Commentary on: High superficial musculoaponeurotic system facelift with finger-assisted facial spaces dissection for Asian patients.

I have been asked to write a discussion of the article entitled “High Superficial Musculoaponeurotic System Facelift With Finger-Assisted Facial Spaces Dissection for Asian Patients” by Drs Ryu and Moon.1 The authors stated that few facelift procedures are designed specifically for Asian patients and that the facial characteristics of Asian patients make it difficult to achieve satisfactory results. After their study, they concluded that more studies are needed to redefine suitable facelift techniques for Asian patients. The authors' description of their surgical technique is comprehensible and concise, their diagrams are clear and support their surgical description, and their intraoperative photographs help to illustrate the procedures that they described. There are pre- and postoperative photographs of 2 patients that show aesthetic improvements. However, both sets of photographs make it impossible to ascertain the portion of the result that is purely related to the facelift technique described because both patients have had fat injections in multiple areas of the face, including the upper medial malar area, the nasolabial folds, and the cheeks. Of the 53 consecutive patients who underwent facelifts using the high superficial musculoaponeurotic system (SMAS) with finger-assisted facial spaces dissection technique, 40 patients underwent fat grafting, 11 patients underwent brow lifts, 7 patients underwent upper blepharoplasty, 13 patients underwent lower blepharoplasty, and 18 patients underwent submentoplasty in medial platysmarrhaphy and subplatysmal fat debulking. A brief summary of the authors’ technique is as follows: After skin flap elevation, an incision was …