The individualized component face lift: Developing a systematic approach to facial rejuvenation

Rod J. Rohrich, Ashkan Ghavami, Joshua A. Lemmon, Spencer A. Brown

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

BACKGROUND:: Accurate preoperative planning combined with facial fat compartment augmentation can improve precision and balance in facial rejuvenation techniques. Understanding the concept of "facial shaping" with respect to symmetry and soft-tissue (fat) distribution preoperatively is critical to optimizing aesthetic outcomes in various face lift techniques. METHODS:: A review of 822 consecutive face lifts performed from January of 1994 to June of 2007 by a single surgeon (R.J.R.) was conducted. From this database, randomly selected cohorts of 50 preoperative and postoperative photographs were critically analyzed by three plastic surgeons exclusive of the senior surgeon (R.J.R.). Three facial parameters were compared on each facial side: facial height, degree of malar deflation, and orbit size. Long-term improvement was evaluated to delineate factors contributing to success in creating an aesthetically balanced facial shape. RESULTS:: Asymmetry between the two facial sides was noted in every patient preoperatively with respect to the three study parameters and was improved postoperatively. There was no statistically significant interobserver bias in the evaluations (p < 0.005). Facial asymmetry dictated differential treatment of the superficial musculoaponeurotic system (SMAS) tissue between facial sides to achieve the desired youthful facial shape. The angle (vector) and extent of SMAS-stacking varied depending on the preoperative analysis. Similarly, the selection of SMAS-ectomy versus SMAS-stacking depended on the degree of malar deflation and resultant cheek fullness. CONCLUSIONS:: Proper preoperative analysis for evaluating facial shape should address (1) facial height, (2) facial width, and (3) overall distribution/location of facial fullness. This method of evaluating facial shape and symmetry is simple and reproducible, and can aid in formulating a comprehensive treatment plan.

Original languageEnglish (US)
Pages (from-to)1050-1063
Number of pages14
JournalPlastic and Reconstructive Surgery
Volume123
Issue number3
DOIs
StatePublished - Mar 2009

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Rhytidoplasty
Rejuvenation
Fats
Facial Asymmetry
Cheek
Orbit
Tissue Distribution
Esthetics
Databases
Superficial Musculoaponeurotic System
Therapeutics
Surgeons

ASJC Scopus subject areas

  • Surgery

Cite this

The individualized component face lift : Developing a systematic approach to facial rejuvenation. / Rohrich, Rod J.; Ghavami, Ashkan; Lemmon, Joshua A.; Brown, Spencer A.

In: Plastic and Reconstructive Surgery, Vol. 123, No. 3, 03.2009, p. 1050-1063.

Research output: Contribution to journalArticle

Rohrich, Rod J. ; Ghavami, Ashkan ; Lemmon, Joshua A. ; Brown, Spencer A. / The individualized component face lift : Developing a systematic approach to facial rejuvenation. In: Plastic and Reconstructive Surgery. 2009 ; Vol. 123, No. 3. pp. 1050-1063.
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