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V Preface

VIII Contributors PART GUEST EDITOR MALCOLM D. PAUL, MD, FACS Clinical Professor of Surgery, Aesthetic and Plastic Surgery Institute, University of California, Irvine, Newport Beach, California AUTHORS FILIPE V. BASILE, MD Member, Brazilian Plastic Surgery Society, Sa o Paulo, Brazil ADIL CEYDELI, MD, MS Attending Plastic Surgeon, The Flowers Clinic, Honolulu, Hawaii; and Bay Medical Center, Panama City, Florida HENRIQUE P.L. CINTRA, MD Associate Professor of Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Pontifical Catholic University of Rio de Janeiro; Full Member, Brazilian Plastic Surgery Society, Sa o Paulo, Brazil MICHAEL EDWARD, MD Sonora, California ROBERT S. FLOWERS, MD Chief of Surgery and Director of Hawaii Postgraduate Fellowship in Aesthetic Surgery, The Flowers Clinic, Honolulu, Hawaii BAHMAN GUYURON, MD, FACS Professor and Chairman, Department of Plastic Surgery, University Hospitals Case Medical Center, Cleveland, Ohio STEVEN R. JACOBSON, MD Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota VAL LAMBROS, MD Clinical Instructor in Plastic Surgery, University of California, Irvine, Newport Beach, California TIMOTHY J. MARTEN, MD, FACS Director, Marten Clinic of Plastic Surgery, San Francisco, California BRYAN C. MENDELSON, MBBS, FRCSE, FRACS, FACS Toorak Cosmetic Surgery Centre, Victoria, Australia MALCOLM D. PAUL, MD, FACS Clinical Professor of Surgery, Aesthetic and Plastic Surgery Institute, University of California, Irvine, Newport Beach, California DAVID J. ROWE, MD Assistant Professor, Department of Plastic Surgery, University Hospitals Case Medical Center, Cleveland, Ohio GORDON H. SASAKI, MD Sasaki Advanced Aesthetic Medical Center, Pasadena; and Clinical Professor, Loma Linda University Medical Center, Loma Linda, California EDWARD O. TERINO, MD Medical Director, Plastic Surgery Institute of Southern California, Thousand Oaks, California

IX PART GUEST EDITOR MALCOLM D. PAUL, MD, FACS Clinical Professor of Surgery, Aesthetic and Plastic Surgery Institute, University of California, Irvine, Newport Beach, California AUTHORS CORI A. AGARWAL, MD, FACS Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah DANIEL C. BAKER, MD Professor of Surgery, New York University Institute of Reconstructive Plastic Surgery, New York, New York ADIL CEYDELI, MD, MS The Flowers Clinic, Honolulu, Hawaii; and Attending Plastic Surgeon, Bay Medical Center, Panama City, Florida RAMSEY J. CHOUCAIR, MD Associate Clinical Professor, Southwestern Medical School, University of Texas, Dallas, Texas BRUCE F. CONNELL, MD, FACS Clinical Professor of Surgery, University of California, Irvine, College of Medicine, Irvine, California CLAUDIO CARDOSO DE CASTRO, MD, FACS Professor and Chief, Plastic Surgery Division, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil CHRISTOPHE DESOUCHES, MD Centre Medical Alliance, Marseille, France ROBERT S. FLOWERS, MD Chief of Surgery; and Director of Hawaii Post Graduate Fellowship in Aesthetic Surgery; Professor to ISAPS, The Flower Clinic, Honolulu, Hawaii ALAIN FOGLI, MD Clinique Cha teau Berger, Marseille, France SAM T. HAMRA, MD Associate Clinical Professor, Southwestern Medical School, University of Texas; and Adjunct Associate Professor, Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas NICANOR ISSE, MD Assistant Clinical Professor, University of California, Irvine, Newport Beach, California TIMOTHY J. MARTEN, MD, FACS Director, Marten Clinic of Plastic Surgery, San Francisco, California JOHN Q. OWSLEY, MD, FACS Clinical Professor of Surgery, Division of Plastic Surgery, University of California; and Director, Aesthetic Surgery Fellowship, California Pacific Medical Center - Davies Campus, San Francisco, California OSCAR M. RAMI REZ, MD, FACS Clinical Assistant Professor, The Johns Hopkins University School of Medicine, Baltimore; and Director, Esthetique Internationale Plastic Surgical Center, Timonuim, Maryland PATRIC TONNARD, MD Coupure Centrum voor Plastishe Chirurgie; and Associate Clinical Professor, Department of Plastic Surgery, Gent University Hospital, Gent, Belgium ALEXIS VERPAELE, MD Coupure Centrum voor Plastishe Chirurgie; and Associate Clinical Professor, Department of Plastic Surgery, Gent University Hospital, Gent, Belgium JOSE GUERREROSANTOS, MD Guadalajara, Jalisco, Mexico

Contents PART 01 Models of Facial Aging and Implications for Treatment Val Lambros, MD 02 The Open Coronal Approach to Forehead Rejuvenation Robert S. Flowers, MD, Adil Ceydeli, MD, MS 03 Optimizing Results in Endoscopic Forehead Rejuvenation David J. Rowe, MD, Bahman Guyuron, MD, FACS 04 Closed, Nonendoscopic, Small-Incision Forehead Lift Timothy J. Marten, MD, FACS 05 Transpalpebral Brow Lifting Henrique P.L. Cintra, MD, Filipe V. Basile, MD

06 Surgical Anatomy of the Midcheek : Facial Layers, Spaces, and the Midcheek Segments Bryan C. Mendelson, MBBS, FRCSE, FRACS, FACS, Steven R. Jacobson, MD 07 Personal Approach to the Aging Lower Lid and Face Gordon H. Sasaki, MD 08 The Magic of Mid-Face Three-Dimensional Contour Alterations Combining Alloplastic and Soft Tissue Suspension Technologies Edward O. Terino, MD, Michael Edward, MD 09 Barbed Sutures for Aesthetic Facial Plastic Surgery : Indications and Techniques Malcolm D. Paul, MD, FACS PART 10 Safely Navigating Around the Facial Nerve in Three Dimensions John Q. Owsley, MD, FACS, Cori A. Agarwal, MD, FACS 11 Silhouette Sutures for Treatment of Facial Aging : Facial Rejuvenation, Remodeling, and Facial Tissue Support Nicanor Isse, MD

12 Mag-5 : a Magnificent Approach to Upper and Midfacial Magic Robert S. Flowers, MD, Adil Ceydeli, MD, MS 13 Less Invasive Face-lifting : Platysma Anchoring Techniques Alain Fogli, MD, Christophe Desouches, MD 14 Lateral SMASectomy, Plication and Short Scar Facelifts : Indications and Techniques Dineal C. Baker MD. 15 Pushing the Clock Back 15 to 20 Years with Facial Rejuvenation Bruce F. Connell, MD, FACS 16 High SMAS Facelift : Combined Single Flap Lifting of the Jawline, Cheek, and Midface Timothy J. Marten, M.D, FACS 17 Extended Superficial Musculaponeurotic System Dissection and Composite Rhytidectomy Ramsey J. Choucair, MD, Sam T. Hamra, MD 18 Anatomy of the Neck and Procedure Selection Claudio Cardoso De Castro, MD, FACS 19 Lower Third of the Face : Indications and Limitations of the Minimal Access Cranial Suspension Lift Alexis Verpaele, MD, Patrick Tonnard, MD

20 Evolution of Technique : Face and Neck Lifting and Fat Injections Jose Guerrerosantos, MD 21 Advanced Considerations Determining Procedure Selection in Cervicoplasty ; Part One : Anatomy and Aesthetics Oscar M. Ramirez, MD, FACS 22 Advanced Considerations Determining Procedure Selection in Cervicoplasty ; Part Two : Surgery Oscar M. Ramirez, MD, FACS

Clinics in Plastic Surgery July 2008 / Volume 35 / Number 3 Part Facelifts 1 2 3 4 5 6 7 8 9

01 Models of Facial Aging and Implications for Treatment Val Lambros, MD KEYWORDS Editorial Commentary Clin Plastic Surg 35 (2008) 317 doi : 10.1016/j.cps.2008.03.001 0094-1298/08/$-see front matter 2008 Elsevier Inc. All rights reserved. 1 Clin Plastic Surg 35 (2008) 319-327 doi : 10.1016/j.cps.2008.02.012 0094-1298/08/$-see front matter 2008 Elsevier Inc. All rights reserved.

4 Clinics in Plastic Surgery Facelifts Part TRIUMPHS OF THE SURGICAL MODEL 2

01 5 3, 4 ISSUES WITH THE SURGICAL MODEL DEFINITION VERSUS VOLUME 5 5

6 Clinics in Plastic Surgery Facelifts Part 6~14 15, 16 17 TREATMENT CHOICES 6~14 BROWS 14 TEAR TROUGH AND INFRAORBITAL AREA

01 7 18

8 Clinics in Plastic Surgery Facelifts Part CHEEKS 19, 20

01 9 ANTERIOR JAWLINE POSTERIOR JAWLINE

10 Clinics in Plastic Surgery Facelifts Part LIPS AND NASOLABIAL FOLDS

01 11 SUBTLETY IN FACIAL SURGERY

12 Clinics in Plastic Surgery Facelifts Part REFERENCES 1. Lambros VS. Facial aging. Presented at American Society for Aesthetic Plastic Surgery. New York, 2001. 2. Forrest C.R.; Phillips J.H.; Bell T.A.; et al. The biomechanical effects of deep tissue support as related to brow and facelift procedures. Plast Reconstr Surg 88 (1991) 427. 3. Little J.W. Three-dimensional rejuvenation of the midface: volumetric resculpture by malar imbrication. Plast Reconstr Surg 105 (1) (2000) 267-285. 4. Ramirez O.M. Three-dimensional endoscopic midface enhancement: a personal quest for the ideal cheek rejuvenation. Plast Reconstr Surg 109 (1) (2002) 341-343. 5. Lambros V.S. Observations on periorbital aging. Plast Reconstr Surg 120 (5) (2007). 6. Fournier P.F. Facial recontouring with fat grafting. Dermatol Clin 8 (1990) 523. 7. Illouz Y.G. Present results of fat injection. Aesthetic Plast Surg 12 (1988) 175. 8. Illouz Y.G. Liposuction: the Franco-American experience. (1985) Calif.: Medical Aesthetic: Beverly Hills (CA). 9. Illouz Y.G. The fat cells graft a new technique to fill depression. Plast Reconstr Surg 78 (1986) 122. letter to the editor. 10. Carraway J.H.; Mellow C.G. Syringe aspiration and fat concentration: a simple technique for autologous fat injection. Ann Plast Surg 24 (3) (1990). 11. In: (editors: Fisher J.C.; Guerrerosantos J.; Gleason M.C.) Manual of aesthetic surgery. (1985) Springer-Verlag. 12. Guerrerosantos J. Long-term outcome of autologous fat transplantation in aesthetic facial recontouring: sixteen years of experience with 1936 cases. Clin Plast Surg 27 (2000) 515. 13. Coleman S.R. The technique of periorbital lipoinfiltration. Operative Techniques in Plastic and Reconstructive Surgery 1 (1994) 20. 14. Lambros V.S. Fat injection for the aging midface. Operative Techniques in Plastic and Reconstructive Surgery 5 (2) (1998). 15. Kolle F.S. Plastic and cosmetic surgery. (1911) Appelton: New York. 16. Goldwyn R.M. The paraffin story. Plast Reconstr Surg 65 (4) (1980). 17. Coleman S.R. Structural fat grafting. (2004) Quality Medical Publishing, Inc.: St. Louis (MO). 18. Little JW. Periorbital rejuvenation presented at Horizons educational foundation meeting. Palm Desert (CA), January 2008. 19. Lambros VS. Presented at Baker Gordon Symposium on cosmetic surgery, Miami (FL) 2006, Horizons Educational Foundation Symposium. Palm Desert (CA). 2005, 2007, 2008. 20. Lambros V.S. Fat contouring in the neck and face. Clin Plast Surg 19 (1992) 401.