The Oriental aging face: an evaluation of a decade of experience with the triangular SMAS flap technique in facelifting.

The triangular SMAS flap technique was developed through a thorough understanding of the morphological and anatomical problems of the aging Oriental face. A unique manipulation of two triangular SMAS flaps--TSF-1 and TSF-2--permits three-directional lifting of the SMAS, which provides supportive and distributive lifting while reducing unwanted tension in the skin. TSF-1 is the excess portion of the main SMAS flap which results from cephalic lifting in the zygomatic area. TSF-2 is created from the excess portion produced by posterior advancement in the preauricular area, and is rotated to the postauricular area. Use of the TSF-1 flap involves complete excision, folding under, or free grafting. The retroauricular TSF-2 flap indirectly achieves platysmal plication. The author evaluates ten years of experience with the triangular SMAS flap technique and describes the entire aspect of the aging face in Orientals.