Rhytidectomy: Principles and Practice Emphasizing Safety

Abstract

There is an unprecedented acceptance of rhytidectomy by today's society. No longer limited to the affluent few, middle class citizens are devoting their expendable income to achieve a more youthful appearance that is natural and inconspicuous. Despite recent difficult economic times, the mindset of the working population continues to be welcoming of rhytidectomy as a way to achieve a refreshed look while expecting minimal downtime and morbidity. To achieve these results, the current literature has described an array of techniques; however, there is no consensus on a preferred method, which reflects limitations and advantages inherent to every style of face-lifting. Each individual patient will have specific needs, and it is key for the facial plastic surgeon to select a technique that can address those areas most affected by the aging process. Whichever method used, an emphasis on safety is of the utmost importance. A solid understanding of the relevant anatomy is imperative as is the awareness of how to best avoid complications. Rhytidectomy can be a challenging procedure, and although complications are fortunately rare, they can be cosmetically devastating and poorly accepted by the elective cosmetic patient. This article aims at providing a summary of the history, the anatomy, and the currently accepted methods in rhytidectomy, emphasizing principles and practices of safety.

Overview of Facial Plastic Surgery and Current Developments

“…[19][20][21] In the mid-1990s, facelifts and rejuvenation operations were becoming increasingly technically demanding and risky due to exposure of the facial nerve branches and extensive soft tissue dissections. 22 These complex procedures yielded superb outcomes in expert hands; however, often patients operated on by less-experienced surgeons experienced prolonged postoperative edema, sensory or motor nerve injury, and facial asymmetry. 22,23 Today there are many facelift approaches, such as the deep plane facelift, composite facelift (which involves repositioning and fixation of the orbicularis oculi muscle), midfacelift, minifacelift, thread lift, periosteal facelift, skin-only facelift, and minimal access cranial suspension lift.…”

Do Patients Access Appropriate Information Online?

“…elective nature of this procedure 15,16 places added emphasis on obtaining reliable and comprehensible information. In our institutional experience, patients interested in this procedure typically seek information on the internet prior to the initial consultation or subsequent visits.…”

Rhytidectomy: Analysis of Videos Available Online

“…In fact, no published studies are identified that provide a critical analysis of YouTube videos on rhytidectomy, a common facial plastic surgery procedure. The elective nature of this procedure 15,16 places added emphasis on obtaining reliable and comprehensible information. In our institutional experience, patients interested in this procedure typically seek information on the Internet prior to the initial consultation or subsequent visits.…”