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Safety and Adjuncts in Face Lifting

Wan, Dinah M.D.; Dayan, Erez M.D.; Rohrich, Rod J. M.D.

Plastic and Reconstructive Surgery: September 2019 - Volume 144 - Issue 3 - p 471e-484e
doi: 10.1097/PRS.0000000000005898
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Patient Safety CME

Learning Objectives: After studying this article, the participant should be able to: 1. Classify the commonly performed types of face-lift procedures based on the extent of skin incision and face and neck dissection, and superficial musculoaponeurotic system treatment and perform the appropriate amount of skin undermining in variations of superficial musculoaponeurotic system techniques. 2. Select the optimal placement of skin incisions and list the danger zones encountered in face-lift dissection and their relationship to the fat compartments and retaining ligaments. 3. Use fat grafting as an adjunctive procedure to face lift and apply safe skin resurfacing techniques at the time of rhytidectomy. 4. Institute a preprocedure and postprocedure skin care regimen and use an antihypertensive protocol for postoperative hematoma prevention. 5. List the commonly injured sensory and motor nerves in rhytidectomy, including prevention and treatment strategies.

Summary: Today’s face lifts can be classified as “traditional,” “short-scar,” or “mini.” Placement of skin incision, extent of dissection in the face and neck, and methods of superficial musculoaponeurotic system treatment are standard components of face-lift techniques. Proper knowledge of facial anatomy and danger zones is crucial for patient safety. Adjunctive fat grafting and skin resurfacing procedures can create superior results without adding to patient morbidity. Management options for more serious yet potentially preventable surgical complications are discussed, including hematoma and sensory and motor nerve injuries.

Patient Safety CME.

Dallas, Texas

From the Dallas Plastic Surgery Institute.

Received for publication January 7, 2019; accepted April 5, 2019.

Disclosure:Dr. Wan has no disclosures to report. Dr. Dayan is a consultant for InMode Aesthetic Solutions. Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Thieme Medical Publishing, he is a clinical and research study expert for Allergan, Inc., Galderma, and MTF Biologics, and the owner of Medical Seminars of Texas, LLC. No funding was received for this article.

Related digital media are available in the full-text version of the article on

By reading this article, you are entitled to claim one (1) hour of Category 2 Patient Safety Credit. ASPS members can claim this credit by logging in to Dashboard, clicking “Submit CME,” and completing the form.

Rod J. Rohrich, M.D., Dallas Plastic Surgery Institute, 9101 North Central Expressway #600, Dallas, Texas 75231,, Twitter: @DrRodRohrich, Instagram: @Rod.Rohrich

Copyright © 2019 by the American Society of Plastic Surgeons