Aesthetic Rejuvenation of the Face and Neck Bruce F. Connell, MD, FACS Clinical Professor of Plastic Surgery University of California-Irvine Private Practice, Plastic Surgery Laguna Beach, California Michael J. Sundine, MD, FACS, FAAP Aesthetic Plastic Surgeon Sundine Center for Plastic Surgery Newport Beach, California Thieme New York • Stuttgart • Delhi • Rio de Janeiro ExecutiveEditor:TimothyHiscock Importantnote:Medicineisanever-changingscienceundergo- ManagingEditor:ElizabethPalumbo ingcontinualdevelopment.Researchandclinicalexperienceare Director,EditorialServices:MaryJoCasey continuallyexpandingourknowledge,inparticularourknowl- EditorialAssistant:HaleyPaskalides edgeofpropertreatmentanddrugtherapy.Insofarasthisbook InternationalProductionDirector:AndreasSchabert mentionsanydosageorapplication,readersmayrestassuredthat VicePresident,EditorialandE-ProductDevelopment:VeraSpillner the authors, editors, and publishers have made every effort to InternationalMarketingDirector:FionaHenderson ensurethatsuchreferencesareinaccordancewiththestateof InternationalSalesDirector:LouisaTurrell knowledgeatthetimeofproductionofthebook. DirectorofSales,NorthAmerica:MikeRoseman Nevertheless, this does not involve, imply, or express any SeniorVicePresidentandChiefOperatingOfficer:SarahVanderbilt guaranteeorresponsibilityonthepartofthepublishersinrespect President:BrianD.Scanlan toanydosageinstructionsandformsofapplicationsstatedinthe book.Everyuserisrequestedtoexaminecarefullythemanufac- turers’leafletsaccompanyingeachdrugandtocheck,ifnecessary inconsultationwithaphysicianorspecialist,whetherthedosage LibraryofCongressCataloging-in-PublicationData schedulesmentionedthereinorthecontraindicationsstatedbythe Aesthetic rejuvenation of the face and neck / [edited by] Bruce manufacturers differ from the statements made in the present Connell,MichaelJ.Sundine.–Firstedition. book.Suchexaminationisparticularlyimportantwithdrugsthat p.;cm. areeitherrarelyusedorhavebeennewlyreleasedonthemarket. Includesbibliographicalreferences. Everydosagescheduleoreveryformofapplicationusedisentirely ISBN978-1-62623-089-7(hardcover)–ISBN978-1-62623-090-3 attheuser’sownriskandresponsibility.Theauthorsandpublishers (electronic) requesteveryusertoreporttothepublishersanydiscrepanciesor I.Connell,Bruce(BruceFowler),editor.II.Sundine,MichaelJ.,editor. inaccuraciesnoticed.Iferrorsinthisworkarefoundafterpubli- [DNLM: 1. Rhytidoplasty–methods. 2. Blepharoplasty–methods. cation,erratawillbepostedatwww.thieme.comontheproduct WE705] descriptionpage. RD119 Someoftheproductnames,patents,andregistereddesigns 617.9'52–dc23 2015026369 referredtointhisbookareinfactregisteredtrademarksorpro- prietarynameseventhoughspecificreferencetothisfactisnot always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representationbythepublisherthatitisinthepublicdomain. ©2016ThiemeMedicalPublishers,Inc. ThiemePublishersNewYork 333SeventhAvenue,NewYork,NY10001USA +18007823488,[email protected] ThiemePublishersStuttgart Rüdigerstrasse14,70469Stuttgart,Germany +49[0]7118931421,[email protected] ThiemePublishersDelhi A-12,SecondFloor,Sector-2,Noida-201301 UttarPradesh,India +911204556600,[email protected] ThiemePublishersRiodeJaneiro,ThiemePublicaçõesLtda. EdifícioRodolphodePaoli,25ºandar Av.NiloPeçanha,50–Sala2508 RiodeJaneiro20020-906Brasil +55213172-2297/+55213172-1896 Coverdesign:ThiemePublishingGroup TypesettingbyDiTechProcessSolutions Thisbook,includingallpartsthereof,islegallyprotectedbycopy- PrintedinChinabyEverbestPrintingInvestment 54321 right. Any use, exploitation, or commercialization outside the narrowlimitssetbycopyrightlegislationwithoutthepublisher’s ISBN978-1-62623-089-7 consentisillegalandliabletoprosecution.Thisappliesinparticular tophotostatreproduction,copying,mimeographingorduplication Alsoavailableasane-book: ofanykind,translating,preparationofmicrofilms,andelectronic eISBN978-1-62623-090-3 dataprocessingandstorage. ToHelmutG.Wagner,Iwouldliketostatemyappreciationforyoursurgicalhelpassurgicaltechnician,translatorduring foreigncharityclinicsandsurgeries,aswellasassistantfor50yearswhichhasmadethispublicationpossible. BruceF.Connell,MD Iwouldliketodedicatethisbooktotheloveofmylife,mybeautifulwifeToni,whohasblessedmylifefromthe momentsheenteredit.Thankyouforyourpatienceforthetimeawayneededtobringthisprojecttocompletion. Tomydaughters,CandaceandLauren,mybeautifulflowerswholightupmylifedaily.Ihopethattheywillall bepleasedwiththeresultsofthisproject.ToDr.Connell,myfriendandmentor,whoseteachingsandvisionarethe foundationofthisbookandmypractice. MichaelJ.Sundine,MD Contents Preface............................................................................................... ix Acknowledgments................................................................................... x Contributors ........................................................................................ xi 1. AppliedAnatomyforSafetyinFacelifting......................................................... 1 DinoR.Elyassnia 2. FacialAnalysisforFacelifting ...................................................................... 12 MichaelJ.SundineandBruceF.Connell 3. AnalysisoftheNeck................................................................................ 17 NicholasNikolov 4. FacialAging ......................................................................................... 22 BryanG.Forley 5. Energy-BasedTreatmentsforFacialAging ....................................................... 28 LawrenceS.BassandJasonN.Pozner 6. FacialSculptingandFacialSlimmingwithNeurotoxins......................................... 39 WofflesT.L.Wu 7. SoftTissueFillers ................................................................................... 45 TaibaAlrasheed,PaulSchembri,andTrevorM.Born 8. FiftyYearsofProgressioninFaceliftingandNeckLifting....................................... 64 StevenM.HamiltonandBruceF.Connell 9. MaleversusFemaleFaceliftSurgery:IsThereaDifference?.................................... 93 StevenM.Hamilton 10. Foreheadplasty:RecognizingandTreatingAgingintheUpperFace......................... 103 BruceF.Connell 11. EndoscopicBrowlift .............................................................................. 118 ScottR.MillerandAhmadN.Saad 12. PrimarySuperficialMusculoaponeuroticSystem(SMAS)FaceliftandNeckLift ............ 126 BruceF.ConnellandMichaelJ.Sundine 13. SubmentalContouring........................................................................... 149 BruceF.ConnellandMichaelJ.Sundine 14. SimultaneousFaceliftandFatGrafting ......................................................... 160 TimothyJ.MartenandDinoR.Elyassnia 15. MidfaceLift........................................................................................ 188 GaroKassabian vii Contents 16. Condition-SpecificRhytidectomy:AnEvidence-BasedParadigmShiftinFacial Rejuvenation...................................................................................... 193 E.GaylonMcColloughandFredG.Fedok 17. SecondaryFacelifting............................................................................. 214 MichaelJ.SundineandBruceF.Connell 18. AvoidingComplicationsinFacelifts............................................................. 225 G.HuntNeurohr 19. PeriorbitalRejuvenationwithAutologousFat ................................................. 237 YifanGuo,BrianC.Drolet,andPatrickK.Sullivan 20. ComparisonofMidfaceRejuvenationTechniques ............................................. 243 MichaelJ.SundineandBruceF.Connell 21. Upper-EyelidBlepharoplasty..................................................................... 249 RobertS.Flowers,JohnNassif,andChristopherR.Costa 22. Lower-EyelidBlepharoplasty..................................................................... 268 WilliamP.Chen 23. LateralCanthalComplicationsinAestheticEyelidSurgery:Preventionand Reconstruction.................................................................................... 273 M.DouglasGossman 24. TreatmentoftheTear-TroughDeformity....................................................... 280 RamseyJ.Choucair 25. ManagementoftheLateralPeriorbitalArea................................................... 287 ThomasA.B.Bell Index...................................................................................................... 292 viii