title: The lipo-facelift: merging the face-lift and liposculpture: eight years experience and a preliminary observational study.
abstract: BACKGROUND
  Since the introduction of the classic submucosal aponeurotic system (SMAS) face-lift, the surgical approach to improve the changes of an aging face has evolved, and significant technical improvements have been made. However, several problems still have not been solved satisfactorily. These problems include facial lipodystrophy and changes in skin and skin texture.
  
  
  METHODS
  The Lipo-Facelift procedure consists of facial liposculpturing performed simultaneously with a biplanar, bivectorial SMAS face-lift procedure. The authors analyzed pre- and postsurgical photographs of 12 patients with a Lipo-Facelift after 3 and 12 months and analyzed their charts for complications. Furthermore, O2C measurement was performed to assess improved microcirculation. The longest follow-up period was 8 years.
  
  
  RESULTS
  The Lipo-Facelift demonstrated very satisfying results. Initial swelling and bruising were seen as well as two cases of wound-healing disorders, but no surgical intervention or revision was needed. The findings show lasting improvement of skin quality and a youthful appearance.
  
  
  CONCLUSIONS
  The Lipo-Facelift corrects age-related skin and SMAS changes as well as age-related lipodystrophy, improves skin circulation and skin revitalization, and provides a lasting and natural result. The skin quality resulting from simultaneous lipofilling can be explained by improved angiogenesis due to transferred growth factors in the lipoaspirate. Also, differentiation of progenitor cells to fibroblasts and increased production of collagen contribute to firmer skin.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Centre, University Hospital of the RWTH, Pauwelsstrasse 30, 52074, Aachen, Germany, npallua@ukaachen.de.
authors.forename: N
authors.initials: N
authors.lastname: Pallua
authors.forename: T
authors.initials: T
authors.lastname: Wolter
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D008060:Lipodystrophy / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012060:Rejuvenation / Q000502:physiology; D015361:Rhytidoplasty / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D015595:Skin Aging / Q000502:physiology*; D014182:Transplantation, Autologous; D016896:Treatment Outcome