LIFTING OF THE UPPER 2 3RDS OF THE FACE - SUPRAPERIOSTEAL-SUBSMAS VERSUS SUBPERIOSTEAL APPROACH - THE QUEST FOR PHYSIOLOGICAL SURGERY/

The supraperiosteal-subSMAS lifting technique, which has been per-form ed since 1985, for the rejuvenation of the upper two-thirds of the fac e is described, and the results obtained in a series of 128 cases trea ted, emphasizing the attainment of an effective rejuvenation together with a minimum of complications and undesired effects is presented. A discussion on the two dissection planes (supraperiosteal-subSMAS versu s subperiosteal) used most commonly in the lifting of the upper two-th irds of the face is presented. From an anatomohistophysiologic basis, the tissue manipulations that the two techniques mandate are discussed and evaluated. Based on these facts, the supraperiosteal-subSMAS tech nique is the most logical physiologically, because it produces less ti ssue trauma, which leads to fewer complications and a more rapid recov ery to a normal social life.