Chapter-44-Lamellar High SMAS Face-Lift

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Part 1 Facial Aesthetic

FIG 8 (Continued) • C. Oblique. On the left, preoperative view of a woman, age 65. She has had previous upper and lower eyelifts performed by another surgeon. Note sagging midface, cheeks, and jowl, and infraorbital hollowness. On the right, same patient, 13 months after high SMAS face-lift, neck lift, hairline lowering forehead lift, upper and lower eyelifts, preoral dermabrasion, and fat transfer to the cheeks and lips. The midface, cheeks, and jawline have been repositioned in a balanced and harmonious fashion. Note also the improved transition from lower eyelid to malar region. D. Lateral view. Preoperative view of a woman, age 65. She has had previous upper and lower eyelifts performed by another surgeon. Note sagging mid-face, cheek and jowl, and poor transition from lower eyelid to malar area. Same patient, 13 months after high SMAS face-lift, neck lift, hairline lowering forehead lift, upper and lower eyelifts, perioral dermabrasion, and fat transfer to cheeks and lips. The midface, cheek, and jowl have been repositioned harmoniously and in a balanced manner. Note also improved transition from lower eyelid to cheek.

FIG 9  • A. AP view. On the left, preoperative view of a woman, age 55. Note midface ptosis, heavy jowls, deep nasolabial lines, and poor jawline con- tour. She has had no prior plastic surgery. On the right, same patient, 1 year 6 months after high SMAS face-lift, neck lift, limited incision forehead lift, and upper lower eyelifts, chin augmentation, and fat transfer to the lips and cheeks. No skin resurfacing or other ancillary procedures were performed. Midface, cheek, and jowl have been repositioned harmoniously and in a uniform and balanced manner. Note smooth facial contours, more youthful facial shape and absence of a pulled or a “face-lifted” appearance. B. AP Frowning. On the left, preoperative view of a woman, age 55 frowning. She has had no prior plastic surgery. On the right, the same patient, 1 year 6 months after High SMAS face-lift, neck lift, limited incision forehead lift, upper and lower eye blepharoplasties, chin augmentation, and fat transfer to the cheeks and lips. She is trying to frown in this photograph but is no longer able to do so due to muscle modification performed as part of the forehead lift procedure. C. Oblique view. On the left, preoperative view of a woman, age 55. Note midface ptosis, sagging cheek, and jowl, and perioral laxity. She has had no prior plastic surgery. On the right, same patient, 1 year 6 months after High SMAS face-lift, neck lift, limited incision forehead lift, upper and lower blepharoplasties, chin augmentation, and fat transfer to the cheek and lips. The midface, cheek, and jowl have been repositioned harmoniously in a balanced manner. Note smooth facial contours, more youthful facial shape. D.  Lateral view. On the left, preoperative view of a woman, age 55. Note midface ptosis, sagging cheek, and jowl and poor transition from lower eyelid to malar area. She has had no prior plastic surgery. On the right, same patient, 1 year 6 months after High SMAS face-lift, neck lift, limited incision forehead lift, upper and lower eyelifts, chin augmentation, and fat transfer to cheeks and lips. Note restoration of attractive malar contour, improved transition from lower eyelid to cheek, elevation of perioral area, and well-defined jawline.