Nuances in Rhytidectomy Surgery

Session Description

Rhytidectomy, or face and necklift surgery, was initially performed by Dr. Eugene Hollander in Berlin, Germany in 1901. His technique and that of numerous other early facelift surgeons, consisted of preauricular skin excision and redraping, i.e. the “skin only” technique. The first “muscle suspension” or SMAS rhytidectomy was described by Tord Skoog in 1968. Over the past 53 years, there have been numerous “modifications” to Dr. Skoog’s original technique, but the overall rhytidectomy procedure in terms of incisions, planes of dissection, and fixation techniques have not changed significantly from his original description.

During the course of a surgeon’s career, the surgical techniques that were taught during residency and fellowship are gradually modified to create efficiencies, improve outcomes, and decrease complications. The author wishes to present his personal journey with respect to his rhytidectomy techniques over the course of 32 years of surgical practice and over 600 rhytidectomy procedures. Modifications to his original surgical technique will be presented as well as the multiple reasons why these modifications were adopted. The advantages of “deep IV sedation” (Propofol) anesthesia in an accredited office surgical setting will be discussed. A number of preoperative and postoperative safety measures designed to minimize post-surgical complications and enhance the overall “patient experience” will also be discussed.