Safety and Adjuncts in Face Lifting

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Classify the commonly performed types of face-lift procedures based on the extent of skin incision and face and neck dissection, and superficial musculoaponeurotic system treatment and perform the appropriate amount of skin undermining in variations of superficial musculoaponeurotic system techniques. 2. Select the optimal placement of skin incisions and list the danger zones encountered in face-lift dissection and their relationship to the fat compartments and retaining ligaments. 3. Use fat grafting as an adjunctive procedure to face lift and apply safe skin resurfacing techniques at the time of rhytidectomy. 4. Institute a preprocedure and postprocedure skin care regimen and use an antihypertensive protocol for postoperative hematoma prevention. 5. List the commonly injured sensory and motor nerves in rhytidectomy, including prevention and treatment strategies. SUMMARY: Today's face lifts can be classified as "traditional," "short-scar," or "mini." Placement of skin incision, extent of dissection in the face and neck, and methods of superficial musculoaponeurotic system treatment are standard components of face-lift techniques. Proper knowledge of facial anatomy and danger zones is crucial for patient safety. Adjunctive fat grafting and skin resurfacing procedures can create superior results without adding to patient morbidity. Management options for more serious yet potentially preventable surgical complications are discussed, including hematoma and sensory and motor nerve injuries.