Refinements of minimal-incision rhytidectomy

Minimal-incision rhytidectomy has achieved increased popularity in recent years and is used successfully to rejuvenate the mid-face and submental regions. A technique of minimal-incision rhytidectomy is presented that eliminates post-auricular scarring and hairline distortion without need for a visible dog ear adjacent to the lobule. All dissection is performed through an incision in the temporal hairline and pre-auricular areas. A multi-vector SMAS plication is performed with the addition of submental liposuction and limited laser resurfacing if necessary. Skin excess is distributed into the temporal hair and a downward rotation flap is utilized to eliminate the resultant dog ear. Representative results are presented utilizing this technique which has become the author's preferred method of facial rejuvenation where limited correction of cervical aging is required. With the exception of more limited correction in the mid and lower cervical areas, results are comparable to traditional methods with a more extensive scar burden. The technique presented is applicable to a wide range of patients and may have special utility in male patients and in tobacco users.