Triple-C SMAS Plication Facelift for Natural Facial Rejuvenation

Abstract

Background: Various methods are used to reposition the superficial musculoaponeurotic system (SMAS) during facelift procedures. This study presents a novel, radially oriented, layered SMAS plication: the triple-C SMAS plication. This technique utilizes customizable vectors in the pattern of a "C"to plicate the SMAS in 3 layers to lift and tighten the deep structures of the face. Methods: A retrospective review was performed of patients undergoing the triple-C SMAS plication over a 1-year period. Patients with a length of follow-up less than 100 days were excluded from the study. Demographic data, operative data, complication rates, and satisfaction rates were assessed. Results: One hundred ninety-one consecutive patients underwent a triple-C SMAS plication over a 12-month period. One hundred ten patients met inclusion criteria. Average follow-up was 404.5 days. Complications assessed included temporary facial nerve neuropraxia (0.91%), major hematoma (1.82%), minor hematoma (2.73%), seroma (4.54%), great auricular nerve injury (0%), postauricular skin slough >2 cm (1.82%), and infection (0.91%). Two revision procedures were performed (1.82%). Patient satisfaction rate was 96.4%. Conclusions: Traditional SMAS plication techniques involve single-layer, straightline plications to lift the lower face and neck, limiting their versatility. The triple- C SMAS plication represents a novel technique to safely and effectively elevate the deep structures of the face in a radial pattern to restore a more youthful contour to the malar area, jawline, and neck. This represents a unique strategy for face lifting by which excellent results can be consistently obtained.