摘要

Objectives: To compare an endoscopic composite flap brow, face and necklift technique to an open composite flap technique in a similar cohort of patients treated by the same surgeon Introduction: Even as modern composite flap and deep-plane facelift techniques evolve to produce increasingly natural-appearing results, the preauricular incision remains a major stigma for many patients. This led the author to develop, for cases with mild to moderate skin laxity, an endoscopic-assisted, en-bloc composite flap face and necklift without a preauricular scar. This paper compares the effectiveness of the author’s “scarless” endoscopic technique with “open” techniques in patients with similar indications and average age. The author describes his technique in detail. Materials / method: Forty-four consecutive patients underwent endoscopic composite flap face and necklift by the author. Forty-four similar patients undergoing “open” composite flap lifting during the period before the author began performing the endoscopic facelift technique. The vertical dimension of skin elevation in both midface and pre-auricular areas was measured in pixels, then normalized as a percentage of total facial height, using size-matched 19 month postoperative (average) high-resolution antero-posterior and lateral photographs. The two groups were compared. Results: Average vertical skin elevation in endoscopic composite flap lift patients was 1.984 percent (midface) and 5.293 percent (pre-auricular), compared with 1.605 percent and 5.852 percent in the open composite flap group. A paired T-test revealed no statistically significant difference between the two groups (p-values, 0.314 for midface and 0.448 for preauricular). Conclusion: In selected patients with deep-tissue laxity but minimal to moderate skin excess, endoscopic en-bloc composite-flap lifting of the SMAS-platysma is a safe and effective technique to achieve a result equivalent to open composite techniques while avoiding a preauricular scar.