Minilifting: Short-Scar Rhytidectomy with Thread Lifting

Abstract

Facelifting techniques have been developed over time to mask the aging process. However, conventional facelifts cause scarring. Because of patient demands, various noninvasive lifting techniques have been introduced, including absorbable thread lifting. Minilifting is known for its short-scar excision and is used to improve skin laxity and lifting using absorbable threads but the definition and operation techniques are not certain. In this article, we described the definition, development, and operative techniques used in minilifts. Minilifting procedures represent an added option for patients with minimal scarring and adequate lifting effects.

Keywords: PDO lifting; minilifting; thread lifting.

Fig. 1

Minilifting posterior hairline incision. A zigzag incision of 2 to 3 cm inside the hairline is visible. The upper line is a virtual line between the point of the nasolabial fold and alar base to 1 cm lateral to the lateral orbital rim. The lower line is a virtual line from 1 cm lower to the nasolabial fold and alar base to the zygomatic ligament area.

Fig. 2

Schematic diagram of insertion points. ( A ) Pulling the skin and designing four points located from the otobasion inferius to the subnasale. ( B ) Four points were made (3–6). Points 3 and 4 are for jowl fat compartment lifting and points 5 and 6 are for lateral cheek fat compartment lifting. Points 1 and 2 are for the most projecting area after pinching the arcus marginalis and zygomatic ligament area.

Fig. 3

Incision and subcutaneous dissection. Dissection border (red line), Pitanguy's line (green line), and lateral zygomaticocutaneous ligament (sky blue line).

Fig. 4

Thread insertion layer. From the insertion point, threads should be inserted deeply to hold the SMAS layer and should exit at the incision space. SMAS, superficial musculoaponeurotic system; SQ, subcutaneous layer.

Fig. 5

Thread insertion and loop formation with two threads. Fixation at the deep temporal fascia is performed, and the lifting effect in the surface anatomy can be seen.

Fig. 6

A 66-year-old woman before and after minilifting. ( A ) Preoperative frontal view. ( B ) Preoperative three-quarter view. ( C ) Preoperative lateral view. ( D ) Postoperative 1-month frontal view. ( E ) Postoperative 1-month three-quarter view. ( F ) Postoperative 1-month lateral view.

Fig. 7

A 42-year-old man 1 month after minilifting. Scar revision coverage with a cephalic flap was performed.