A rhytidoplasty technique without resultant periauricular scarring

Background: Surgical skin incisions in rhytidoplasty are very diverse compared to their original form approximately 100 years ago, when the operation was first performed. Many strategies have been proposed to improve this procedure so as to reduce scarring, anatomic distortion of the external ear, and hair loss. To diminish the inconveniences of periauricu lar scars and hair loss and in order to apply the technique to patients of different age groups, rhytidoplasty without preauricular and retroauricular incisions were performed using 2 surgical access points: the hairline on the temporal region and the submental region. The aim of this study is to report the results obtained using this rhytidoplasty technique which avoided periauricular scarring. Methods: From October 2008 to February 2012, 228 patients (80% female) underwent rhytidoplasty performed by means of a short incision instead of a coronal incision. Patients received cervical treatment through a submental access, which facilitated an extensive selective dissection linked to the midface plane for platysma treatment and, when necessary, resection of excess skin. SMAS-plasty, liposuction, fat graft, and laser treatment, in addition to other non-surgical procedures, were selectively combined in the same procedure or an additional procedure. The procedure is contraindicated in patients who present after extensive weight loss and with excessive flaccidity of facial and cervical skin. Results: Overall, the aesthetic results obtained with rhytidoplasty without periauricular scarring were considered satisfactory both by the patients and the surgical team and provided good midand long-term results. Few complications were observed after surgery; these included asymmetry in the temporal region and non-aesthetic scars, which were detected in 2.6% and 2.2% of the patients, respectively. Conclusions: Rhytidoplasties without periauricular scarring that were performed through submental and precapillary incisions in the temporal region provided good midto long-term results. This justified their use, particularly if we consider that treatment of the midface plane and cervical region might prevent the development of possible complications described in the literature.