Goals/Purpose: Treatment of the superficial muscular aponeurotic system (SMAS) with rhytidoplasty has been continually improving since the pioneering works of the 1970s. The procedures in current usage and described in the literature differ with regard to results as well as to what constitutes an efficient operation. This article describes a surgical procedure that has been applied for SMAS treatment for the last 5 years and which provides satisfactory mid- and long-term results.
Methods/Technique: During the past 5 years, we operated on 274 patients (age range, 35–84; 233 female and 41 male) and monitored them thereafter. In all cases, the procedure followed the same strategy, which involved suturing the SMAS according to 5 vectors, 3 in the face and 2 in the neck, instead of dissecting it. (Fig.1,2,3,4,5,6)
Results/Complications: Most cases were clinically and photographically evaluated yearly. In all age groups, this treatment yielded better results than the traditional methods involving SMAS dissection, as no additional surgeries were required.(Fig.7,8,9,10)
Conclusion: SMAS suturing according to 5 specifically oriented vectors in the face and neck provides better long-lasting results in patients of various ages submitted to rhytidoplasty. Moreover, this procedure avoids the complications described in the literature.
