ANTERIOR SMAS PLICATION FOR THE TREATMENT OF PROMINENT NASOMANDIBULARFOLDS AND RESTORATION OF NORMAL CHEEK CONTOUR

Prominent nasomandibular folds and cheek concavities are common sequel ae of the aging process. The difficulty in achieving initial and long- lasting correction has been well documented. Anterior SMAS plication a s an adjunct to subcutaneous rhytidectomy has proven to be an effectiv e, straightforward method of flattening and rejuvinating the nasomandi bular folds. Ptotic cheek fat is returned to the cheek hollow, and the end result is a more youthful, symmetrical flattening of the nasomand ibular folds and jowls. The anterior SMAS is plicated vertically with a row of permanent sutures placed just lateral to the nasomandibular f old. Less tension is required on the skin naps at closure, and this pe rmits precise control of anterior SMAS vectors without the time, expen se, and potential morbidity of more extensive dissections. The additio nal cost is that of two sutures and an extra 10 to 15 minutes of opera tive time. This technique has been performed on 226 patients of both s exes, and there have been no complications, including nerve injuries, infections, or dehiscences. The longest follow-up has been 2.2 years, and there have been no asymmetries, contour irregularities, or early r ecurrences.