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Objectives: Present the two-layer face lift as an effective technique to achieve natural and lasting face lift results

Introduction: Many techniques have evolved for treatment of the SMAS: composite dissections, two-layer dissections, plication techniques, SMASectomies, but there is a lack of quality data in comparing different techniques.

Materials / method: We are presenting the two-layer face lift as our standard face lift procedure. Skin and SMAS are dissected independently and pulled along different vectors. Surgical anatomy and goals of the technique by region are detailed.

Results: A video explains the dissection of the SMAS flap. Results are shown.

Conclusion: Two-layer facelift has proven efficient but is a comparably heavy operation with a long recovery time. Current demand goes for noticeable results with minimal recovery. A two-layer microlift with skin resection, SMAS dissection and preservation of retaining ligaments yields promising results and is briefly described.

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Objectives: The treatment of the midface with SMAS plication is efficient and safe

Introduction: Several are the surgical treatments aiming to improve the midface, more specifically the nasolabial sulcus, jowls and mandible. We have used plication instead of SMAS flaps over the last 20 years as a midface treatment because it is a faster safe technique whose results are comparable to those with SMAS detachments.

Materials / method: We have used this technique with plicature of SMAS whose design is similar to that of Lateral SMASectomy proposed by Daniel Baker in 1997 in a 350 face lift.

Results: The short-term cosmetic results have been shown to be similar to other techniques. In those patients that we were able to follow in the later postoperative period it has maintained its aesthetic result and in some patients there was a loss without compromising the general appearance, not causing dissatisfaction for the patient nor for the surgeon

Conclusion: Our conclusion is that SMAS plication is a safe, rapid technical alternative with predictable results in the treatment of midface in facial aesthetic surgeries

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Objectives: To demonstrate and convince the audience why fat grafting should be performed in most patients who present with facial volume loss at the time of their facial rejuvenation procedure.
To discuss the major features of facial aging and why they should be addressed anatomically with multiple modalities, including biologic restoration of tissue losses

Introduction: Facial aging is associated changes in the skin surface, the deeper tissue layers and the bone. When a patient presents for facial rejuvenation, our preference is to evaluate the degree of photo-damage, the degree of volume loss and the degree of laxity and to make recommendations based on a continuum of care, ranging from prevention to non-surgical and minimally invasive approaches to a full range of surgical treatments.

Materials / method: Patients are evaluated for degree of photo-damage, volume loss and laxity. Volume loss is not a generalize finding, but is composed of losses in specific tissues including thinning of the epithelium and dermis, loss of superficial and deep compartment fat and losses of bone. From facial topography, these specific losses in each of the tissues comprising the face are evaluated and a treatment plan is composed.

Results: Patients undergoing facial rejuvenation almost always presented with volume loss. In the majority of patients, volume loss was treated with 3 types of fat grafts, a more structural graft called millifat (2mm parcel size), a microfat graft (1mm parcel size) and nanofat (500 micron parcel size). Fat was injected prior to the facelift and following grafting, the facelift was performed, generally using a high SMAS approach.

Conclusion: Each of the major features of facial aging should be simultaneously addressed and following treatment should be maintained in a serial fashion. Facial volume losses are not corrected by skin and SMAS operations alone and the vast majority of surgical candidates benefit from fat grafting that is performed as a procedure that anatomically replaces decayed tissues.

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请注明名称（个人，公司，学会等等）: Tulip, Millenium Medical, Lipocube

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请注明日期: Patent pending
和审阅情况: ITR2, Lipocube

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Objectives: To demonstrate how important is prep facial analysis and its related anatomy

Introduction: Facial expression is the key of any surgical or non surgical procedure. TWO of the 8 -STEP LOWER EYELID CHECK LIST important are TILT and LATERAL ORBITAL CANTHAL RIM -B&J OCULOPLASTIC APP- available at IMCAS ACADEMY, https://oculoplasty.sciencestanding.com )

Materials / method: TILT analysis is corrected using canthoplasty or canthopexy//limited cheek suspension and understanding the difference 6 fat pads on the middle face throughout the gliding effect ©B&J. to correct nasojugal deformity without big undermining . 3 Types of correction are presented

Results: Type I: BLEPHAROPLASTY+ARCUS MARGINALIS RELEASED+ CTPY+ FAT RESECTION + VOLUME RESTORATION. TYPE II: BLEPHAROPLASTY + CANTHOPLASTY+ CHEEK LIFT. TYPE III: BLEPHAROPLASTY+ ARCUS MARGINALIS RELEASED+ CANTHOPLASTY+ CHEEK SUPPORT+FAT RESECTION+VOLUME RESTORATION

Conclusion: Cheek lift is a formidable technique for the correction of the nasojugal groove but not the facial expression. Nevertheless, we believe that a good individualized eyelid support (CTPY) and the cheek together with repositioning of the middle third fat pads minimize the morbidity of the treatment with an equal or better result.

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