SMAS-platysma facelift. A bidirectional cervicofacial rhytidectomy

The technique of SMAS-platysma facelift has been reviewed. The deep layer lift with the SMAS-platysma myocutaneous flap of the anterior neck and lower face facilitates correction of submental deformities without the necessity of direct approach with a submental incision. Wide superficial undermining of the upper and mid-cheek skin which is pulled laterally for correction of the nasolabial fold achieves a bidirectional facelift. The author's experience over six years with 460 patients who had a SMAS-platysma facelift indicates that the operation can be performed safely with a low incidence of complications.