Long-term results of face lift surgery: patient photographs compared with patient satisfaction ratings.

Background: Surgical facial rejuvenation (face lift) remains the aesthetic standard for correction of the anatomical changes of the aging face and for long-lasting results. However, younger patients (younger than 50 years) with early facial aging are often fearful of or discouraged from face-lift surgery in favor of simpler yet short-lived nonsurgical and surgical options. The superficial musculoaponeurotic system-platysma face lift is associated with a high degree of patient satisfaction at 1 year (97.

The measure of face-lift patient satisfaction: the Owsley Facelift Satisfaction Survey with a long-term follow-up study.

Background: Patient satisfaction is a major factor in determining success in aesthetic surgery. To the authors' knowledge, a long-term study measuring patient satisfaction with face-lift surgery has not been published. The authors' study was designed to measure patient satisfaction with the overall experience of a face lift and to assess the patient's level of satisfaction 10 to 15 years after surgery.

The course of the frontal branch of the facial nerve in relation to fascial planes: an anatomic study.

Background: Despite a wealth of literature describing the anatomy of the temporal region, controversy still exists over the depth of the frontal branch of the facial nerve as it travels over the zygomatic arch. It is commonly stated that the frontal branch travels within the superficial musculoaponeurotic system (SMAS) as it crosses the zygomatic arch. Clinically, however, it is apparent that the nerve runs at a deeper level as it crosses the arch, allowing for safe elevation and division of the SMAS to a point at or above the superior border of the zygomatic arch.

Identical twin face lifts with differing techniques: a 10-year follow-up.

To evaluate the efficacies of four different surgical techniques in facial rejuvenation, two sets of identical twins were operated on by four different surgeons. The technical approaches to facial rejuvenation included lateral superficial musculoaponeurotic system (SMAS)-ectomy with extensive skin undermining, composite rhytidectomy, SMAS-platysma flap with bidirectional lift, and endoscopic midface lift with an open anterior platysmaplasty. All patients were photographed by an independent surgeon at 1, 6, and 10 years postoperatively.

Safely navigating around the facial nerve in three dimensions.

Although much literature discusses the anatomy and injury of the facial nerve branches, the fascial plane of the nerves, particularly where they transition from one plane to another, is rarely emphasized and information is often contradictory. This article describes in three-dimensional, accurate surgical terms where the facial nerve branches are located and how they can be protected during dissection above and below the superficial musculoaponeurotic system-platysma plane.

Some anatomical observations on midface aging and long-term results of surgical treatment.

Background: Controversy exists as to whether the changes of midface aging (elongation of the lower eyelid caused by infraorbital hollowing, flattening of the malar eminence, and increased prominence of the nasolabial fold) are attributable to gravitational migration of the check fat or to fat atrophy.

Methods: The anatomical explanation of the gravitational migration of the malar fat pad is based on previously reported magnetic resonance imaging studies of the midface cheek fat in young and older subjects and histologic studies of the superficial fascia in face-lift patients.

Results: Clinical and laboratory observation of the midface malar fat pad suggests that, during repeated movements of animation, levator muscle contraction and shortening produces tissue expansion pressures within the overlying cheek fat pad that cause the acutely prominent nasolabial fold of animation.

Incidence of cervical branch injury with "marginal mandibular nerve pseudo-paralysis" in patients undergoing face lift.

The anatomy of the cervical and marginal mandibular branches of the facial nerve is reviewed. In the senior author's practice, "pseudoparalysis of the marginal mandibular nerve" due to cervical branch injury occurred in 34 of 2002 superficial musculoaponeurotic system-platysma face lifts (1.7 percent) and was associated with a full recovery in 100 percent of cases within a time period ranging from 3 weeks to 6 months.

Midface lift of the malar fat pad: technical advances.

Most of the advances of the past decade in face lift technique have been directed to correcting the aging changes of the midface. With many midface lift techniques, patients typically experienced a prolonged period of periorbital ecchymosis and edema. Pessa's description of the anatomy of the malar septum has led to modifications of the senior author's (J.