Vertical Superior Vector Suspension of the Anterior Mobile Face with the V Plication Facelift: A Volumization and Lifting Technique.

Background: In most of the published plication techniques in face lift surgery, the vectors of plication are not entirely superiorly and vertically directed. The same applies with the deep plane, SMAS elevation techniques in the majority of which the vectors of traction are not superiorly vertically directed. The aging symptoms are mostly prominent at the anterior mobile face due to the gravity effect, and this is the area where attention should be focused to correct these symptoms following a face lift surgery.

Methods: We have evaluated the results of 58 patients who underwent the V plication face lift between January 2021 to January 2024 in terms of demographics, procedure, surgical technique, adjuvant treatments, final outcomes and complications.

Results: All 58 patients underwent primary face lift with the V plication for vertical superior traction and suspension of the facial tissues. The average age value was 64 years. Forty-six patients underwent concomitant upper and lower blepharoplasty, and 25 fat transfer of the upper periorbital region. There were one self-resolving neurapraxia of the right buccal branch of facial nerve and three minor self-absorbed localized blood collections.

Conclusion: The extensive V plication face lift of the anterior face together with the progressively less extensive plication of the lateral face due to the shape of plication addressed satisfactorily the prominent symptoms of gravity effect on the face with the action of the vertical superior suspension of the facial tissues and corrected the malar deflation by repositioning the downwards sliding malar fat pad.

Level Of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .