Facelift Surgery: History, Anatomy, and Recent Innovations

Abstract

Facelift surgery has become a beautifully predictable, safe, and extremely effective operation. Our patients can expect natural and long-lasting results as a direct outcome of our improved understanding and applications of surgical facial anatomy. Rhytidectomy, once an operation of simple well-placed elliptical skin excisions, evolved to include longer skin flaps, skin and platysma flaps with various superficial muscular aponeurotic system (SMAS) manipulations, and various deep plane techniques involving the skin and SMAS as a single unit composite flap. Extended deep plane rhytidectomy and vertical vector neck and SMAS lifting have emerged in recent years as techniques that extend the traditional deep plane dissection into the neck in a subplatysmal plane to allow for release of the platysma from the cervical retaining ligaments. This, ultimately, allows for the creation of a dramatically more youthful appearing face, neck, and jawline.

The Use of Multifilament Suture for SMAS Plication in Rhytidectomy

“…Although the term superficial musculoaponeurotic system (SMAS) was first coined by Mitz and Peronie under the supervision of Tessier in 1976, 6–8 the layer is believed to have been originally described by Sir Charles Bell as early as 1799. 8 Attention to this layer and its handling by Skoog is what resulted in a paradigm shift for facelift surgery.…”

Use of Micro Botulinum Toxin for a Face-lifting Effect: A Systematic Review

“…Commensurate with improved understanding in facial anatomy and greater societal acceptance, surgical face-lifts have evolved over time from a procedure shrouded in mystery to one that is generally safe, reproducible, and effective. 16 Accordingly, the International Society of Aesthetic Plastic Surgery reported face-lifts as the 10th most common aesthetic surgical procedure performed worldwide in 2019 with 448,485 cases, which represents a 9% increase from 2015. 17 Currently, even with the ongoing COVID situation, studies have shown that interest in aesthetic procedures, in general, are on the rise 18 and analysis of social media platforms, such as Twitter, has confirmed that interest in “face-lifts” increased significantly post declaration (March 2020) of the current pandemic by the World Health Organization.…”

Stab access fascia suspension lift: A facelift technique without skin excision and visible scar

“…Surgeons quickly became unsatisfied with the results and began to perform extended subcutaneous undermining. 2,3 Skoog operated on the deeper layer, which was later named SMAS by Mitz and Peyronie. 4,5 This technique has become the foundation of the modern facelift.…”

“…The early facelift merely cut a piece of skin. Surgeons quickly became unsatisfied with the results and began to perform extended subcutaneous undermining 2,3 . Skoog operated on the deeper layer, which was later named SMAS by Mitz and Peyronie 4,5 .…”