Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach

INTRODUCTION: Rhytidectomy has become one of the most performed aesthetic surgeries in the world. Some surgeons prefer a more conservative approach, and others maintain that aggressive interventions are required to obtain results that are more durable and effective. This study aimed to compare the r...

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Main Author: Diego Vigna Carneiro
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2017-06-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/1831/en_v32n2a02.pdf
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author Diego Vigna Carneiro
author_facet Diego Vigna Carneiro
author_sort Diego Vigna Carneiro
collection DOAJ
description INTRODUCTION: Rhytidectomy has become one of the most performed aesthetic surgeries in the world. Some surgeons prefer a more conservative approach, and others maintain that aggressive interventions are required to obtain results that are more durable and effective. This study aimed to compare the results of 40 rhytidectomies performed using either of two techniques, namely superficial musculoaponeurotic system (SMAS)-plasty according to vector suturing and the sub-SMAS flap approach, at the Federal Hospital of Andaraí over 22 months. METHODS: This is a descriptive study that included 20 patients who underwent SMAS-plasty and 20 patients who received a sub-SMAS flap. An assessor identified some variables in specific regions of the face from an aesthetic point of view, and he rated improvements based on photographs obtained before and 6 months after operation. The data collected allowed to quantify complications of both techniques separately. RESULTS: From an aesthetic point of view, the two techniques showed similar results in terms of facial rejuvenation, improvement of cervical flaccidity, and definition of face/neck transition. The flap provided better results regarding the attenuation in the nasogenian sulcus. A case of hematoma occurred in each technique. Nerve injury occurred in the SMAS-plasty group. However, neither facial nerve injury nor infection occurred in both groups . Edema for >3 months was more prevalent in the sub-SMAS flap group. CONCLUSIONS: The two methods have advantages and disadvantages, and the best result depended on the degree of aging of the facial skeleton, the loss of supporting tissues in critical areas such as the malar region and next to the labiomandibular fold, the preoperative characteristic of the skin, and the surgeon's experience in the technique.
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spelling doaj-art-acbde41b759c480a8dc01be7d100639b2025-08-20T03:20:27ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352017-06-01320216116810.5935/2177-1235.2017RBCP0026Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approachDiego Vigna Carneiro0Hospital Federal do Andaraí, Rio de Janeiro, RJ, BrazilINTRODUCTION: Rhytidectomy has become one of the most performed aesthetic surgeries in the world. Some surgeons prefer a more conservative approach, and others maintain that aggressive interventions are required to obtain results that are more durable and effective. This study aimed to compare the results of 40 rhytidectomies performed using either of two techniques, namely superficial musculoaponeurotic system (SMAS)-plasty according to vector suturing and the sub-SMAS flap approach, at the Federal Hospital of Andaraí over 22 months. METHODS: This is a descriptive study that included 20 patients who underwent SMAS-plasty and 20 patients who received a sub-SMAS flap. An assessor identified some variables in specific regions of the face from an aesthetic point of view, and he rated improvements based on photographs obtained before and 6 months after operation. The data collected allowed to quantify complications of both techniques separately. RESULTS: From an aesthetic point of view, the two techniques showed similar results in terms of facial rejuvenation, improvement of cervical flaccidity, and definition of face/neck transition. The flap provided better results regarding the attenuation in the nasogenian sulcus. A case of hematoma occurred in each technique. Nerve injury occurred in the SMAS-plasty group. However, neither facial nerve injury nor infection occurred in both groups . Edema for >3 months was more prevalent in the sub-SMAS flap group. CONCLUSIONS: The two methods have advantages and disadvantages, and the best result depended on the degree of aging of the facial skeleton, the loss of supporting tissues in critical areas such as the malar region and next to the labiomandibular fold, the preoperative characteristic of the skin, and the surgeon's experience in the technique.http://www.rbcp.org.br/export-pdf/1831/en_v32n2a02.pdfrhytidoplastyrejuvenationskin agingsurgical flaps
spellingShingle Diego Vigna Carneiro
Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
Revista Brasileira de Cirurgia Plástica
rhytidoplasty
rejuvenation
skin aging
surgical flaps
title Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
title_full Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
title_fullStr Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
title_full_unstemmed Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
title_short Evaluation of 40 rhytidoplasties performed at the Federal Hospital of Andaraí to compare two different techniques: cervicofacial SMAS-plasty according to vector suturing and the sub-SMAS flap approach
title_sort evaluation of 40 rhytidoplasties performed at the federal hospital of andarai to compare two different techniques cervicofacial smas plasty according to vector suturing and the sub smas flap approach
topic rhytidoplasty
rejuvenation
skin aging
surgical flaps
url http://www.rbcp.org.br/export-pdf/1831/en_v32n2a02.pdf
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