Demystifying Deep Layer Face-Lift Techniques: A Systematic Review of Superficial Musculoaponeurotic System Techniques.
Level 3 - non-randomized controlled study
Systematic review of predominantly non-randomized surgical studies and case series
PubMed 41100833 · doi:10.1097/PRS.0000000000012526
What was done
A systematic review was conducted across 17 articles detailing superficial musculoaponeurotic system (SMAS) face-lift procedures and aesthetic outcomes. Surgical techniques were classified into medially based (extended sub-SMAS dissection medial to retaining ligaments, such as deep-plane techniques) and laterally based approaches. Aesthetic outcomes and complications were analyzed to evaluate whether any specific technique demonstrated superiority in restoring facial contour.
What was found
The abstract reports no numerical data, statistical comparisons, follow-up durations, or complication rates. Across all included studies, patient satisfaction and overall improvement in facial contour were noted. However, medially based deep-plane techniques were not shown to provide significant improvements in midface appearance or result longevity.
Why it matters
Despite increasing adoption of extensive deep-plane rhytidectomy, this review finds that dissecting medial to stout facial retaining ligaments lacks demonstrable evidence of superior contouring or durability over less invasive lateral SMAS manipulation.
Limits
The abstract provides no quantitative metrics, complication rates, or meta-analytic comparisons. The underlying literature is constrained by non-randomized designs, heterogenous surgical approaches, and reliance on subjective aesthetic and patient-satisfaction endpoints.
Cited by
- supports Studies comparing SMAS facelifts and deep plane facelifts show that both techniques have similar longevity of surgical results.