Background: Split Thickness Skin Graft (STSG) donor site healing still becomes concerned since it caused massive pain, discomfort, irritation, soaked, and thick dressing. None of the dressing can be said as the ideal and universal way to treat donor site. Aloe vera has been used as wound treatment, but the mechanism is not well understood yet. This study aims to determine the application of aloe vera gel to heal split-thickness skin graft donor sites on Wistar rats.Methods: An experimental study was conducted among 32 male Wistar rats, 8-12 weeks age with STSG donor area divided into 4 control groups that treated with paraffin gauze and 4 groups that treated with Aloe vera gel. All wounds are closed by transparent dressing and being changed every 2 days. Healing time was count when all wound areas had epithelialization. In the microscopic evaluation, fibroblast, angiogenesis, and collagen deposition were counted on Day 5, 14, and 21. Data were analyzed using SPSS version 17 for Windows.Results: Topical Aloe vera gel for STSG donor site treatment proved initiating significant faster epithelialization time (p=0.018), increasing the amount of fibroblast (p=0.006), and collagen deposition (p=0.001) on Day 5. However, topical aloe vera did not significantly affect the amount of angiogenesis in the early phase (Day 5) of wound healing (p=0.114) but proved to increase significantly in Day 21 (p=0.027). Conclusion: Topical Aloe vera gel proved to heal the STSG donor site faster than paraffin gauze. Aloe vera can be used as one of STSG donor site treatment as it induces faster wound healing.

A number of facelift procedures have been introduced by many surgeons but there is no consensus has yet been established to carry. Since the first description of superficial musculoaponeurotic system (SMAS), it is used as the basis for many facelift methods that produce superior result in rejuvenation compared to traditional skin only facelift. Extended SMAS facelift becoming SMAS modification techniques that is still being developed. It produces two different vector of subcutaneous and SMAS flap, that is essential to restore drooping deep facial tissue with natural appearance. Despite the beneficial use of extended SMAS flap, most of plastic surgeons still traditionally incise the SMAS under the zygomatic arch. However, the low SMAS incision results only on rejuvenation of the lower face and is not sufficient to correct mid-facial aging. Fundamental concepts of high SMAS facelift by  reviewing some literatures explain that high SMAS flap transection allowing the surgeon to achieve greater vertical elevation of the deep structures of the face by undermining the middle face, combined with fixation to a fixed structure produces lasting results and oblique vector of skin envelope creating no tension look. Incision above zygomatic arch turns out to be safely performed without facial nerve injury thorough knowledge of the anatomy. The final result is a balanced and harmonious elevation of sagging tissues of the midface, cheek, and jawline, to such an extent that high SMAS facelift becomes optimal, durable, technically simple, reproducible and with a comparatively high safety margin in facelift procedures.