Abstract：
BACKGROUND: A face-lift or rhytidectomy is the procedure most directly associated with rejuvenation. There are several surgical techniques for face-lifts, but criteria for the selection of techniques, based on the patient\'s face shape, are lacking. In this study, we report on our experience with specific indication criteria for each technique and the consequent achievement of good outcomes.
METHODS: From 2015 to 2023, 1 surgeon performed face-lifts on 1000 patients. Three different superficial musculoaponeurotic system (SMAS) techniques (SMAS dissection, SMASectomy, and SMAS plication) were applied depending on the degree of sagging of the patient\'s lower face, lateral facial profile, and SMAS mobility and condition. Superficial musculoaponeurotic system dissection was considered for the improvement of a square face, sagging jowls, and marionette lines. Superficial musculoaponeurotic system plication was applied with patients with less sagging jowls and prominent zygoma with concave lateral facial profile. SMASectomy was applied with patients with convex lateral facial profiles or when the SMAS was too thin or damaged. Patient postoperative satisfaction was surveyed using the FACE-Q score 1 year post surgery.
RESULTS: Most of the patients attained natural-looking and long-lasting aesthetic outcomes and exhibited high satisfaction. The patients indicated that they looked about 11.2 ± 5.2 years younger than their actual age after the surgery. The mean satisfaction scores for each facial feature were as follows: cheeks (91.1 ± 7.8), marionette lines (88.5 ± 13.6), lower face and jawline (92.5 ± 14.2), under chin (87.8 ± 15.1), and neck (86.2 ± 18.5). Complications such as facial nerve injury, infection, hematoma, and flap necrosis were very rare.
CONCLUSIONS: Establishing criteria for the selection of face-lift surgical techniques based on the degree of lower face sagging, lateral facial profile, and SMAS mobility and condition led to good outcomes. These criteria can be used by physicians to determine the most effective face-lift surgery technique based on a patient\'s individual features, which may improve surgical outcomes.
METHODS: From 2015 to 2023, 1 surgeon performed face-lifts on 1000 patients. Three different superficial musculoaponeurotic system (SMAS) techniques (SMAS dissection, SMASectomy, and SMAS plication) were applied depending on the degree of sagging of the patient\'s lower face, lateral facial profile, and SMAS mobility and condition. Superficial musculoaponeurotic system dissection was considered for the improvement of a square face, sagging jowls, and marionette lines. Superficial musculoaponeurotic system plication was applied with patients with less sagging jowls and prominent zygoma with concave lateral facial profile. SMASectomy was applied with patients with convex lateral facial profiles or when the SMAS was too thin or damaged. Patient postoperative satisfaction was surveyed using the FACE-Q score 1 year post surgery.
RESULTS: Most of the patients attained natural-looking and long-lasting aesthetic outcomes and exhibited high satisfaction. The patients indicated that they looked about 11.2 ± 5.2 years younger than their actual age after the surgery. The mean satisfaction scores for each facial feature were as follows: cheeks (91.1 ± 7.8), marionette lines (88.5 ± 13.6), lower face and jawline (92.5 ± 14.2), under chin (87.8 ± 15.1), and neck (86.2 ± 18.5). Complications such as facial nerve injury, infection, hematoma, and flap necrosis were very rare.
CONCLUSIONS: Establishing criteria for the selection of face-lift surgical techniques based on the degree of lower face sagging, lateral facial profile, and SMAS mobility and condition led to good outcomes. These criteria can be used by physicians to determine the most effective face-lift surgery technique based on a patient\'s individual features, which may improve surgical outcomes.
摘要：
背景：整容或除皱术是与年轻化最直接相关的手术。有几种整容手术技术,但是选择技术的标准，根据病人的面部形状，缺乏。在这项研究中,我们报告了我们对每种技术的特定适应症标准的经验，以及随之而来的良好结局。
方法：从2015年到2023年，1名外科医生对1000名患者进行了整容。三种不同的浅表肌腱膜系统（SMAS）技术（SMAS解剖，SMA切除术,和SMAS折叠)根据患者下面部的下垂程度进行应用，侧面面部轮廓,和SMAS流动性和条件。考虑了浅表肌腱膜系统解剖以改善方形面部，下垂的下颚，和木偶线。浅表肌筋膜系统折叠术适用于下颌骨下垂较少，zygoma突出，面部侧面凹陷的患者。SMASecometory适用于外凸面部轮廓或SMAS太薄或受损的患者。术后1年使用FACE-Q评分调查患者术后满意度。
结果：大多数患者获得了自然和持久的美学结果，并表现出很高的满意度。患者表示，手术后他们看起来比实际年龄年轻11.2±5.2岁。每个面部特征的平均满意度得分如下：脸颊（91.1±7.8），木偶线(88.5±13.6),下表面和下颚线（92.5±14.2），下巴下（87.8±15.1），和颈部(86.2±18.5)。并发症如面神经损伤，感染,血肿,皮瓣坏死非常罕见。
结论：根据下面部下垂的程度，建立选择整容手术技术的标准，侧面面部轮廓,和SMAS流动性和条件导致了良好的结果。医生可以使用这些标准来根据患者的个体特征确定最有效的整容手术技术，这可能会改善手术结果。
方法：从2015年到2023年，1名外科医生对1000名患者进行了整容。三种不同的浅表肌腱膜系统（SMAS）技术（SMAS解剖，SMA切除术,和SMAS折叠)根据患者下面部的下垂程度进行应用，侧面面部轮廓,和SMAS流动性和条件。考虑了浅表肌腱膜系统解剖以改善方形面部，下垂的下颚，和木偶线。浅表肌筋膜系统折叠术适用于下颌骨下垂较少，zygoma突出，面部侧面凹陷的患者。SMASecometory适用于外凸面部轮廓或SMAS太薄或受损的患者。术后1年使用FACE-Q评分调查患者术后满意度。
结果：大多数患者获得了自然和持久的美学结果，并表现出很高的满意度。患者表示，手术后他们看起来比实际年龄年轻11.2±5.2岁。每个面部特征的平均满意度得分如下：脸颊（91.1±7.8），木偶线(88.5±13.6),下表面和下颚线（92.5±14.2），下巴下（87.8±15.1），和颈部(86.2±18.5)。并发症如面神经损伤，感染,血肿,皮瓣坏死非常罕见。
结论：根据下面部下垂的程度，建立选择整容手术技术的标准，侧面面部轮廓,和SMAS流动性和条件导致了良好的结果。医生可以使用这些标准来根据患者的个体特征确定最有效的整容手术技术，这可能会改善手术结果。
