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Evidence-Based Medicine: Face Lift

Derby, Brian M. M.D.; Codner, Mark A. M.D.

Plastic and Reconstructive Surgery: January 2017 - Volume 139 - Issue 1 - p 151e-167e
doi: 10.1097/PRS.0000000000002851
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Learning Objectives: After studying this article, the participants should be able to: 1. Describe pertinent surgical anatomy relevant to safe and effective face-lifting techniques. 2. Identify key aspects of facial aging. 3. Incorporate risk-reduction strategies during preoperative assessment. 4. Tailor their approach to face lifting based on patient anatomy. 5. Identify and treat complications after face-lift surgery. 6. Incorporate use of valid patient outcomes assessment tools in their practice to facilitate standardized outcomes reporting in the face-lift literature.

Summary: Treating the aged face requires an understanding of bone and soft-tissue anatomy, including the analogous lamellar layers of the face and neck, and the techniques designed to restore youthful skin tone and facial contours. Although volume restoration with fillers is effective for restoring youthful facial contours, the power of face lifting is unmatched in its ability to rejuvenate a sagging facial shape. Standard face-lifting techniques are described, along with the authors’ preferred approach, supplemented by video demonstration of the high–superficial musculoaponeurotic system technique. Complications, along with their prevention and treatment, are reviewed. Currently available comparative studies of face-lifting outcomes consider surgeon opinion and postoperative complications rates. A valid, standardized, patient-reported outcome tool, the FACE-Q, has been available since 2010, and should be a component of any comparative discussion of face-lifting techniques in the future.

Sarasota, Fla.; and Atlanta, Ga.

From the Sarasota Plastic Surgery Center; and Mark Codner M.D. Plastic Surgery.

Received for publication February 25, 2015; accepted August 25, 2015.

Disclosure:Dr. Derby has no financial information to disclose. Dr. Codner receives direct, ongoing funding that is used for the purpose of supporting research project expenses, has a consulting relationship with Mentor Corporation (Santa Barbara, Calif.) and Ulthera, Inc. (Mesa, Ariz.), and receives royalties for books published by Quality Medical Publishing and Elsevier.

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Mark A. Codner, M.D., Mark Codner M.D. Plastic Surgery, 1800 Howell Mill Road, Suite 140, Atlanta, Ga. 30318,

Copyright © 2016 by the American Society of Plastic Surgeons