The extended face-lift with ancillary procedures.

Our present face-lift technique is a double-layered operation, consisting of standard skin flap dissection in the cheeks and undermining in the neck, often across the midline. The underlying foundation for the lift is created by superficial musculoaponeurotic system advancement in the cheeks, partial medial and lateral transection of the platysma muscle in the neck, and suturing together of the medial borders of the platysma in the submental region. We do not divide the platysma completely. When ancillary procedures are indicated, the operations are done in two stages because of the increased operating time required. We believe the improvement in quality and duration of results makes the increased time, effort, and expense worthwhile, though scientific proof of our impression is not yet available. A method for objective evaluation of results is suggested.