Rhytidectomy with lateral SMASectomy.

Since 1992 an alternative to formal elevation of the superficial fascia is to perform a lateral SMASectomy, removing a portion of the SMAS in the region directly overlying the anterior edge of the parotid gland. Excision of the superficial fascia in this region secures mobile anterior SMAS to the fixed portion of the superficial fascia overlying the parotid. The direction in which the SMASectomy is performed is oriented so that the vectors of elevation following SMAS closure lie perpendicular to the nasolabial fold, thereby producing improvement not only of the nasolabial fold but also of the jowl and jawline. This method represents a rapid, safe, and reproducible operation, allowing the surgeon the versatility obtained with formal SMAS flap undermining while producing both the safety and rapidity of SMAS plication.