Platysma-SMAS plication facelift

SummaryWhilst numerous facelifting techniques have been described there remains a continual drive towards minimal access and limited ‘downtime’ in order to maintain the effects of more aggressive procedures. The MACS (minimal access cranial suspension) lift is well-established, but has limitations, particularly with respect to its vectors and effect on the neck. Platysma-SMAS plication (PSP) represents an evolution that seeks to balance procedural invasiveness with recovery time and aesthetic outcome. The study reports the initial 117 consecutive patients who were followed prospectively. Using a 5-point assessment scale, the cosmetic outcome was graded 4.45 and 4.49 by patients and surgeon respectively at initial follow up. At final follow up 82.2% of scores had either improved or remained the same and overall grading was 4.43 and 4.45 respectively. Complications were seen in 15.4%:3.4% haematoma and 3.4% transient facial nerve motor dysfunction. There were no long-lasting or permanent motor palsies and all occurred in the initial 30th centile. We have found platysma-SMAS plication to give high satisfaction and reproducible results. With the SMAS being plicated rather than being raised as a flap, it is a quick procedure and is safe with regard to the facial nerve. The technique has furthermore been shown to be easily acquired by less experienced aesthetic surgeons.