Suture suspension malarplasty with SMAS plication and modified SMASectomy: a simplified approach to midface lifting

Plastic and Reconstructive Surgery
R Barrett Noone

Abstract

The elements of midfacial aging include elongation of the lower eyelid, flattening of the malar eminence, hollowing in the submalar area, laxity of the jowls, and deepening of the nasolabial crease. Attention to rejuvenation of these areas has included various techniques involving movement of the superficial musculoaponeurotic system (SMAS) and elevation of the malar fat pad. A trend toward simplification in midface lifting has introduced the use of suspension sutures. This paper describes an approach to midfacial rejuvenation that combines the elements of SMAS plication and lateral SMASectomy with a suture suspension of the malar fat pad to achieve long-lasting improvement of the aging midface. The ptotic malar fat pad is suspended by suture to the deep temporal fascia. The suture passes from the subcutaneous position where it is fixed to the malar fat pad, through the SMAS, and over the periosteum of the zygoma, and is fixed to the deep temporal fascia. Plication of the SMAS over the suture, combined with lateral SMASectomy, provides three vectors of elevation beneath the skin in midface rhytidectomy. This technique was used in 259 patients between October of 2000 and October of 2004, producing effective long-lasting results ...Continue Reading

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Citations

Nov 10, 2006·Aesthetic Plastic Surgery·Reto WettsteinGerhard Pierer
Aug 28, 2007·Aesthetic Plastic Surgery·Daniel F KalbermattenGerhard Pierer
May 29, 2008·Aesthetic Plastic Surgery·Ruth GrafLincoln Graça Neto
Jun 8, 2014·Aesthetic Plastic Surgery·Patricio CenturionPaul Kaufmann Pardo
Oct 8, 2013·Clinics in Plastic Surgery·Nasim S Huq, Tariq I Nakhooda
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Feb 16, 2019·Aesthetic Surgery Journal·Andrew A JaconoJoseph L Russell
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Feb 16, 2019·Aesthetic Plastic Surgery·Igor BelyiMikhail Barannik
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Jul 13, 2006·Current Opinion in Otolaryngology & Head and Neck Surgery
Jun 26, 2007·Annales de chirurgie plastique et esthétique·M Choisy-KlifaJ-M Faivre

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