"Quantifying the Effective Lift of Skin Only, SMAS Plication (Lateral SMASectomy), and Extended SMAS Facelift Techniques in a Cadaveric Comparison Study".

PURPOSE: Rhytidectomies are performed to rejuvenate the aging face. Various techniques exist to achieve soft tissue elevation and skin tightening. This study analyzes three common facelift techniques - Skin Only, superficial musculoaponeurotic system (SMAS) Plication, and Extended SMAS lifts. We characterize effective facial changes with each procedure in a cadaver model.

METHODS: We performed facelift procedures on 18 cadaver hemi-faces. Each face was measured along horizontal and vertical vectors. The primary outcome was change along these vectors. Skin Only, SMAS Plication, and Extended SMAS lifts were performed sequentially on each hemi-face. SMAS Plication was used to approximate a Lateral SMASectomy procedure. Parameter measurements were compared.

RESULTS: All three procedures exhibited a significant tightening along horizontal vectors. SMAS procedures provided a significant lift along all vertical vectors while the Skin Only lift failed to demonstrate significant vertical elevation. SMAS procedures achieved significantly greater composite horizontal and vertical lifts compared to the Skin Only operation. There was only an incremental increase in lift between the SMAS Plication and Extended SMAS procedures in the upper and midface regions. The Extended SMAS led to the greatest lift in the lower face.

CONCLUSION: SMAS procedures provided a greater lift along both horizontal and vertical vectors than the Skin lift alone. The increased dissection in the Extended SMAS technique resulted in only a modest increase in lift compared to SMAS Plication. The Extended SMAS approach appears to offer the most benefit at the lower face and may be the best choice for targeting this region.