Update on minimally invasive face lift technique.

[BACKGROUND] The aging face is characterized by loss of skin elasticity, fat resorption, loss of muscle tone and volume, and loss of bone volume. Restorative procedures should be based on the condition of the soft tissues and the relationship between these tissues and the existing skeletal volume and can be performed through open, endoscopic, or minimally invasive approaches.

[OBJECTIVE] A minimally invasive approach to the face lift is presented, updated with useful details that the author has incorporated into his clinical technique on the basis of 15 years of experience.

[METHODS] The minimally invasive face lift is not a mini-lift but a full face lift performed through minimal incisions located in the frontal hairline, temporal area, triangular fossae of the auricle, submentalis, and eyelids. A wide dissection was performed to liberate the parietotemporal fascia from the zygomatic arch and to pull it up in continuity with the superficial musculoaponeurotic system and the platysma as one continuous layer or composite flap. These structures were selectively secured in a higher position, restoring the contour of the face and the consistency of the soft tissues.

[RESULTS] The described procedures, or combinations of these procedures, were performed in 539 patients during a 9-year period. Preauricular incisions were avoided in 83% of cases. Complications were minimal and included temporary hypoesthesia of the forehead or cheek and temporary palsy of the frontotemporal branch of the facial nerve that resolved after 2 to 4 weeks. There were few problems with hematomas.

[CONCLUSIONS] The minimally invasive face lift technique described here can reduce morbidity, achieve more durable results, and give a greater degree of satisfaction to patients. The procedures are relatively simple and easy to carry out but require somewhat of a learning curve to achieve optimal results.