The S-lift facelift featuring the U-suture and O-suture combined with skin resurfacing

BACKGROUND. A short-flap S-lift may be helpful for minor jowling or submental laxity in cases of early facial ptosis, revision facelifts, or where skin resurfacing is combined with neck lifting. OBJECTIVE. To develop a safe and effective method to lift the jowl either as a single procedure or combined with other rejuvenation methods. METHODS. After the induction of monitored anesthesia care the skin resurfacing is completed, if necessary, and the submental and lateral S-lift incisions are marked next to the tragus. The submental area is hydrodissected with modified tumescent solution. After a 15-minute waiting period, the submental area is debulked with small spatula cannulas using reduced pressure liposuction. Often the platysma bands are tied together with a running locked suture. The right cheek area is hydrodissected and debulked in a similar fashion. A 3-4 cm flap is elevated. If necessary, further blunt dissection is passed through the anterior mandible ligament and the nasolabial fold. Care is taken to keep the skin trabeculae intact. The SMAS is plicated with a U-shaped and O-shaped purse-string suture. Following this tightening of the subcutaneous tissue, the skin is closed with a double-layer closure. The face is dressed in two layers of tube gauze. Sutures are removed in 7-9 days. RESULTS. This S-lift gives a pleasing rejuvenation of the jowl and submental area. It is also possible to combine this procedure with other procedures such as corset platysmaplasty, skin resurfacing, fat augmentation, a browlift, or blepharoplasty. CONCLUSION. The S-lift provides a safe and effective method for rejuvenation of the early sagging face or for revision facelift.