MEASUREMENT OF SMAS ADVANCEMENT WITH AND WITHOUT ZYGOMATICUS MAJOR MUSCLE RELEASE
Dr. Henry Mentz, Dr. Amado Ruiz, Dr. German Newall, Dr. Christopher Patronella 

MATERIALS AND METHOD This comparative study was performed on 11 consecutive patients, by the first author, measuring their right and left SMAS flaps during rhytidectomy. Measurements of the vertical advancement (shift) were performed of the release from the Zygomaticus Major Muscle (ZMM), and again after a 3cm back cut was performed along the lateral edge of the ZMM. Measurements were made considering the following anatomical landmarks: > The vertical advancement of the flap at the lateral edge of the SMAS > The vertical advancement of the flap at the medial edge (over the ZMM origin) of the SMAS. Tension force was exerted with the use of a conventional digital fish scale (Rapala Corp., China) at 2 lbs. of weight before and after the back cut was performed.

RESULTS: The table to the left illustrates the results of the SMAS advancement (shift) in millimeters obtained with and without zygomaticus major muscle release. An average of 14.04mm of additional advancement was gained by releasing the SMAS from the ZMM.

CONCLUSION: We believe this is a particular interesting finding, because it explains and quantifies the increased medial SMAS advancement, which therefore improves the cosmetic appearance of the jowl and midface.

REFERENCES: 1. Mentz, H.: “A Multilayer Rhytidectomy” in Chapter 15: 143-162 in Operative Plastic Surgery, by Evans, G., McGraw Hill, 2000 2. Marten, T.J.: “Facelift: Planning and Technique” Clin Plast Surg 24:269-308, 1997 3. Massiha, H.: “Short Scar Face Lift with Extended SMAS Platysma Dissection and Lifting and Limited Skin Undermining” Plast. Reconstr. Surg 112(2):663-669, August 2003 4. Saulis, A., Lautenschlager, E., and Mustoe, T.A:, “Biomechanical and Viscoelastic Properties of Skin, SMAS, and Composite Flaps as they Pertain to Rhytidectomy” Plast. Reconstr. Surg 110(2):590-598, August 2002 5. Ivy, E., Lorenc, Z., and Aston, S.: “Is there a Difference? A Prospective Study Comparing Lateral and Standard SMAS Face Lifts with Extended SMAS and Composite Rhytidectomies” Plast. Reconstr. Surg 98(7):1135- 1143, December 1996 6. Stuzin, J.M., Baker, T.J., Gordon, H.L., and Baker, T.M.: “Extended SMAS Dissection as an Approach to Midface Rejuvenation” Clin. Plast. Surg. 22:295, 1995 7. Connell, B.F. and Semlacher, R.A.: “A Contemporary Deep Layer Facial Rejuvenation” Plast. Reconstr. Surg. 100:1513, 1997 8. Baker,T.J., and Stuzin, J.M.: “Personal Technique of Face Lifting” Plast. Reconstr. Surg. 100:502, 1997 9. Baker, D.C.: “Lateral SMASectomy” Plast. Reconstr. Surg. 100:509, 1997 10. Stuzin, J., Baker, T.J., and Baker, T.M.: “Refinements in Face Lifting: Enhanced Facial Contour using Vicryl Mesh Incorporated into SMAS Fixation” Plast. Reconstr. Surg. 105(1):290-301, January 2000

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For additional information on this Medical Research article, please contact:

ACPS: The Aesthetic Center For Plastic Surgery
(713) 799-9999

Source: Dr. Henry Mentz
http://www.drmentz.com

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