eMedicine Specialties > Plastic Surgery > Rhytidectomy

Facelift, Skin Only: Follow-up

Author: Jonathan L Kaplan, MD, MPH, Fellow in Plastic Surgery, Cleveland Clinic
Coauthor(s): Dean Fardo, MD, Associate Staff, Department of Plastic Surgery, Cleveland Clinic Foundation; Gregory A Buford, MD, FACS, Medical Director, Body by Buford; Randall Yetman, MD, Head, Section of Plastic Surgery of the Breast, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation; James E Zins, MD, Chairman, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation
Contributor Information and Disclosures

Updated: Feb 19, 2008

Future and Controversies

The subcutaneous (skin-only) facelift still may produce good results in selected individuals but most surgeons agree that paying attention to the deeper SMAS layer (ie, through plication, SMAS-ectomy, or a composite facelift) usually produces a better result. Most also believe that a surgery involving SMAS support usually produces a longer-lasting improvement in the patient's appearance. However, no objective data of this assumption have been obtained. In 1995, Gamble et al compared composite facelifts to subcutaneous techniques and found that the composite flap resisted stretch more than the subcutaneous flap.29 This meant that less skin excision was possible for a given tension in the composite flap. However, they felt that this resistance could be overcome by placement of deep support sutures.

Summary

The last 25 years have seen many advancements in rhytidectomy techniques over the standard skin-only facelift. Most of these techniques address the sagging muscular layers under the subcutaneous tissue. However, in selected patients, a skin-only facelift still may produce safe and pleasing results to both the patient and surgeon. Attention to detail and careful planning should help ensure optimal results.

 


More on Facelift, Skin Only

Overview: Facelift, Skin Only
Workup: Facelift, Skin Only
Treatment: Facelift, Skin Only
Follow-up: Facelift, Skin Only
Multimedia: Facelift, Skin Only
References
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References

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Further Reading

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Keywords

rhytidectomy, skin-only facelift, face lift, subcutaneous facelift

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Contributor Information and Disclosures

Author

Jonathan L Kaplan, MD, MPH, Fellow in Plastic Surgery, Cleveland Clinic
Jonathan L Kaplan, MD, MPH is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Dean Fardo, MD, Associate Staff, Department of Plastic Surgery, Cleveland Clinic Foundation
Dean Fardo, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Gregory A Buford, MD, FACS, Medical Director, Body by Buford
Gregory A Buford, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Medical Student Association/Foundation, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Dermik Aesthetics Honoraria Speaker/National Trainer; Allergan Honoraria Speaker/National Trainer; Medicis Honoraria Speaker/National Trainer; Sound Surgical Technologies Honoraria Speaker/National Trainer; Kinetic Concepts International Honoraria Speaker/National Trainer

Randall Yetman, MD, Head, Section of Plastic Surgery of the Breast, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation
Disclosure: Nothing to disclose.

James E Zins, MD, Chairman, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation
James E Zins, MD is a member of the following medical societies: American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American Medical Association, American Society of Maxillofacial Surgeons, Ohio State Medical Association, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

David W Furnas, MD, Clinical Professor Emeritus, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California at Irvine
David W Furnas, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Head and Neck Society, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society of Transplantation, California Medical Association, Phi Beta Kappa, Plastic Surgery Research Council, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, and Society of University Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS, Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center
Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

 
 
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