Frey Jordan D, Zide Barry M
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.
Plast Reconstr Surg Glob Open. 2020 May 14;8(5):e2791. doi: 10.1097/GOX.0000000000002791. eCollection 2020 May.
Any face/neck lift operation has a natural flow of slower and speedier portions; slower when dissecting under the superficial musculoaponeurotic system and around nerves while faster during opening, undermining, defatting, and closing. Surgeons can maximize efficiency with these simple maneuvers.
We introduce and demonstrate ten reproducible surgical techniques based on anatomy, which span aspects of the entire face and neck lift procedure including markings, skin flap elevation, sub-superficial musculoaponeurotic system manipulation, preplatysmal fat management, skin re-draping, and post-operative dressings.
As examples, altered scissors facilitate "push" undermining, scoops reduce time for fat removal in the neck, a non-inset method for lobule creation, and digital measurements for certain technical maneuvers are discussed. Moreover, a block and tackle method of facial nerve blocks is reviewed which permits local-only face and neck lifting as well as hematoma drainage without patient intolerance.
Implementation of these surgical techniques in face and neck lift procedures allows the surgeon to potentially decrease operative time and work towards minimizing post-operative edema while attaining aesthetic and natural results.
任何面部/颈部提升手术都有自然的快慢节奏；在浅表肌肉腱膜系统下和神经周围进行解剖时较慢，而在切开、分离、去脂和缝合过程中较快。外科医生可通过这些简单操作实现效率最大化。
我们介绍并演示基于解剖学的十种可重复的手术技术，这些技术涵盖了整个面部和颈部提升手术的各个方面，包括标记、皮瓣提升、浅表肌肉腱膜系统操作、颈前脂肪处理、皮肤重新铺展和术后敷料。
例如，改进的剪刀便于“推”式分离，勺子可减少颈部去脂时间，一种用于创建小叶的非嵌入方法，以及某些技术操作的数字测量方法都进行了讨论。此外，还回顾了一种面神经阻滞的滑轮方法，该方法允许仅在局部进行面部和颈部提升以及血肿引流，而不会引起患者不耐受。
在面部和颈部提升手术中实施这些手术技术，外科医生有可能减少手术时间，并努力将术后水肿降至最低，同时获得美观自然的效果。
