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Is It Possible to Measure the Amount of the SMAS-Facelift According to Facial Vectors?

Is It Possible to Measure the Amount of the SMAS Face Lift According to Facial Vectors? S the initial description of the importance of the superficial musculoaponeurotic system (SMAS) in the face-lift procedure, surgical treatment of the facial aging through SMAS face lift evolved to be less invasive, mainly because of potential temporary or permanent facial nerve damage1 with disturbance of the normal function of facial muscles, which could require reconstruction such as the transplantation of subunits of the latissimus dorsi muscle.2 When treatment of the SMAS involves plication, there is a consensus that the SMAS face lift must be performed superiorly and posteriorly; regardless of the technical choice, the concept of the facial vectors is well established.1 The main superior vectors are performed parallel to the body of the mandible, at the level of the projection of the zygomatic arch, and the posterior ones are performed along the projection of the ramus of the mandible. The convergence of these two vectors generally occurs at the preauricular area in the level of projection of the root of the helix, resulting in an inverted-L shape or a 7 shape with an oblique final vector.3 Considering all of the different types of faces and deformities, the distance between the two horizontal and vertical vectors and, consequently, the amount of SMAS lift, will vary according to each patient.1,3 Real et al. described a technique of frontotemporal minilifting using the concept of facial vectors and, based on anatomical points, quantified the amount of eyebrow tail suspension.4 Fig. 1. Vectors of the two parallel 7-shaped figures at the third middle of the face (arrow indicates the oblique final vector according to the maximum traction of the SMAS).