Abstract
To determine if there are aesthetic differences in patients who have undergone a SMAS
lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical
vectors. To determine if there are aesthetic differences in the results of the neck
using sutures placed in specific areas of the platysmal muscle versus randomly placed
sutures for platysmal plication to the mastoid. Comparative, retrospective, blind,
and randomized study. Evaluation of preoperative and postoperative photographs of
54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53
patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed
by three external, unbiased facial plastic surgeons in a blind study. A 7-point scale
was used to grade the improvement of the face and the neck. In the face, SMAS lifting
with predominantly oblique-vertical vectors used during the procedure offer statistically
better results (p ≤ 0.001) in comparison to predominantly oblique-horizontal vectors in the aesthetical
improvement of the malar eminence, melolabial fold and jowls. In the neck, both techniques
offer excellent results, but the sutures used for platysmal plication in specific
areas offer no statistical differences in aesthetical results from those sutures that
are randomly placed in the platysmal muscle. In our study of 107 patients, SMAS lifting
using predominantly oblique-vertical vectors seem to have better results than using
predominantly oblique-horizontal vectors. For the neck, we do not find statistical
differences between randomly placed sutures for platysmal plication versus sutures
placed in specific areas of the muscle.
Keywords
rhytidoplasty - facelift - neck lift - SMAS - vectors
