[Recent progress in facial esthetic surgery (excluding endoscopic technics)].

Recent advances offer a new approach to cosmetic surgery of the frontal, cervico-facial and orbito-palpebral areas. Conservative frontal lifting procedures displace the entire frontal muscle (without section or resection) over the underlying bone and periosteal planes by raising the galea and the antagonist muscles. This repositioning reduces or eliminate wrinkles by preventing hyperfunction of the frontal muscle. The risk of sensorial or motor nerve lesions is reduced and the forehead and eyelids have a natural appearance. Unlike extensive lifting of the cervico facial areas, physiological conservative cervico-facial lifting maintains the cutanéomusculo-aponeurotic unity which associates the skin with the superficial musculo-aponeurotic system. The procedure limits detachment in the parotido-masseter region. Early results on the lower cheeks and platysmal cords are significant. The absence of cutaneous detachment preserves the natural appearance of the palpebral complex and the orbital fat allowing improved function and a pleasant aspect of the eyelids. This surgery should be widened beyond the orbito-palpebral area and be used in the frontal, jugal and, in certain cases, the endonasal areas.