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The 3-Level Approach to Facelift Planning: A Simple Paradigm for Surgical Rejuvenation of the Face

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  • Face and Neck Surgery
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Abstract

Our role as aesthetic surgeons demands individualized surgical planning that maximizes patient input and understanding. The value of such shared decision-making (SDM) in aesthetic surgery is becoming increasingly appreciated. This is particularly true for potential patients seeking surgical rejuvenation of the face, where the volume of “educational” information available on the internet, and through various social medial channels, may be overwhelming and even misleading. Presented is a “3-Level approach to facelift planning” named for the facial subregions targeted. This novel paradigm maximizes SDM with its simplicity and reproducibility, serves as an invaluable educational tool for patients, novice and seasoned surgeons alike, and facilitates communication between senior surgeons through its descriptive standardization.

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References

  1. Miller C (1907) The correction of featural imperfections. Oak Printing, Chicago

    Google Scholar 

  2. Hollander E (1912) Diekosmetichechirurgie. In: Joseph M (ed) Handbuch der kosmetik. Verlag von Veit, Leipzig, pp 668–692

    Google Scholar 

  3. Joseph J (1921) Hangewangenplastik (melomioplastik). Dtsch Med Wochenschr 47:287–294

    Article  Google Scholar 

  4. Barrett DM, Casanueva FJ, Wang TD (2016) Evolution of the rhytidectomy. World J Otorhinolaryngol Head Neck Surg. https://doi.org/10.1016/j.wjorl.2015.12.001,February4,2016

    Article  PubMed  PubMed Central  Google Scholar 

  5. Stuzin JM (2007) MOC-PSSM CME article: face lifting. Plast Reconstr Surg. https://doi.org/10.1097/01.prs.0000294656.92618.2b,August27,2007

    Article  PubMed  Google Scholar 

  6. Wan D, Dayan E, Rohrich RJ (2019) Safety and adjuncts in face lifting. Plast Reconstr Surg. https://doi.org/10.1097/PRS.0000000000005898,April5,2019

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nahai F (2011) The art of aesthetic surgery principles & techniques, 2nd edn. Quality Medical Publishing, St. Louis

    Google Scholar 

  8. Schmidt H, Cohen A, Mandeli J et al (2016) Decision-making in breast cancer surgery: where do patients go for information? Am Surg 5:397–402

    Article  Google Scholar 

  9. Couper MP, Singer E, Levin CA et al (2010) Use of the Internet and ratings of information sources for medical decisions: results from the DECISIONS survey. Med Decis Making. https://doi.org/10.1177/0272989X10377661

    Article  PubMed  PubMed Central  Google Scholar 

  10. Parmeshwar N, Reid CM, Park AJ et al (2018) Evaluation of information sources in plastic surgery decision-making. Cureus. https://doi.org/10.7759/cureus.2773,June9,2018

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bustos VP, Haddad A, Kinney JR et al (2023) Evaluation of health literacy in plastic surgery using a crowdsourced patient survey. Plast Reconstr Surg Glob Open. https://doi.org/10.1097/GOX.0000000000004803,February20,2023

    Article  PubMed  PubMed Central  Google Scholar 

  12. Offodile AC, Clemens MW (2018) Decisions and incisions: the role of choice architecture in surgical decision making. Aesthet Surg J. https://doi.org/10.1093/asj/sjy009,January23,2018

    Article  PubMed  Google Scholar 

  13. Feldman J (2006) Neck lift. Quality Medical Publishing, St. Louis

    Book  Google Scholar 

  14. Stuzin JM, Rohrich RJ, Dayan E (2019) The facial fat compartments revisited: clinical relevance to subcutaneous dissection and facial deflation in face lifting. Plast Reconstr Surg. https://doi.org/10.1097/PRS.0000000000006181

    Article  PubMed  Google Scholar 

  15. Zimbler MS (2001) Tord skoog: face-lift innovator. Arch Facial Plast Surg 3:63–75

    Article  CAS  PubMed  Google Scholar 

  16. Robbins LB, Brothers DB, Marshall DM (1995) Anterior SMAS plication for the treatment of prominent nasomandibular folds and restoration of normal cheek contour. Plast Reconstr Surg. https://doi.org/10.1097/00006534-199511000-00007

    Article  PubMed  Google Scholar 

  17. Rohrich RJ, Pessa JE (2007) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. https://doi.org/10.1097/01.prs.0000265403.66886.54

    Article  PubMed  Google Scholar 

  18. Stuzin JM, Baker TJ, Gordon HL (1995) Extended SMAS dissection as an approach to midface rejuvenation. Clin Plast Surg 2:295–311

    Article  Google Scholar 

  19. Mendelson BC (1992) Correction of the nasolabial fold: extended SMAS dissection with periosteal fixation. Plast Reconstr Surg 5:822–833

    Article  Google Scholar 

  20. Marten T (2006) Lamellar high SMAS face and midface lift: a comprehensive technique for natural-appearing rejuvenation of the face. In: Nahai F (ed) The art of aesthetic surgery principles & techniques, 2nd edn. Quality Medical Publishing, St. Louis, pp 1526–1619

    Google Scholar 

  21. Barton FE, Hunt J (2003) The high-superficial musculoaponeurotic system technique in facial rejuvenation: an update. Plast Reconstr Surg. https://doi.org/10.1097/01.PRS.0000091420.04613.0A

    Article  PubMed  Google Scholar 

  22. Kim EM, Bucky LP (2008) Power of the pinch: pinch lower lid blepharoplasty. Ann Plast Surg. https://doi.org/10.1097/SAP.0b013e318172f60e

    Article  PubMed  Google Scholar 

  23. Rosenfield LK (2005) The pinch blepharoplasty revisited. Plast Reconstr Surg. https://doi.org/10.1097/01.prs.0000157020.67216.31

    Article  PubMed  Google Scholar 

  24. Niburski K, Guadagno E, Mohtashami S et al (2020) Shared decision making in surgery: a sco** review of the literature. Health Expect. https://doi.org/10.1111/hex.13105

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ubbink DT, Santema TB, Lapid O (2016) Shared decision-making in cosmetic medicine and aesthetic surgery. Aesthet Surg J. https://doi.org/10.1093/asj/sjv107

    Article  PubMed  Google Scholar 

  26. Bismark MM, Gogos AJ, McCombe D et al (2012) Legal disputes over informed consent for cosmetic procedures: a descriptive study of negligence claims and complaints in Australia. J Plast Reconstr Aesthet Surg. https://doi.org/10.1016/j.bjps.2012.05.004,November2012

    Article  PubMed  Google Scholar 

  27. Bashour M (2006) History and current concepts in the analysis of facial attractiveness. Plast Reconstr Surg. https://doi.org/10.1097/01.prs.0000233051.61512.65,September2006

    Article  PubMed  Google Scholar 

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Correspondence to Kiya Movassaghi.

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Supplementary Information

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Supplementary file1 Initial facelift consultation (MOV 7596 KB)

Supplementary file2 Demonstration of 3-level facelift paradigm (MOV 9496 KB)

Supplementary file3 Level 1 lift (MOV 10954 KB)

Supplementary file4 Level 2 plication markings and technique (MOV 12688 KB)

Supplementary file5 Lateral subcutaneous browlift (MOV 16147 KB)

Supplementary file6 Level 3 plication markings and technique (MOV 8408 KB)

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Gougoutas, A.J., Movassaghi, K. The 3-Level Approach to Facelift Planning: A Simple Paradigm for Surgical Rejuvenation of the Face. Aesth Plast Surg 48, 1076–1083 (2024). https://doi.org/10.1007/s00266-023-03840-y

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  • DOI: https://doi.org/10.1007/s00266-023-03840-y

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