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Cutaneous Layer and SMAS Suspension (CaSS) Lift as a Minimally Invasive Lateral Midface Lift
Jin Suk Byun1, Kenneth K Kim2,3
1Dr. Byun's Plastic Surgery Clinic, Daegu, South Korea.
The Journal of Craniofacial Surgery
|November 20, 2023
Summary
This study shows a minimally invasive facelift technique effectively rejuvenates the lateral midface. Improvements in nasolabial folds and skin elasticity were significant and long-lasting, with reduced swelling and shorter operating times.
Area of Science:
- Plastic Surgery
- Dermatology
- Aesthetic Medicine
Background:
- Prior research indicated superficial adipose layer manipulation is superior to superficial musculoaponeurotic system (SMAS) lifting.
- This study applies the principle of using the superficial adipose layer for force transmission in lateral midface lifting.
Purpose of the Study:
- To evaluate the efficacy and duration of improvements in patients undergoing lateral midface lifting.
- To assess a minimally invasive multilayer lifting technique focused on the superficial adipose layer.
Main Methods:
- A W-shaped zigzag incision was made in the hairline, followed by a second lateral/posterior incision.
- Superficial temporal fascia/SMAS and superficial adipose layer were sutured and tunneled.
- Dermis was pulled and fixed to the deep temporal fascia before scalp closure.
Main Results:
- Surgical outcomes were monitored for 6 to 42 months.
- Significant improvements in nasolabial folds and skin elasticity were observed.
- Sustained improvements lasted up to 42 months.
Conclusions:
- The technique offers a minimally invasive alternative to traditional facelifts, avoiding wide dissection and skin undermining.
- Shorter operating times and minimized postoperative swelling are key benefits.
- Individualized lifting of superficial adipose layer, SMAS, and dermis ensures comprehensive lateral midface rejuvenation.
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