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Facelift With Power-Assisted Dissection: A Preliminary Report.

BACKGROUND
Subcutaneous elevation of the skin has remained a key component in all facelift techniques.


OBJECTIVES
In this preliminary report, the ABC facelift is introduced as a three-step method addressing photodamage, soft tissue laxity, and areas of bone and volume loss.


METHODS
The procedure consists of: (A) Anatomic and regenerative adipose grafting prior to skin elevation; (B) Baraf elevator for takedown of perpendicular subcutaneous fibers following hydro-dissection of the skin flaps with tumescent solution; and (C) Cautery dissection of the SMAS and platysma in the neck.


RESULTS
Thirty-four patients, (31 females; 3 male) 50-77 years of age at the date of service, underwent an ABC facelift. Dissection of the skin flaps and SMAS elevation was faster compared to traditional methods, averaging 10-15 minutes per hemiface. Bleeding was reduced (average EBL, 12 ml) and the skin flaps appeared better perfused with less venous engorgement and ecchymosis compared to sharp scissor dissection. In general, patients appeared to have shorter postoperative recovery courses and less social downtime secondary to bruising and edema.


CONCLUSION
The ABC facelift addresses facial laxity, volume loss, and skin aging with three simple steps: anatomic and regenerative fat grafting, combined with power-assisted dissection of the skin and cautery elevation of the SMAS. Further improvements in layer separation using more advanced tools for hydro-dissection are currently being investigated.