High Superficial Musculoaponeurotic System Facelift with Finger-Assisted Facial Spaces Dissection for Asian Patients

Background: Few facelift methods are designed specifically for Asian patients. Because of their characteristic thick skin and flat, wide facial geometry, satisfactory facelift results can be difficult to achieve in these patients. Objectives: The authors evaluated outcomes achieved with a high superficial musculoaponeurotic system (high-SMAS) facelift with finger-assisted facial spaces dissection to rejuvenate the aging Asian face. Methods: Fifty-three patients underwent this facelift procedure. The indication for surgery was typical sagging of the face associated with aging; the relative contraindications were previous facelift and severe facial atrophy. Results: Mean patient age was 50.7 years. Patients received follow-up for a mean of 19 months. In all cases, improvement was seen in soft-tissue sagging of the midface and lower face. One patient experienced unilateral temporal nerve injury, 3 experienced hematoma, and 2 had wound dehiscence. Conclusions: Understanding surgical anatomy including facial layers, spaces, and retaining ligaments is crucial for stable application of facelift techniques in Asian patients. Because of the small number of patients evaluated in this study and the limited follow-up period, more research is needed to define suitable facelift methods for these patients.