Title: New Mini Invasive Technique Of Rejuvenation And Adelagazamiento (Visual) Of The Lower Third Facial And Top Cervical Third

Gerardo Rafael Manuell Lee

Hospital Sedna, Mexico


Dr Gerardo Manuell is currently working at the Hospital Sedna, Mexico.


The Facial Contour technique is presented for cases in which there is an imbalance between the volume of the lower third, and the appearance of excess fat of the lower facial and cervical third, by means of a cutaneous ligament replacement technique, and micro-lipotransference through minimal incisions.


Traction of the auriculo-platysmal fascia is performed, through the rotation and traction of the auricular pavilion and the facial SMAS, with minimal incisions and fixation to the deep fascia and periosteum, this technique has been carried out in two modalities: the first with traction exclusive of the fascia in the retroaricular areas and minimal atrial rotation, and the second with rotation of the auricle and atria platysmal fascia. In the same surgical time, the necessary volumes of micro-grafts in the facial region are restored, with special emphasis on mandibular angle and melolabial groove.

The procedure is carried out under local anesthesia with sedation, which favors a shortening in the recovery period (lower 96 hrs).

In specific cases, a chin implant is placed through a submental skin incision.


32 cases were followed surgically with follow up of up to 4 years, with excellent results in 80%, good in 13.3%, and regular in 6.6%. The 15 cases with micro-lipograft application in predetermined amount, presented over its life, in a percentage higher than 80%.

This last year, 10 cases were intervened in which this procedure was combined with a face lift, with excellent results in all cases.

The areas with notable changes were: mandibular angle, facial cervical angle, upper third of the neck, mandibular line and jowls area.

In addition, a clear aspect of facial thinning was observed, especially in the cheeks and in the upper cervical third.


The traction and fixation of the auricle platysmal fascia to the periosteum of the mastoid process, either alone or in conjunction with the rotation of the auricle, produces a remarkable retensioned of the cervical region mandibular angle and mandibular line that is maintained over time without need to perform dissection or removal of skin tissue. In association with atrial rotation, and retroposition of the same, it is possible to retensioned the SMAS of the cheek and the auriculo - cheek fascia that provides a tense and natural appearance of the cheek.

The retensioning of the structure of the three-dimensional SMAS helps to correct facial skin tension, while the application of microlipoinjertios in predetermined quantities produces natural and long-lasting results (more than 4 years).

The procedure is safe and results in short convalescence, minimal morbidity, and in most cases, no ecchymosis.