Kamer F M, Frankel A S
University of California, Los Angeles, Division of Head and Neck Surgery, USA.
Plast Reconstr Surg. 1998 Sep;102(3):878-81. doi: 10.1097/00006534-199809030-00041.
Although there are a multitude of techniques currently used for performing face lifts, there is no general agreement as to which, if any, of these techniques is most effective. There may never be a definitive answer to this issue because of the highly subjective nature of aesthetics, variability among surgeons, differences in patient anatomy, and specific patient desires. In an attempt to evaluate face lift techniques objectively, this study compares the rate of patients undergoing a tuck procedure after traditional SMAS (superficial musculoaponeurotic system) rhytidectomy to that of patients after deep plane rhytidectomy. A retrospective chart review was performed on all patients who underwent a tuck procedure following a face lift by the senior author (Kamer) between July of 1990 and January of 1997. There were 634 patients who electively underwent either a SMAS or deep plane type of rhytidectomy during the 6.5-year period; 48 patients subsequently underwent tuck operations, and adequate information was available on 44 patients. Of these, 43 were women and the average age was 57 years. The overall tuck rate from July of 1990 to January of 1997 was 7.5 percent. The tuck rate following SMAS rhytidectomy was 11.4 percent, and that following deep plane rhytidectomy was 3.3 percent. Therefore, a tuck was required 71 percent less frequently after a deep plane lift than after a SMAS lift. This was found to be a statistically significant difference with a p value of .0001 (Fisher's exact test, 2-tail). If the assumption is made that the need for a tuck procedure implies a less than optimal face lift, then the data of this study suggest that the deep plane technique is more effective than the SMAS technique.
尽管目前有多种技术用于实施面部提升术，但对于这些技术中哪一种（如果有的话）最为有效，尚无普遍共识。由于美学具有高度主观性、外科医生之间存在差异、患者解剖结构不同以及患者的特定需求，这个问题可能永远不会有一个确定的答案。为了客观地评估面部提升技术，本研究比较了接受传统SMAS（表浅肌肉腱膜系统）除皱术后进行除皱手术的患者比例与深层平面除皱术后患者的比例。对1990年7月至1997年1月期间由资深作者（卡默）实施面部提升术后进行除皱手术的所有患者进行了回顾性病历审查。在这6.5年期间，有634名患者选择性地接受了SMAS或深层平面除皱术；48名患者随后接受了除皱手术，并且有44名患者的信息足够完整。其中，43名是女性，平均年龄为57岁。1990年7月至1997年1月的总体除皱率为7.5%。SMAS除皱术后的除皱率为11.4%，深层平面除皱术后的除皱率为3.3%。因此，深层平面提升术后需要进行除皱手术的频率比SMAS提升术后低71%。经发现，这是一个具有统计学意义的差异，p值为0.0001（费舍尔精确检验，双侧）。如果假设需要进行除皱手术意味着面部提升效果欠佳，那么本研究的数据表明深层平面技术比SMAS技术更有效。
