title: The Pinch Rhytidectomy: A Safe, Effective, "Low SMAS" Variation on the Theme.
abstract: BACKGROUND
  The competitive efficacy of the superficial musculoaponeurotic system (SMAS) rhytidectomy (SMASectomy) facelift has been well established. However, the outcomes after an associated open necklift have not been as reliable; the persistent incidence of recurrent bands and iatrogenic deformities has prompted a change in technique.
  
  
  OBJECTIVE
  The author conducted a long-term retrospective review to evaluate a variation on the SMASectomy facelift technique. A solely lateral, "low SMAS" approach was substituted for direct necklift in all patients.
  
  
  METHODS
  Patients who were candidates for a facelift underwent this laterally based, SMASectomy technique. Those who underwent concomitant full-face CO2 laser resurfacing were excluded from the review. A total of 198 patients treated consecutively during a 7-year period (2006-2012) were included in the study.
  
  
  RESULTS
  Postoperative follow-up ranged from 1 to 7 years. All patients' neck deformities were fully corrected by the solely lateral SMASectomy technique. In addition, the patients recovered more rapidly than with traditional direct necklift, with no nerve injuries, skin compromise, or hypertrophic scarring.
  
  
  CONCLUSIONS
  Results indicate that midline open necklift can be replaced by the low SMASectomy.
  
  
  METHODS
  4.
authors.affiliation: Dr Rosenfield is a professor in the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, and an adjunct assistant professor in the Division of Plastic Surgery, Department of Surgery, Stanford University, Stanford, California drr@drrosenfield.com.
authors.forename: Lorne King
authors.initials: LK
authors.lastname: Rosenfield
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012060:Rejuvenation; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000009:adverse effects / Q000379:methods*; D015595:Skin Aging; D013997:Time Factors; D016896:Treatment Outcome
keywords: facelift; lateral SMASectomy; low SMAS; neck rejuvenation; necklift; pinch rhytidectomy