Segmental stepwise lift: two years of experience

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Facial Anatomy

Background:

• Facial aging involves the descent of internal structures due to the relaxation of facial retention ligaments.
• The skin and subcutaneous tissue act as a mask over these underlying structures.
• Current techniques may not fully address the volumetric changes associated with aging.

Purpose of the Study:

• To present a novel surgical approach for facial rejuvenation: the segmental stepwise lift.
• To describe the fundamental principles and techniques of this procedure.
• To highlight the importance of a volumetric and segmental approach to facial anatomy in aesthetic surgery.

Main Methods:

• The segmental stepwise lift involves individualized incision placement and scar management.
• It treats the face and neck as distinct aesthetic units.
• Wide segmental undermining is performed, progressing from the neck to the face and forehead.
• Tension is applied exclusively to the SMAS-platysma, maintaining the mandibular edge as a fixed point.
• Vertical-only traction is applied to all facial structures.
• The orbital region is addressed with a focus on volumetric balancing.

Main Results:

• Over two years of practice demonstrate the feasibility and application of the segmental stepwise lift.
• The technique allows for targeted repositioning of facial and cervical structures.
• Emphasis on vertical vector forces and SMAS-platysma tensioning aims to restore youthful contours.
• Individualized scar placement enhances aesthetic outcomes.

Conclusions:

• The segmental stepwise lift offers a comprehensive approach to facial aging, considering anatomical layers and volumetric changes.
• This technique emphasizes vertical restoration and targeted tensioning for natural-looking rejuvenation.
• It provides a structured method for addressing ptosis in the face and neck regions.