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The "Super-High SMAS" Face lift Technique with Tailor Tack Plication

Kristopher Katira MD, Nazilla Seyed Forootan BA, Bahman Guyuron MD.
Case Western Reserve School of Medicine
2017-02-12

Presenter: Kristopher Katira MD

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.

Director Name: Devra Becker

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Background: Super-high SMAS suspension and tailor-tack SMAS plication are powerful facelift tools frequently used by the senior author in cases of primary facial rhytidectomy.

Technique: Following thorough pre-operative patient screening and counseling, the surgery is performed in an outpatient cosmetic surgery center. A Super-high SMAS flap is developed along the line extending from the tragus to lateral canthus sufficiently enough to observe movement of the lateral nose and the oral commissure with pull on the SMAS. The SMAS flap is suspended to the deep temporal fascia at the level of the sideburn. Tailor tack sutures are placed strategically in the SMAS to eliminate any laxity in it below the malar area. This is repeated until the pull on the SMAS no longer results in any movement in the SMAS. The orbicularis muscle is suspended laterally conservatively, facial volume is restored with fat grafting, neck contouring is done if necessary and the vest-over-the-pants type platysma overlap is done very commonly. Forehead rejuvenation, blepharoplasty and laser resurfacing are done often as ancillary procedures.
The steps of the operation are shown on multiple short videos that clearly demonstrate how the surgery is performed.

Patients and Results: This technique has been used on two hundred twenty-six patients as the primary face lift surgery.

Conclusion: Super-high SMAS elevation with custom submalar plication is a powerful tool for primary facial rhytidectomy that provides significant malar lift, orbicularis suspension and repositioning of the oral commissure.

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