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Ten Surgical Hacks Based on Anatomy and Design to Dramatically Reduce Your Face and Neck Lift Time
Jordan D. Frey, M.D., Barry M. Zide, D.M.D. M.D..
NYU Langone Health, New York, NY, USA.

Any face/neck lift operation has a natural flow of slower and speedier portions; slower when dissecting under the superficial musculoaponeurotic systemand around nerves while faster during opening, undermining, defatting, and closing. Surgeons can maximize efficiency with these simple maneuvers. We introduce and demonstrate ten reproducible surgical hacks based on anatomy, which span aspects of the entire face and neck lift procedure including markings, skin flap elevation, sub- superficial musculoaponeurotic system manipulation, preplatysmal fat management, skin re-draping, and post-operative dressings.
1. Incision Hack - Pre-operative markings including a superior, transverse 4 centimeter “cross-bar” located exactly 2 centimeters above the superior tragus, a step-cut to preserve the tragal incisura, and a varied, wavy postauricular incision to avoid dog ear formation.
2. Scissor Push Hack- Modified scissors to cut while pushing for skin undermining
3. Sub-Superficial Musculoaponeurotic System (SMAS) Spreading Hack- Oblique sub-SMAS blunt scissor spreading to elevate the SMAS flap without nerve injury as the nerves stay on the downside
4. Digital Measuring Stick Hack - “Digital measuring sticks” to guide incision positions and anatomic dissection including safe sub-SMAS release and placement of SMAS flap suspension sutures
5. Scoop Hack - Modified scoops (small, sharpened measuring devices) for rapid pre-platysmal fat removal
6. Quick Skin Split & Trim Hack - Using the lowest point of the anti-tragus as a guide for initial splitting and insetting of the skin flap followed by skin flap trimming using the skin trim hack
7. Tragus Preserving Hack - Pre-tragal divot to prevent tragal distortion with flap thinning, hair reduction, and a single suture
8. Anti-Pixie Ear Hack- “No-inset” method for the lobule to save time and prevent pixie ear deformity
9. Dressing Hack - One minute dressing with a silicone pad prevents fluid accumulation
10. Block & Tackle Hack - Block and tackle the face for local-only face and neck lifts or painless hematoma drainage
Implementation of these surgical hacks in face and neck lift procedures allow the surgeon to decrease operative time dramatically and minimize post-operative edema while attaining aesthetic and natural results.


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