The Super-High SMAS Facelift Technique with Tailor Tack Plication

Aesthetic Plastic Surgery
Bahman GuyuronKris Katira

Abstract

Super-high superficial musculoaponeurotic system (SMAS) suspension and tailor tack plication are powerful facelift tools used in cases of primary facial rhytidectomy. Thorough pre-operative patient screening and counseling are completed in an outpatient cosmetic surgery center. A super-high SMAS flap is developed by undermining and incising along a line extending from the tragus to lateral canthus and dissecting the SMAS sufficiently to induce movement of the lateral nose and the oral commissure with traction on the SMAS. The SMAS is suspended from the deep temporal fascia using 4-0 Mersilene sutures. Tailor tack sutures are placed strategically in the SMAS caudal to the malar bone to eliminate any residual laxity in the SMAS close to the oral commissures and the cheek area. This is repeated until the laxity of the SMAS is completely eliminated. The orbicularis muscle is conservatively suspended laterally from the deep temporal fascia, facial volume is restored with fat grafting, the neck is contoured, if necessary, and the vest-over-pants platysma overlap technique is commonly utilized. Concomitant forehead rejuvenation, blepharoplasty, and laser resurfacing are extremely common. Of the 72 cases of primary rhytidectomy perform...Continue Reading

References

Nov 1, 1988·Annals of Plastic Surgery·B Guyuron
Apr 1, 1994·Annals of Plastic Surgery·B GuyuronA Tirgan
Mar 21, 1998·Plastic and Reconstructive Surgery·B GuyuronM A Ellison
Aug 20, 2004·Plastic and Reconstructive Surgery·Bahman Guyuron
Feb 5, 2005·Plastic and Reconstructive Surgery·Bahman GuyuronAli Totonchi
Apr 19, 2007·Plastic and Reconstructive Surgery·Arian MowlaviBahman Guyuron
Jun 19, 2007·Plastic and Reconstructive Surgery·Bahman Guyuron, Ramsey K Majzoub
Oct 17, 2008·Clinics in Plastic Surgery·Timothy J Marten
Sep 1, 2002·Aesthetic Surgery Journal·Fritz E Barton
Apr 2, 2009·Plastic and Reconstructive Surgery·Bahman GuyuronSeree Iamphongsai
Jan 1, 2006·Aesthetic Surgery Journal·Sydney R Coleman, Rajiv Grover
May 14, 2010·Plastic and Reconstructive Surgery·Bahman GuyuronRouzbeh Ahmadian
Nov 19, 2011·Plastic and Reconstructive Surgery·Carey FaberBahman Guyuron
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Dec 29, 2012·Plastic and Reconstructive Surgery·Jamal JaliliBahman Guyuron
Jun 29, 2013·Plastic and Reconstructive Surgery·Samantha J ZwiebelBahman Guyuron

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Citations

Feb 16, 2019·Aesthetic Surgery Journal·Andrew A JaconoJoseph L Russell
May 2, 2020·Aesthetic Plastic Surgery·John A ChaoBahman Guyuron
Jan 27, 2021·The Journal of Craniofacial Surgery·Safvet Ors

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