Extended superficial muscular aponeurotic system rhytidectomy: a graded approach.

Surgical approaches for rhytidectomy continue to evolve. For the past 26 years, the senior author has used a graded approach in combination with the modified deep-plane facelift, consistently achieving natural-appearing results and satisfied patients. This article outlines the analysis of the patient, preoperative preparation of the patient, an algorithm for adjunctive procedures to achieve a youthful yet balanced face, the associated surgical technique, and also possible complications.