Simultaneous Tightening of Deep and Superficial Fasciae in Midface Lifting.

[INTRODUCTION] In our ongoing efforts to improve our techniques for facial lifting, we have consistently made strides towards achieving better, more reliable, and longer-lasting results. To accomplish this, we have incorporated additional procedures into our current methods.

[METHODS] Our current methods include lateral superficial musculoaponeurotic system (SMAS) excision, SMAS plication, and malar fat pad lifting. The new procedures that have been added include parotideamasseteric fascia plication or anchoring, as well as SMAS flap elevation and lifting. To evaluate the effectiveness of these new applications, we conducted a study involving 2 groups of patients. The first group consisted of 200 patients who underwent the older applications, while the second group comprised 167 individuals who received the newer applications. We compared both groups and analyzed their results in relation to previous research.

[RESULTS] No significant differences were observed between the two groups in terms of skin necrosis, seroma formation, hematoma occurrence, temporary frontal nerve injury issues, scarring problems, or patient revision requests. However, it is worth noting that the second group experienced a remarkable decrease in revision requests (8.98%) compared to a rate of 13% in the first group.

[CONCLUSION] In our opinion, the combination of these maneuvers is particularly crucial when dealing with cases where facial soft tissues are loose or delicate, as this increases the likelihood of early recurrence. Our recent practices suggest that we may be on track towards discovering longer lasting and more reliable methods for facial rejuvenation. We believe that conducting larger series will provide us with more precise information in future studies.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.