The subperiosteal bicoronal approach to total facelifting: the DMAS--deep musculoaponeurotic system

Craniofacial surgery, developed by Paul Tessier, has shown that subperiosteal undermining and lifting of the soft tissues of the upper two-thirds of the face results in an excellent and long-lasting rejuvenated look to the entire face. The result is significantly more durable and longer lasting than the classic subcutaneous facelift reinforced with SMAS plication, transposition, and shortening. The authors--three surgeons working independently--are convinced that we have entered a new era in facelift procedures. We decided to combine our experiences which total 250 patients with followups of 6 months to 6 years.