Comparing the Safety and Efficacy of Superficial Musculoaponeurotic System and Deep Plane Facelift Techniques: A Systematic Review and Meta-analysis.

IF 1.6 4区 医学 Q3 SURGERY
Sushanth Vayalapra, Daniel N Guerero, Vinesh Sandhu, Armand Ak Happy, Delaram Imantalab, Priyanka Kissoonsingh, Ankur Khajuria
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引用次数: 0

Abstract

Background: Facelift surgery (rhytidectomy) addresses skin laxity, soft tissue descent, and volume loss, with techniques such as the superficial musculoaponeurotic system (SMAS) and deep plane facelifts offering distinct advantages. However, the optimal technique remains debated due to differences in complication rates and aesthetic outcomes.

Objective: The aim of the study was to compare complication rates and aesthetic outcomes of modern facelift techniques.

Methods: A systematic search of databases, including MEDLINE, Embase, Cochrane Library, CINAHL, and LILACS, was conducted up to May 2024. Eligible studies reported on SMAS or deep technique facelifts with outcomes such as complication rates, aesthetic results, and patient satisfaction. Studies included randomized controlled trials, cohort studies, and case series with more than 10 patients. A random-effects meta-analysis was used to pool complication rates.

Results: A total of 47 studies involving 10,766 patients were included. Hematoma rates were 3% for deep technique facelifts and 2% for SMAS facelifts. Infection rates were low for both techniques. Nerve injury rates were similar between groups; most reported nerve injuries were temporary and resolved over time, while permanent nerve injury was rare. Aesthetic outcomes showed significant improvements with both techniques; however, only one study directly compared them, finding superior midface rejuvenation with deep technique facelifts.

Conclusions: Both SMAS and deep techniques demonstrate comparable safety profiles, although limited comparative data and heterogeneous outcome measures preclude definitive conclusions about relative efficacy. While some evidence suggests potential advantages of deep approaches in midface rejuvenation, technique selection should be individualized. Future research requires standardized outcome measures and prospective comparative studies.

比较浅表肌筋膜神经系统和深度平面拉皮技术的安全性和有效性:系统回顾和荟萃分析。
背景:面部拉皮术(除皱术)解决皮肤松弛、软组织下降和体积减少等问题,其中浅表肌筋膜神经系统(SMAS)和深层拉皮术具有明显的优势。然而,由于并发症发生率和美学结果的差异,最佳技术仍然存在争议。目的:比较现代拉皮术的并发症发生率和美容效果。方法:系统检索截至2024年5月的MEDLINE、Embase、Cochrane Library、CINAHL、LILACS数据库。符合条件的研究报告了SMAS或深度技术面部提升的结果,如并发症发生率、美学结果和患者满意度。研究包括随机对照试验、队列研究和超过10例患者的病例系列。随机效应荟萃分析用于汇总并发症发生率。结果:共纳入47项研究,涉及10766例患者。深度技术面部拉皮术的血肿率为3%,SMAS面部拉皮术为2%。两种技术的感染率都很低。两组间神经损伤率相似;大多数报道的神经损伤是暂时的,并随着时间的推移而消退,而永久性神经损伤是罕见的。两种技术的美学效果均有显著改善;然而,只有一项研究直接比较了这两种方法,发现深层技术拉皮术在面部中部恢复活力方面更胜一筹。结论:SMAS和深度技术都显示出相当的安全性,尽管有限的比较数据和不同的结果测量排除了对相对疗效的明确结论。虽然一些证据表明深层方法在中面部年轻化方面具有潜在优势,但技术选择应个性化。未来的研究需要标准化的结果测量和前瞻性比较研究。
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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
584
审稿时长
6 months
期刊介绍: The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.
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