9909-1093 Cardenas-Camarena
Cardenas-Camarena L, Gonzalez LE.
Multiple, combined plications of the SMAS-platysma complex: breaking down the
face-aging vectors.
Plast Reconstr Surg. 1999 Sep;104(4):1093-100; discussion 1101-2.
PMID: 10654753
Reconstructive Surgery Institute of Jalisco, Guadalajara, Mexico.
plassurg@foreigner.class.udg.mx
After analyzing how facial tissues are affected during the aging process, 36
rhytidoplasties were performed by plicating the superficial musculoaponeurotic
system (SMAS)-platysma complex. Also, additional procedures were performed to
improve the aesthetic result. Patients were followed for 3 to 33 months (median,
13 months); their ages ranged from 42 to 72 years (median, 53 years). Because
the facial soft tissues present specific anatomic particularities and the
force-vector determinants for facial ptosis are many and varied, specific
plications were combined to obtain the desired results during a rhytidoplasty.
Combinations of six different types of plications are described; some of them
are used individually by various authors to manage the SMAS-platysma complex.
Major complications did not occur, despite extensive cutaneous undermining, and
morbidity was similar to that of other techniques that handle the SMAS. The
results were satisfactory for all patients, and clinical improvement was noted
in all cases. On the basis of these results, using combined plication to manage
the SMAS-platysma complex during a rhytidoplasty is recommended. The opposing
vectors should be considered when planning the combination of plications.
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