The Use of Multifilament Suture for SMAS Plication in Rytidectomy

In the public's mind, rhytidectomy, better known as a facelift procedure, is the technique most closely associated with plastic surgery. When done correctly, it yields highly satisfactory results. The aim of our study was to retrospectively review results of our patients whose procedures were performed using the superficial musculoaponeurotic system (SMAS) plication technique. Plication was performed with multifilament braided sutures, which provided a sustainable lift and satisfactory results.

This study involves a retrospective review of 137 patients who underwent primary or secondary facelift procedures over a period of 46 months. The average patient age was 59 years, with ages ranging from 30 to 77. Patients were reviewed at 6 and 12 months postoperatively. Subjective evaluation based on photographic analysis was performed pre- and postoperatively.

All cases included in this study indicated satisfaction with postoperative results on 1 year postoperative review for both the patients and performing surgeons. Four patients presented with a postoperative hematoma that required surgical intervention. One patient developed skin infection that was followed by skin necrosis. Another patient presented with wound infection that resulted in partial wound dehiscence. Both cases were managed conservatively.

With the abundance of techniques directed toward the SMAS layer, it has become a pivot point for facelift procedures. This expansion in approaches places emphasis on the SMAS layer and its manipulations. The type of suture material utilized in SMAS plication is, therefore, undoubtedly essential. Our use of braided multifilament sutures for SMAS plication provided satisfactory results at 1-year postoperative review.