Wound tension in rhytidectomy. A preliminary report

In superficial musculoaponeurotic system (SMAs) suspension procedures in rhytidectomy, skin closing tension seems to be lower at the main anchor points than with non-SMAS procedures. To evaluate this clinical impression, a preliminary investigation into the effect of SMAS suspension on wound closing tension was undertaken. Intraoperatively, skin closing tension was compared with and without SMAS plication sutures at the two key anterior and posterior skin anchor points. Results confirmed decreased tension with SMAS plication. Anteriorly in the temporal part of the scalp, a significant difference of 87 g was demonstrated. Posteriorly in the occipital hairline, a significant difference of 96 g was demonstrated. Individual differences in tension were more pronounced in patients with prominent SMAS laxity than in those patients with mild laxity.