Rhytidectomy: suprazygomatic and infrazygomatic SMAS treatment

Abstract

The soft tissues of the face and neck are firmer above the zygomatic arch than below it. The SMAS should be treated differently according to where it is situated with respect to this arch. Above the arch, both the skin and the S-SMAS are firmly attached making it possible to correct both simultaneously by means of a flap that includes both layers. Beneath the zygomatic arch correcting the I-SMAS by stretching and relocating it enhances the contour of the jaw and neck and gives greater support to the skin. This provides for even better conformation when excess subcutaneous tissue is resected. An intermediate region exists between the corrected areas of the S-SMAS and the I-SMAS where the rhytidoplasty is exclusively performed through traction and rotation of the skin, but added resources diminish traction sequels.