Composite rhytidectomy. Finesse and refinements in technique.

These points of refinement in flap dissection and closure may be helpful to surgeons who perform composite rhytidectomy. My experience in the past 6 years of doing exclusively composite facelifts is that there is consistent improvement in results with shorter and shorter convalescent times after using these refinements. When a primary rhytidectomy is performed, repositioning of all the deep elements of the aging face is necessary to maintain harmony in facial rejuvenation (Fig. 9). Composite rhytidectomy is of enormous benefit in secondary rhytidectomy (Fig. 10) when the surgeon's goal must be to regain harmony, which frequently is lost following conventional rejuvenative procedures.