Segmental stepwise lift: two years of experience

We conceive the facial skin and its subcutaneous tissue as a mask which envelopes the internal structures. The relaxation of the facial retention ligaments causes these structures to fall. On the basis of these concepts, for more than two years we have been practicing the segmental stepwise lift. Its basic features are: Placement of the incisions and final scars in function of each particular case. Consideration of the face and neck as two totally different aesthetic units. Wide segmental undermining, starting at the neck region, the face next, and the forehead lastly, in cases that it is deemed necessary. Volumetric concept of the different structures. Placement of tension only on the SMAS-platysma. Maintenance of the mandibular edge as a fixed point.Vertical-only traction on all facial structures. The orbital region, which will be necessary influenced by the movement of the face, will be approached with the idea of balancing the different components in a volumetric sense.