Anatomic evaluation of the vertical face-lift in cadavers.

IMPORTANCE

This study investigates how different orientations of tension vectors affect the amount of soft-tissue lift in specific cervicofacial regions.

OBJECTIVES

To compare differences in cosmetic neck and face changes generated by 3 different face-lift techniques, to quantify the amount of lift across different points on the face, and to quantify changes in platysmal dehiscence in each of 3 standard superficial musculoaponeurotic system plication face-lift techniques applied to fresh-frozen cadaver heads.

DESIGN, SETTING, AND PARTICIPANTS: Ten cadaver heads in an academic tertiary care center.

INTERVENTION(S): Three different superficial musculoaponeurotic system plication rhytidectomy procedures were conducted in the following sequence: (1) vertical tension vector plication (vertical lift), (2) superolateral tension vector plication (superolateral lift), and (3) superolateral tension vector plication combined with midline platysmal plication (superolateral lift with platysmal plication).

MAIN OUTCOMES AND MEASURES

After completion of each technique, the amount of lift at 4 standard key points was measured and recorded, and differences in lift at the key points were analyzed.

RESULTS

Vertical lift was associated with greater total lift than superolateral lift alone or superolateral lift with platysmal plication (P < .001 for both). Platysmal dehiscence increased from baseline measurements after superolateral lift and decreased after vertical lift (P = .002 for both).

CONCLUSIONS AND RELEVANCE

Our findings establish how different orientations of tension vectors applied during face-lift surgery achieve different structural changes to various key points across the face. This study helps the face-lift surgeon and student understand the underlying structural anatomic changes associated with different face-lift techniques, which ultimately result in different cosmetic outcomes.

LEVEL OF EVIDENCE

NA.