Presuturing in rhytidectomy: a case report.

The use of intraoperative tissue expanders or staged skin excision to improve the results of facelift surgery has been previously reported. However, it is debatable whether excess skin excision improves the final result of rhytidectomy. To determine whether increased skin excision without increased skin tension on the suture line could improve the final results of facelift surgery, a unilateral presuturing technique was used on one patient. Equal bilateral skin tension at the suture line, checked with a spring dynamometer, resulted in a marked increase in the amount of skin excised on the presutured side. No significant difference was noted initially after the operation, but the results at six weeks and at one year after surgery were felt by both patient and physician to be slightly better on the presutured side.