The Super-High SMAS Facelift Technique with Tailor Tack Plication.

Area of Science:

• Plastic Surgery
• Facial Rejuvenation Techniques

Background:

• Super-high superficial musculoaponeurotic system (SMAS) suspension and tailor tack plication are established techniques for primary rhytidectomy.
• These methods are employed to address facial aging and laxity.

Purpose of the Study:

• To describe an altered SMAS elevation and suspension technique with strategic submalar plication for primary facelifts.
• To evaluate the efficacy and outcomes of this modified rhytidectomy approach.

Main Methods:

• A super-high SMAS flap is elevated and suspended to the deep temporal fascia with Mersilene sutures.
• Tailor tack sutures are strategically placed in the SMAS to eliminate laxity in the malar, cheek, and oral commissure areas.
• Procedures may include concomitant fat grafting, neck contouring, platysma overlap, forehead rejuvenation, blepharoplasty, and laser resurfacing.

Main Results:

• The study included 72 primary rhytidectomy cases (89% female, average age 58).
• No facial nerve injury occurred; 4% experienced minor, resolved hematomas.
• Patient satisfaction was high, with 24 out of 26 documented patients expressing high satisfaction.

Conclusions:

• The described SMAS elevation and suspension with submalar plication is a powerful technique for primary facial rhytidectomy.
• It reliably achieves significant malar lift, orbicularis suspension, jowl improvement, and oral commissure repositioning.
• The technique allows for optimal, natural outcomes while preserving normal facial anatomy.