The two-stage concept of rhytidectomy

The two-stage concept is a plan for the management of rhytidectomy patients. Preoperatively, all patients are told that they may need a minor secondary temporal tuck-up procedure 6 to 12 months after surgical treatment. Although only 20% of patients require this secondary surgical procedure, the possibility of its need encourages all patients to return for follow-up and removes a source of patient discontent. The indications for the secondary procedure are significant gravitational jowling and malar sagging developing 6 to 12 months after the primary surgical treatment. The technique is described in detail.