The Pinch Rhytidectomy: A Safe, Effective, "Low SMAS" Variation on the Theme

The competitive efficacy of the superficial musculoaponeurotic system (SMAS) rhytidectomy (SMASectomy) facelift has been well established. However, the outcomes after an associated open necklift have not been as reliable; the persistent incidence of recurrent bands and iatrogenic deformities has prompted a change in technique.

The author conducted a long-term retrospective review to evaluate a variation on the SMASectomy facelift technique. A solely lateral, "low SMAS" approach was substituted for direct necklift in all patients.

Patients who were candidates for a facelift underwent this laterally based, SMASectomy technique. Those who underwent concomitant full-face CO2 laser resurfacing were excluded from the review. A total of 198 patients treated consecutively during a 7-year period (2006-2012) were included in the study.

Postoperative follow-up ranged from 1 to 7 years. All patients' neck deformities were fully corrected by the solely lateral SMASectomy technique. In addition, the patients recovered more rapidly than with traditional direct necklift, with no nerve injuries, skin compromise, or hypertrophic scarring.

Results indicate that midline open necklift can be replaced by the low SMASectomy.

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