Indications and Techniques for Short-Scar Face-Lift
Steven M. Levine
Daniel C. Baker
DEFINITION
Surgery is the standard treatment to address descent and laxity in the aging face.
Short-scar face-lift is defined as an incision that remains completely preauricular.
Most also apply that definition to face-lift incisions the extend behind the lobe and into the retroauricular sulcus, but that do not have a transverse component or cross into the hairline at any point.
ANATOMY
Relevant anatomy is the earlobe and retroauricular sulcus.
PATIENT HISTORY AND PHYSICAL FINDINGS
Beyond usual history and physical findings to indicate a patient for a face-lift and neck lift, the question is, “Does the patient have a significant amount of cervical laxity?”
Short-scar face-lifts compromise on the ability to address neck laxity, specifically, inferior neck laxity. Better stated, the short-scar face-lift is ideal for a patient with minimal neck laxity who desires improvement along the jawline and midface.
SURGICAL MANAGEMENT
Surgery should be performed in an accredited operating room.
A short-scar face-lift can be performed under local anesthesia with or without sedation or general anesthesia.
Preoperative Planning
Consideration should be given as to whether the surgeon believes the patient will be satisfied from the limited neck lift provided by the short-scar approach.
Positioning
The patient is supine on the procedure table.
Usually, the head of the bed is slightly elevated.
The authors prefer to sit for maximum stability.
Approach
An incision pattern is chosen, either preauricular or intratragal.
The skin is elevated in the subcutaneous plane after infiltration with local anesthesia with epinephrine.
The superficial musculoaponeurotic system (SMAS) is addressed by any number of acceptable means.
TECHNIQUES
▪ True Short-Scar Face-Lift
The skin incision stops at the base of the earlobe without separating the neck skin from lobe.1
The skin flap is undermined (TECH FIG 1A).Related posts:
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