The "SMAS sling": an additional fixation in face lift surgery.

A pennant-shaped "SMAS sling" is developed from the preauricular SMAS, leaving it attached inferiorly between the level of the earlobe and the angle of the mandible. This is rotated posteriorly over the mastoid process, tension is applied, and it is secured with nonabsorbable sutures to the mastoid fascia, thereby providing a backward and upward lift to a very secure area. Minimal problems and complications occurred in 34 patients over the past four years.