Anatomic evaluation of the vertical face-lift in cadavers.

[IMPORTANCE] This study investigates how different orientations of tension vectors affect the amount of soft-tissue lift in specific cervicofacial regions.

[OBJECTIVES] To compare differences in cosmetic neck and face changes generated by 3 different face-lift techniques, to quantify the amount of lift across different points on the face, and to quantify changes in platysmal dehiscence in each of 3 standard superficial musculoaponeurotic system plication face-lift techniques applied to fresh-frozen cadaver heads.

[DESIGN, SETTING, AND PARTICIPANTS] Ten cadaver heads in an academic tertiary care center.

[INTERVENTION(S)] Three different superficial musculoaponeurotic system plication rhytidectomy procedures were conducted in the following sequence: (1) vertical tension vector plication (vertical lift), (2) superolateral tension vector plication (superolateral lift), and (3) superolateral tension vector plication combined with midline platysmal plication (superolateral lift with platysmal plication).

[MAIN OUTCOMES AND MEASURES] After completion of each technique, the amount of lift at 4 standard key points was measured and recorded, and differences in lift at the key points were analyzed.

[RESULTS] Vertical lift was associated with greater total lift than superolateral lift alone or superolateral lift with platysmal plication (P < .001 for both). Platysmal dehiscence increased from baseline measurements after superolateral lift and decreased after vertical lift (P = .002 for both).

[CONCLUSIONS AND RELEVANCE] Our findings establish how different orientations of tension vectors applied during face-lift surgery achieve different structural changes to various key points across the face. This study helps the face-lift surgeon and student understand the underlying structural anatomic changes associated with different face-lift techniques, which ultimately result in different cosmetic outcomes.

[LEVEL OF EVIDENCE] NA.