Stab access fascia suspension lift: A facelift technique without skin excision and visible scar.

[BACKGROUND] Traditional middle and lower facelifts are not suitable for patients with mild skin laxity or who wish to avoid incision scars.

[OBJECTIVE] We present the stab access fascia suspension lift (SAFS-lift) technique, which does not require regular skin incisions, as a reliable surgical facelift strategy for the lower and middle face.

[METHODS] From September 2020 to September 2021, 38 patients underwent SAFS-lift. SAFS-lift involved (1) incomplete subcutaneous undermining with hydrodissection-assisted tunneling; (2) complete subcutaneous undermining with a dissecting cannula in the zygomatic buccal groove area and hollow below zygomatic arch; and (3) maximal firm superficial musculoaponeurotic system suspension with polydioxanone barbed threads in loops. All patients evaluated the outcome according to the Global Aesthetic Improvement Scale. Four plastic surgeons evaluated postsurgery result with a five-point Likert scale (5 = excellent, 4 = good, 3 = fair, 2 = no change, and 1 = worse).

[RESULTS] Thirty-six patients were successfully enrolled. The mean follow-up period was 14.72 ± 3.89 months. No patients showed visible scarring 6 months after surgery. The minor complication rate was 19.4%. They all subsided within 1-6 weeks without treatment. No infection, hematoma, seroma, or facial nerve injury was observed. Patients' outcome ratings were 4.22 ± 0.58 (3 months), 4.69 ± 0.46 (6 months), and 4.69 ± 0.54 (1 year). Surgeons' outcome scoring was 3.98 ± 0.95.

[CONCLUSIONS] Stab access fascia suspension-lift is a predictable, effective, and safe facelift technique that can be performed without making noticeable incisions and resecting the skin.