Full SMAS: Endoscopy-Assisted Full Facial Rejuvenation.

Background: Every region of the face may bear the signs of aging. Treating isolated areas without adequate anatomical knowledge can lead to incomplete or artificial-looking results and decrease patient satisfaction. The authors' "Full SMAS" technique for complete rejuvenation addresses the anatomical continuity of the superficial musculoaponeurotic system (SMAS)-platysma to the deep-plane suspension of the face.

Objectives: The aim of this study was to evaluate the contribution of endoscopic techniques to traditional facelift and neck lift procedures. Procedures treating from the frontal and temporal regions of the superior part of the face to its mid and lower parts, including the cervical region, were evaluated.

Methods: Treatment of the 3 sub-SMAS layers of the face was performed using endoscopy for repositioning the frontal region and midface. This procedure involved frontal and zygomatic-masseter ligament release, open treatment of the lower subplatysmal section, and the complete release of the retaining ligaments of the face and approach to the jowl.

Results: One hundred sixty-one patients underwent the Full SMAS technique, leading to long-lasting results, low complication rates, and high patient satisfaction.

Conclusions: The Full SMAS is a systematic technique that provides complete facial rejuvenation by combining an endoscopic approach for the temporal and midface regions with traditional open approaches for the lower face and neck. Treating the temporal and midface regions by minimally invasive techniques (endoscopy) reduces the possibility of permanent nerve injuries, provides smaller scars, and creates natural, long-lasting results.

Level of evidence: 4 (therapeutic):