Center for Plastic and Aesthetic Surgery

Marbella, Spain

Center for Plastic and Aesthetic Surgery

Marbella, Spain

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Kaye K.O.,Center for Plastic and Aesthetic Surgery | Schaller H.-E.,Trauma Center | Jaminet P.,St Marien Hospital | Gonser P.,Center for Plastic and Aesthetic Surgery | Gonser P.,Trauma Center
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2016

The peeling-assisted volume-enhancing (PAVE) lift is a single-stage approach that combines superficial musculoaponeurotic system (SMAS) plication techniques with fat grafting and different peeling agents. To evaluate the safety of this approach, we analyzed the records of 159 patients who underwent surgery between 2008 and 2014. The percentage of complications observed was not higher than values reported in the literature for each treatment entity: surgical facelift: n=3 haematomas (1.89 %), n=2; temporary apraxia of the mandibular branch (1.26%); fat transfer: minor asymmetry in n = 5 cases (3.14%); peeling: temporary hyperpigmentation in trichloroacetic acid (n = 5; 3.8%) and phenol peels (n = 4; 3.1%), permanent hypopigmentation (n = 6; 5.6%), formation of skin miliae persisting longer than 2 to 3 months (n = 5; 4.6%) and prolonged erythema (n = 3; 0.28%) in phenol peels. The single-stage use of chemical peels, autologous fat transfer, and surgical rhytidectomy was safe. © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons


PubMed | Trauma Center, St Marien Hospital and Center for Plastic and Aesthetic Surgery
Type: Journal Article | Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS | Year: 2016

The peeling-assisted volume-enhancing (PAVE) lift is a single-stage approach that combines superficial musculoaponeurotic system (SMAS) plication techniques with fat grafting and different peeling agents. To evaluate the safety of this approach, we analyzed the records of 159 patients who underwent surgery between 2008 and 2014. The percentage of complications observed was not higher than values reported in the literature for each treatment entity: surgical facelift: n=3 haematomas (1.89 %), n=2; temporary apraxia of the mandibular branch (1.26%); fat transfer: minor asymmetry in n=5 cases (3.14%); peeling: temporary hyperpigmentation in trichloroacetic acid (n=5; 3.8%) and phenol peels (n=4; 3.1%), permanent hypopigmentation (n=6; 5.6%), formation of skin miliae persisting longer than 2 to 3 months (n=5; 4.6%) and prolonged erythema (n=3; 0.28%) in phenol peels. The single-stage use of chemical peels, autologous fat transfer, and surgical rhytidectomy was safe.


The main drawback of the classic MACS-lift is the poor lifting effect in the medial neck and submandibular area, which results in a suboptimal aesthetic outcome in cases of severe excesses of neck skin, as well as poor outcome in cases of severe platysmal banding. To overcome these limitations, we describe a modification of the original technique, which maximizes the rejuvenation effect on the neck while keeping the proven advantage of short and less visible scars. Modifying the technique by introducing a 4th SMAS suture to perform lateral platysma plication through a caudally extended dissection 3-4 cm below the mandibular arch/jaw line creates a more accentuated submandibular angle resulting in a sharper, more defined jaw line. Combined with extensive submandibular liposuction/ lipectomy and in some cases closed platysma myotomy, this technique creates a concave submandibular space which enables redraping of a large volume of midneck skin, often eliminating the need for additional posterior or anterior cervicoplasty ("convex becomes concave"). © Springer-Verlag 2012.


Surgical rhytidectomy techniques have become an indispensable part of modern concepts of facial rejuvenation during the last 20 years. Many different techniques have been described and the tendency over the last decade shows a clear trend towards less invasive surgical techniques with natural results, where the overall goal is a rejuvenated not an overstretched face. The rejuvenation or regeneration of the skin itself is an essential part of any facial rejuvenation and significantly influences the overall result; the repositioning of facial volumes and the tightening of aged skin alone cannot achieve a complete and convincing rejuvenation of the face. This article highlights the possibilities and limitations of the adjuvant intraoperative use of various peeling and autologous fat injection techniques during surgical rhytidectomy and outlines the effectiveness and safety of the peeling-assisted volume enhancing (PAVE) lift concept. © 2013 Springer-Verlag Berlin Heidelberg.

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