Aesthetic and safety considerations in composite rhytidectomy: a review of 145 patients over a 3-year period.

Abstract

Since Hamra described the composite rhytidectomy, many surgeons have been using the technique, but few have published their experience concerning this subject. A series of 145 composite rhytidectomies (133 primary, 8 secondary, and 4 tertiary) in a 3-year period (from September of 1992 through October of 1995), including male and female patients ranging in age from 40 to 74 years, was selected to evaluate my personal approach to the technique, the indications, the aesthetic results, and complications. In this series, all patients were operated on by the same surgeon, from incision to complete closure of the skin. All the preoperative and postoperative photographs were taken by the same photographer. The tripronged hallmark of my contribution to the original technique is (1) cheek fat undermining through the upper approach instead of the lateral approach (easy to perform with low risk of nerve injury), (2) systematized surgical steps (reduced amount of anesthetic solution, low surgical risk, significant reduction in bleeding, lower cost, and easier and quicker recovery phase), and (3) a low complication rate. The postoperative results have been improved with this technique, satisfying both patient and surgeon.