SMAS in rhytidectomy.

The continuity between the aponeurotic facial fascia and the platysma is an anatomical fact which can be useful in performing face-lift surgery. We have used a "suspender flap" that we fix securely to the periosteum of the mastoid. This fixation using a face-to-face adhesion gives a harmonious and strong lifting of the lower third of the face and creates an acute cervicofacial angle. After 2 years of systematic use of this flap as a routine procedure, we have had no complications related to the procedure itself. Scarring of the skin behind the ear is better than after a purely cutaneous lifting, probably because there is less tension on the skin. Early results have been satisfactory. Further follow-up needs to be done to determine long-term results.