Sunday, October 8, 2006
10343

Volumetric Facelift

Richard Ellenbogen, MD, Gary D. Motykie, MD, and John Diaz, MD.

BACKGROUND: Many facelift techniques have been presented that manipulate the SMAS in order to correct a perceived descent of deeper facial structures. This, however, can produce insufficient volume restoration, which may only be correctable by actual fat replacement. OBJECTIVE: A facelift technique that utilizes a combination of volume restoration by fat grafting conservative skin redraping is described. METHODS: A short scar incision is utilized, and limited flap dissection is performed in the subcutaneous plane. Direct defatting is performed of the fat superficial to the platysma and inferior to the mandibular border. The platysma is treated only if prominent banding is present preoperatively. The skin is redraped utilizing a suspension suture between the flap and the cartilaginous canal of the ear, and excess skin is excised. Fat grafting is then performed into volume-deficient areas using a blunt-tipped cannula in order to create a youthful “ogee.” The SMAS and other deeper layers are not manipulated. RESULTS: A retrospective review of 83 consecutive patients revealed an overall complication rate of 6% after a mean follow-up of 12 months. CONCLUSION: The described procedure represents an evolution to a more simpler and effective technique that produces a natural, youthful appearance with minimal morbidity and downtime.