[Composite rhytidectomy a modo Hamra]

Conventional face lift techniques--subcutaneous, SMAS have always incorporated unopposed lateral vector tissue advancement. In case they are not adequately repositioned, the tissues of the lower eyelid and upper cheek continue to age, which create a "lateral sweep" of the lower face as those malar soft tissues descend at a more rapid rate than the repositioned SMAS. Hollow eyes and the lateral sweep could be prevented with a rhytidectomy technique that includes orbicularis repositioning and preservation of the lower eyelid fat with an arcus marginalis release or with the composite rhytidectomy of Hamra. The technique was applied in 19 cases and the results are discussed.