Lifting of the upper two-thirds of the face: supraperiosteal-subSMAS versus subperiosteal approach. The quest for physiologic surgery.
The supraperiosteal-subSMAS lifting technique, which has been performed since 1985, for the rejuvenation of the upper two-thirds of the face is described, and the results obtained in a series of 128 cases treated, emphasizing the attainment of an effective rejuvenation together with a minimum of complications and undesired effects is presented. A discussion on the two dissection planes (supraperiosteal-subSMAS versus subperiosteal) used most commonly in the lifting of the upper two-thirds of the face is presented. From an anatomohistophysiologic basis, the tissue manipulations that the two techniques mandate are discussed and evaluated. Based on these facts, the supraperiosteal-subSMAS technique is the most logical physiologically, because it produces less tissue trauma, which leads to fewer complications and a more rapid recovery to a normal social life.
de la Plaza
R
R
Plastic Surgery Unit, La Luz Clinic, Madrid, Spain.
de la Cruz
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010521:Periosteum / Q000098:blood supply / Q000502:physiology; D015361:Rhytidoplasty / Q000379:methods*; D000267:Tissue Adhesions