Visual comparative analysis of the effectiveness of SMAS and deep rhytidectomy

Abstract

Objective. To visually assess the harmony of the face in patients with age–related changes in the face and neck after SMAS or deep rhytidectomy. Materials and methods. A total of 210 patients were operated on. Deep rhytidectomy was performed in 90 patients, 15 of them in combination with medial plasmaplasty. SMAS rhytidectomy was performed in 120 patients, in 26 of them it was supplemented with medial plasmaplasty. The results of the operation were evaluated after 6 months. Results. The visual results of deep rhytidectomy were better and confirmed the patients' expectations of surgical facial contour correction. Specific result combinations inherent in deep rhytidectomy were observed: harmony of the eyebrow line, reduction of the depth of the glabella and crow's feet (upper third of the face); visual reduction of the upper eyelid droop, increase in the fullness of the upper and lower cheeks, reduction of the periorbital zone (middle third of the face); reduction of "marionette lines", nasolabial lines, increase in the fullness of the upper and lower lips, harmony of the corners of the mouth (lower third of the face); roundness of the primary arch of the lower jaw line; reduction in the relative height of the lower third of the face and increase in the difference between the length of the interzygomatic and intergonial lines. Conclusions. Deep rhytidectomy is a more advanced surgical procedure that eliminates sagging not only of the skin, but also of deeper tissues and structures of the face, including muscles, ligaments and fascia, and its results are more pronounced comprehensive facial rejuvenation, clarity of the lower third of the face and jawline.