This document discusses preoperative evaluation and clinical evaluation for facelift surgery. It explores patient motivations and potential contraindications like diabetes or smoking. Ideal candidates are described as having elastic skin and good bone structure. The anatomy of the superficial musculoaponeurotic system (SMAS) is explained in detail. Various facelift techniques are outlined like subcutaneous lift, SMAS lift, and deep-plane lift. Incision sites, platysma muscle positioning, and suturing techniques are shown. Potential complications of facelift surgery are also listed.
9. SMAS
Facial nerve lies deep to the SMAS
Posteriorly, the SMAS fuses with the fascia overlying
the sternocleidomastoid muscle, but it is a distinct
layer superficial to the parotid fascia
Anterosuperiorly, the SMAS invests the facial
mimetic muscles of the mid-face (i.e., orbicularis
oculi, zygomatic major/minor, levator labii superioris)
the melolabial crease and upper lip
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11. Scalp
galea
Upper face
continuous with frontalis and
orbicularis oculi
Temporal region
temporoparietal fascia (superficial
temporal fascia)
Parotid region
dense fibrous layer overlying parotid
gland
Cheek
thin layer invests superficial mimetic
muscles
Lower face
continuous with platysma
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15. Temporal branch is most
superficial
Crosses junction of anterior
1/3 and posterior 2/3 of
zygomatic arch
Above the arch it travels in
the temporoparietal fascia
to innervate frontalis and
orbicularis oculi
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16. Platysma
Origin: clavicles and 1st
rib and 5 cm below the
angle of the mandible
Insertion: blends with
the SMAS and lip
depressors
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52. MACS lift
Minimal access cranial suspension
Insicion is including skin fold of front of the ear and
following hairline
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53. Suturing
First suture is going from deep temporalis fascia to
angle between the mandible and the neck.
Second suture is going from deep temporalis fascia to
cyrcle between the cheek . It is parallel with
nasolabial fold.
Third suture lift the lower eyelid and malar.
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