Peter A. Adamson, M.D., F.R.C.S.C., F.A.C.S., and Jason A. Litner, M.D.
The limited rhytidectomy technique has been re-popularized of late, and travels under many monikers, including the Short Flap technique, the S-lift, the mini-lift, the ‘lunchtime’ lift, the ‘weekend’ lift, etc. As these various names imply, this procedure comprises a limited pre-auricular incision terminating just posterior to the lobule, associated with a short segment of skin undermining. The SMAS is often addressed in a minor fashion, such as by plication or limited imbrication. This procedure may be coupled with adjuvant procedures to refine the neck such as platysmaplasty or midline plication, and cervical liposuction. Indications include a mild degree of skin laxity in a younger patient without significant midface ptosis or jowling. Professed advantages include an outstanding record of safety, diminished operating time and expense, rapid recovery owing to reduced tissue trauma, the ability to perform skin resurfacing concomitantly, and the suitability of a wider range of surgical candidates. However, as one might expect, such limited procedures may yield limited and transitory benefits, possibly foreshadowing patient dissatisfaction and the need for follow-up rejuvenative surgery in the future. This technique is selected by both patient and surgeon who desire a safe and reasonable, yet subtle, improvement in the marks of aging. It is particularly appropriate for the patient who is time-constrained or who is especially risk-averse.