrophic scarring. Conclusion: Restoring the harmonious facial anatomy during facelift procedure is crucial step. Lamellar facelift ensures addressing all facial components as a safe, reliable procedure that ensures long term desired aesthetic outcome | ||||
| Keywords | ||||
| Facelift; Aging; Elastosis | ||||
| References | ||||
|
1- Khavkin J. and Ellis D.A.: Aging skin: Histology, physiology, and pathology. Facial Plast Surg. Clin. North Am., 19: 229-234, 2011. 2- Gonyon D.L. Jr. and Barton F.E. Jr.: The aging face: Rhytidectomy and adjunctive procedures. Sel. Read Plast. Surg., 11, 2012. 3- Nahai F. ed.: The Art of Aesthetic Surgery: Principles & Techniques. St Louis: Quality Medical Publishing, 2005. 4- Rohrich R.J., Ghavami A., Lemmon J.A., et al.: The individualized component face lift: Developing a systematic approach to facial rejuvenation. Plast. Reconstr. Surg., 123: 1050-1063, 2009. 5- Lambros V.: Observations on periorbital and midface aging. Plast. Reconstr. Surg., 120: 1367-1376, 2007. 6- Rohrich R.J., Pessa J.E. and Ristow B.: The youthful cheek and the deep medial fat compartment. Plast. Reconstr. Surg., 121: 2107-2112, 2008. 7- Hamra S.T.: Composite rhytidectomy. Plast. Reconstr. Surg., 90: 1-13, 1992. 8- Baker D.C., Aston S.J., Guy C.L., et al.: The male rhytidectomy. Plast. Reconstr. Surg., 60: 514-522, 1977 | ||||
|
Statistics Article View: 202 PDF Download: 312 |
||||
