Triple-Anchoring Sub-SMAS Face-lift

Basile, F; Basile, Antonio Roberto; Basile, Vinicius Volpe

doi:10.1007/s00266-012-9872-7

Cited by 10 publications

(2 citation statements)

References 33 publications

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“…This is achieved by sculpting the segmental sub-SMAS volume via tethering while simultaneously preserving the Bguardians of facial individuality,^i.e., the retaining ligaments and the zygomatic SMAS border (PRESTO). Most recently, Basile et al have reported an interesting technique that dissects the retaining ligaments and make a reduced tunneling release of the SMAS in order to facilitate upwards movement of the sub-SMAS volumetric tissue mass together with interconnecting structures [25]. However, this technique differs from the current one in that it does not employ the composite layer technique of Hamra [26], and therefore impacts less on the decisive midface and suborbital area.…”

Section: Discussionmentioning

confidence: 99%

Presto lift—a facelift that preserves the retaining ligaments and SMAS tethering

Funk

2016

Oral Maxillofac Surg

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Background Producing youthful facial appearance by facelifting often comes along with an undesired loss of patient's individual phenotype. This may result from insufficient preservation of retaining ligaments, the Bguardians of facial identify,^and from severance of the intersegmental connections of the superficial musculo-aponeurotic system (SMAS), which tether, structure, and compartmentalize facial soft tissue into defined, relevant anatomical zones. Methods The technique reported here preserves most retaining ligaments. They serve to fix the facial soft tissue mass in loco. With the possible exception of the zygomatic-cutaneous ligament, they are only carefully distended. The SMAS intersegmental connections and the zygomatic SMAS border are preserved to retain effective points of facial tissue fixture. Agingassociated thinning and lengthening of the lower eyelid are reduced by midfacial-submalar preparation (Aston 1996). Subplatysmal preparation and disconnection of the cranialplatysmal border permits optimal modeling of neck structure. Results The combination of preservation of retaining ligaments and SMAS tethering (BPRESTO facelift^) introduced here as a novel face-lifting technique conserves the individual esthetics of the patient by approaching her/his individual phenotype from decades ago. In addition, undesired outcomes of facelift surgery and common risks of facelift surgery are circumvented. Conclusions The PRESTO facelift technique generates optimal esthetic results that conserve a patient's personal facial identity, besides restoring a more youthful appearance and being rapid and safe.

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Section: Discussionmentioning

confidence: 99%

Presto lift—a facelift that preserves the retaining ligaments and SMAS tethering

Funk

2016

Oral Maxillofac Surg

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“…Two decades ago, it was reported that at least fifty percent of face-lift procedures included some sort of SMAS dissection [ 7 ], highlighting the importance of clarifying the morphology and spatial relationships of the fascial layers of the face and particularly the SMAS. Various SMAS techniques related to aesthetic surgery continue to be described in the literature [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Superficial Musculoaponeurotic System of the Face: A Model Explored

Broughton

Fyfe

2013

Anatomy Research International

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Regional differences in the integument of the body are explained, at least in part, by differences in fascial arrangements. In the face, where the skin is more mobile due to the action of the underlying facial muscles, fascial organisation is important for support and separation of muscle groups. This study used bequeathed cadaver material to investigate a current model of the SMAS proposed by Macchi et al., the original boundaries of which were explored and extended using both histology and gross dissection. As a clearly identifiable structure spanning the lateral and midface, the SMAS in the specimen supported the model proposed by Macchi et al. The three main findings that support the model were the layered morphological appearance of the SMAS, its progression from fibrous to aponeurotic in a lateral to medial direction, and the enveloping of the zygomaticus musculature. Extension beyond the proposed model into the temporal region was observed, but nasal and forehead regions showed no evidence of SMAS, while its presence in the cervical platysma region remained inconclusive. Fascial and soft tissue variability was considerable within facial regions of the examined specimen, helping to explain the debate around the SMAS in the literature.

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