PubMed · 4482528
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J Conley. 1972. New face, same owner.. https://pubmed.ncbi.nlm.nih.gov/4482528/
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PURPOSE: This report reviews the unique technical and conceptual oculoplastic innovations in the discipline of facelift surgery by analyzing the evolution of facelift technique at a university-based oculoplastic program. DESIGNED: Retrospective, noncomparative case series. PARTICIPANTS: We analyzed 313 patients undergoing a facelift from 1980 through 1997. Most procedures were performed by the senior author. METHODS: Three primary eras of surgical technique were identified: limited skin flap with superficial musculo-aponeurotic system plication (25 patients), extended skin flap with neck dissection and superficial musculo-aponeurotic system plication (210 patients), and deep plane facelift with robust superficial musculo-aponeurotic system flap (78 patients). RESULTS: The steps in the evolution were designed to improve the results of the surgery regarding rejuvenation of the neck, jowls, and nasolabial fold, and to reduce the "tattletale signs" of facelift surgery including postauricular scarring, change in the position of the sideburn and temporal hairline, and unnatural results caused by pulling the tissues posteriorly, rather than repositioning them vertically. There were no complications in the skin flap only group. In the extended skin flap and superficial musculo-aponeurotic system plication group, there was one mandibular paresis which partially resolved. In the deep plane facelift (n = 78), there was one laceration of the parotid duct, successfully stented during surgery. CONCLUSIONS: The deep plane facelift, with vertical elevation of the midface, jowls, and neck, is a logical extension of the mid-facelifting techniques that have been used by oculoplastic surgeons. Compared with cutaneous undermining with superficial musculo-aponeurotic system plication, we found patient and physician acceptance higher using the deep plane technique.
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Since the 1970s, surgical procedures on platysma muscle, aiming to achieve better results in face lifting, became popular and turned out to be an important surgical step for the plastic surgeon. Many plastic surgeons have contributed to the topic throughout these years, as several articles on the subject have been published. Articles dealing with platysma muscle still bring great interest among plastic surgeons. My concern with platysma muscle began in the mid-1970s and since then has grown continuously. I have steadily been studying the importance of the platysma muscle in the surgeries for facial rejuvenation, involving its anatomy, the techniques proposed, the results obtained, the recommendations for the best surgical procedure for each patient, and the complications. My experience and studies regarding platysma muscle, and the contributions I have brought into this field, are thoroughly described and discussed in this article.