Rao Vinay, Basta Marten N, Jehle Charles C, Crozier Joseph W, Woo Albert S
From the Division of Plastic Surgery, The Warren Alpert Medical School, Brown University.
Plast Reconstr Surg. 2023 Feb 1;151(2):223e-233e. doi: 10.1097/PRS.0000000000009834. Epub 2022 Nov 8.
Rhytidectomies are performed to rejuvenate the aging face. Various techniques exist to achieve soft-tissue elevation and skin tightening. This study analyzes three common face-lift techniques: skin-only, superficial musculoaponeurotic system (SMAS) plication, and extended SMAS lifts. The authors characterize effective facial changes with each procedure in a cadaver model.
The authors performed face-lift procedures on 18 cadaver hemifaces. Each face was measured along horizontal and vertical vectors. The primary outcome was change along these vectors. Skin-only, SMAS plication, and extended SMAS lifts were performed sequentially on each hemiface. SMAS plication was used to approximate a lateral SMASectomy procedure. Parameter measurements were compared.
All three procedures exhibited a significant tightening along horizontal vectors. SMAS procedures provided a significant lift along all vertical vectors, whereas the skin-only lift failed to demonstrate significant vertical elevation. SMAS procedures achieved significantly greater composite horizontal and vertical lifts compared to the skin-only operation. There was only an incremental increase in lift between the SMAS plication and extended SMAS procedures in the upper and midface regions. The extended SMAS led to the greatest lift in the lower face.
SMAS procedures provided a greater lift along both horizontal and vertical vectors than the skin lift alone. The increased dissection in the extended SMAS technique resulted in only a modest increase in lift compared to SMAS plication. The extended SMAS approach appears to offer the most benefit at the lower face and may be the best choice for targeting this region.
除皱手术旨在使衰老的面部恢复青春活力。存在多种实现软组织提升和皮肤紧致的技术。本研究分析了三种常见的面部提升技术：单纯皮肤提升、表浅肌肉腱膜系统（SMAS）折叠术和扩展SMAS提升术。作者在尸体模型中描述了每种手术所产生的有效面部变化。
作者对18个尸体半脸进行了面部提升手术。每个面部均沿水平和垂直方向进行测量。主要结果是沿这些方向的变化。在每个半脸上依次进行单纯皮肤提升、SMAS折叠术和扩展SMAS提升术。使用SMAS折叠术来模拟外侧SMAS切除术。对参数测量结果进行比较。
所有三种手术在水平方向上均表现出显著的紧致效果。SMAS手术在所有垂直方向上均提供了显著的提升，而单纯皮肤提升术未能显示出显著的垂直提升效果。与单纯皮肤手术相比，SMAS手术在水平和垂直方向上实现了显著更大的综合提升。在中上面部区域，SMAS折叠术和扩展SMAS手术之间的提升仅略有增加。扩展SMAS在下面部产生了最大的提升。
与单纯皮肤提升相比，SMAS手术在水平和垂直方向上均提供了更大的提升。与SMAS折叠术相比，扩展SMAS技术中增加的解剖操作仅导致提升略有增加。扩展SMAS方法似乎在下面部提供了最大的益处，可能是针对该区域的最佳选择。
