Endoscopic, "Scarless" Composite Flap Face and Neck Lift

Area of Science:

• Plastic Surgery
• Facial Rejuvenation Techniques

Background:

• Deep-plane and composite flap facelifts rejuvenate the face by releasing retaining ligaments in the sub-superficial musculoaponeurotic system (sub-SMAS) plane.
• These techniques involve elevating and fixing the SMAS/platysma/skin flap as a single unit, with preauricular incisions often serving only for access.

Purpose of the Study:

• To develop and evaluate an endoscopic-assisted, en bloc composite flap facelift and neck lift technique that eliminates the need for preauricular incisions.
• To assess the safety and efficacy of this novel approach in achieving deep structural facial rejuvenation.

Main Methods:

• Development of an endoscopic technique utilizing prezygomatic, premasseteric, and subplatysmal spaces for dissection and ligament release.
• Application of verticalization fixation vectors and modified concho-mastoid traction sutures to reduce preauricular skin redundancy.
• Detailed description of the surgical procedure and clinical experience in 41 consecutive cases.

Main Results:

• The endoscopic en bloc composite flap facelift consistently and safely produced results comparable to conventional open composite flap facelifts.
• The technique effectively rejuvenated the deep structures of the face and neck.
• Minimization of preauricular skin redundancy was achieved through specific fixation and traction methods.

Conclusions:

• The endoscopic en bloc composite flap facelift without preauricular incisions is a safe and effective alternative to conventional open techniques.
• This approach offers comparable aesthetic outcomes with potential benefits in reduced scarring and recovery.
• The technique leverages anatomical spaces for endoscopic dissection, allowing for deep structural rejuvenation.