+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Is there a difference? A prospective study comparing lateral and standard SMAS face lifts with extended SMAS and composite rhytidectomies



Is there a difference? A prospective study comparing lateral and standard SMAS face lifts with extended SMAS and composite rhytidectomies



Plastic and Reconstructive Surgery 98(7): 1135



Presented is a prospective study comparing limited SMAS (lateral SMASectomy), conventional SMAS, extended SMAS, and composite rhytidectomies. Randomized patients received either a limited SMAS or conventional SMAS face lift on one side and an extended SMAS or composite rhytidectomy on the other. All procedures were performed at Manhattan Eye, Ear and Throat Hospital in accordance with their well-defined surgical descriptions. Postoperative courses were followed clinically for at least 1 year. Photographs were taken preoperatively and at 6 and 12 months postoperatively. Photographs were reviewed by three independent experienced face lift surgeons. The study comprises 21 patients, 20 women and 1 man, with a mean age of 59 years (range 47 to 70 years). Nineteen patients underwent primary rhytidectomies; two underwent secondary face lifts. For the first 12 patients, each had an extended SMAS procedure performed on one side; on the other, 7 had a conventional SMAS and 5 had a limited SMAS (lateral SMASectomy) face lift. In the last 9 patients, a conventional SMAS was carried out on one side in 8, a limited SMAS in 1, and on the opposite side, a composite rhytidectomy was performed. Complications were few. Temporary weakness of the buccal branch of the facial nerve occurred in 2 patients on the side of the more extensive surgery. On the operating table at completion of the surgery, there was more improvement in reversal of midfacial ptosis and flattening of the nasolabial folds with both extended SMAS and composite rhytidectomies. The composite flap had the most dramatic effect on the nasolabial folds and oral commissure. After 24 hours, once swelling developed and facial motion became reactivated, the noticeable differences in the midface and nasolabial folds were lost. No discernible differences in facial halves were noted again. Differences between facial sides on the 6- and 12-month postoperative photographs were not detectable. We conclude that for routine facial plasty, comparable clinical outcomes are obtained at 6 months and 1 year with limited (lateral SMASectomy) and conventional SMAS face lifts compared with extended SMAS and composite rhytidectomies. All procedures are lacking in their improvement of midface ptosis and the nasolabial folds. The increased surgical risks, morbidity, and convalescence associated with those more extensive procedures do not seem to be warranted in the average patient.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 046479963

Download citation: RISBibTeXText

PMID: 8942899

DOI: 10.1097/00006534-199612000-00001


Related references

Comparison of SMAS plication with SMAS imbrication in face lifting. Laryngoscope 92(8 Pt 1): 901-912, 1982

Long-term Analysis of Lip Augmentation With Superficial Musculoaponeurotic System (SMAS) Tissue Transfer Following Biplanar Extended SMAS Rhytidectomy. JAMA Facial Plastic Surgery 19(1): 34-39, 2017

Is the SMAS Flap Facelift Safe? A Comparison of Complications Between the Sub-SMAS Approach Versus the Subcutaneous Approach With or Without SMAS Plication in Aesthetic Rhytidectomy at an Academic Institution. Aesthetic Plastic Surgery 39(6): 870-876, 2015

Results of biplane face lifts with maximal skin underlining and vertical SMAS flap. Annales de Chirurgie Plastique et Esthetique 41(6): 603-612, 1996

Anatomical Considerations to Prevent Facial Nerve Injury: Insights on Frontal Branch and Cervicofacial Trunk Nerve Anatomy in SMAS Face Lifts. Plastic and Reconstructive Surgery 137(4): 751e, 2016

The contribution of the SMAS to the blood supply in the lateral face lift flap. Plastic and Reconstructive Surgery 100(4): 1011-1018, 1997

The arterial and venous anatomies of the lateral face lift flap and the SMAS. Plastic and Reconstructive Surgery 123(5): 1581-1587, 2009

The viscoelastic properties of the SMAS and its clinical translation: firm support for the high-SMAS rhytidectomy. Plastic and Reconstructive Surgery 128(3): 757-764, 2011

Computerized morphometric quantitation of elastin and collagen in SMAS and facial skin and the possible role of fat cells in SMAS viscoelastic properties. Plastic and Reconstructive Surgery 102(7): 2466-2470, 1998

The Considered and Considerate Facelift Part II: SMAS Plication vs. Imbrication, Theory of SMAS Anatomy and Dynamics, and Conservation of Platysma. American Journal of Cosmetic Surgery 2(3): 1-5, 1985

Short-scar face lift with extended SMAS platysma dissection and lifting and limited skin undermining. Plastic and Reconstructive Surgery 112(2): 663-669, 2003

The extended SMAS facelift: identifying the lateral zygomaticus major muscle border using bony anatomic landmarks. Annals of Plastic Surgery 52(4): 353-357, 2004

Total Ambulatory SMAS Lift by Hidden Minimal Incisions Part 1: Temporal SMAS Lift. International Journal of Cosmetic Surgery and Aesthetic Dermatology 4(3): 179-185, 2002

Validation of the self-management ability scale (SMAS) and development and validation of a shorter scale (SMAS-S) among older patients shortly after hospitalisation. Health and Quality of Life Outcomes 10: 9, 2012

The sub-SMAS and subperiosteal rhytidectomy of the forehead and middle third of the face: a new approach to the aging face. Facial Plastic Surgery 8(1): 18-32, 1992