{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:05:52Z","timestamp":1791875152220,"version":"4.3.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T00:00:00Z","timestamp":1554940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The vector of superficial musculoaponeurotic system (SMAS) redraping in rhytidectomy is often described in relation to the zygomaticus major muscle (ZMM), so that suspension prevents distortion of the mimetic musculature and a \u201cfacelifted appearance.\u201d There are no data describing the true orientation of this muscle in the midface.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to define the vector of the ZMM relative to the Frankfort horizontal plane.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One hundred patients underwent deep plane rhytidectomy. As part of this procedure the tissues overlying the ZMM are elevated, allowing muscle orientation to be measured as an angle relative to the Frankfort horizontal plane.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data for 200 hemifaces were aggregated. The average ZMM angle was 59\u00b0 (standard deviation, 6\u00b0; range, 41\u201372\u00b0) relative to the Frankfort horizontal plane, and showed a statistically significant pattern of change with advancing age, becoming more acute with increasing age below the age of 60 years and more obtuse with age over 60 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The native vector of the ZMM varies significantly between rhytidectomy patients as demonstrated by the high variance in this cohort. Assumptions about its orientation should not be made in rhytidectomy techniques that do not identify its course. Standard vectors of SMAS redraping, such as superior-lateral, vertically oblique, and purely vertical, should be reconsidered and a customized vector implemented in each case. Aging affects the orientation of the muscle, which can potentially be explained by soft tissue and bony changes at its attachments. This furthers the variability of the SMAS vector in each individual case.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjz114","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T05:43:04Z","timestamp":1555566184000},"page":"351-356","source":"Crossref","is-referenced-by-count":26,"title":["Optimal Facelift Vector and its Relation to Zygomaticus Major Orientation"],"prefix":"10.1093","volume":"40","author":[{"given":"Andrew A","family":"Jacono","sequence":"first","affiliation":[{"name":"Facial Plastic and Reconstructive Surgery, North Shore University Hospital , Manhasset, NY"},{"name":"Division of Facial Plastic and Reconstructive Surgery, Albert Einstein College of Medicine , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-8087","authenticated-orcid":false,"given":"Lucas M","family":"Bryant","sequence":"additional","affiliation":[{"name":"facial plastic surgeon in Lebanon , TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Sean","family":"Alemi","sequence":"additional","affiliation":[{"name":"private facial plastic surgery practice in New York , NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,11]]},"reference":[{"issue":"2","key":"2022122918514403000_CIT0001","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0094-1298(20)31065-8","article-title":"Facelift. Planning and technique","volume":"24","author":"Marten","year":"1997","journal-title":"Clin Plast Surg."},{"issue":"4","key":"2022122918514403000_CIT0002","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.cps.2008.04.002","article-title":"High SMAS facelift: combined single flap lifting of the jawline, cheek, and midface","volume":"35","author":"Marten","year":"2008","journal-title":"Clin Plast Surg."},{"issue":"5","key":"2022122918514403000_CIT0003","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/BF00453874","article-title":"The trifurcated SMAS flap: three-part segmentation of the conventional flap for improved results in the midface, cheek, and neck","volume":"19","author":"Connell","year":"1995","journal-title":"Aesthetic Plast Surg."},{"issue":"7","key":"2022122918514403000_CIT0004","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1177\/1090820X12455826","article-title":"Patient-specific rhytidectomy: finding the angle of maximal rejuvenation","volume":"32","author":"Jacono","year":"2012","journal-title":"Aesthet Surg J."},{"issue":"1","key":"2022122918514403000_CIT0005","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1001\/archfacial.2007.16","article-title":"Surgical anatomy of the face: implications for modern face-lift techniques","volume":"10","author":"Gassner","year":"2008","journal-title":"Arch Facial Plast Surg."},{"issue":"8","key":"2022122918514403000_CIT0006","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1177\/1090820X11424146","article-title":"The minimal access deep plane extended vertical facelift","volume":"31","author":"Jacono","year":"2011","journal-title":"Aesthet Surg J."},{"issue":"5","key":"2022122918514403000_CIT0007","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/asj\/sju171","article-title":"Three-dimensional analysis of long-term midface volume change after vertical vector deep-plane rhytidectomy","volume":"35","author":"Jacono","year":"2015","journal-title":"Aesthet Surg J."},{"issue":"5","key":"2022122918514403000_CIT0008","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/asj\/sjw274","article-title":"Characterization of the cervical retaining ligaments during subplatysmal facelift dissection and its implications","volume":"37","author":"Jacono","year":"2017","journal-title":"Aesthet Surg J."},{"issue":"1","key":"2022122918514403000_CIT0009","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/00006534-199007000-00008","article-title":"The deep-plane rhytidectomy","volume":"86","author":"Hamra","year":"1990","journal-title":"Plast Reconstr Surg."},{"issue":"1","key":"2022122918514403000_CIT0010","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/PRS.0b013e3181f95b2d","article-title":"Aging of the facial skeleton: aesthetic implications and rejuvenation strategies","volume":"127","author":"Shaw","year":"2011","journal-title":"Plast Reconstr Surg."}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjz114\/28355196\/sjz114.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/40\/4\/351\/48445321\/asj_40_4_351.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/40\/4\/351\/48445321\/asj_40_4_351.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T18:51:52Z","timestamp":1672339912000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/40\/4\/351\/5445374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,11]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,11]]},"published-print":{"date-parts":[[2020,3,23]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjz114","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2019,4,11]]}}}