The surgeons behind the modern facelift

Each section uses four lines: Technique (what it is), First paper (year and PMID, checked with NCBI esummary and a PubMed author search 2026-10-01), Changed (what it did that earlier methods did not), Evidence now (systematic reviews, trials and series to 2026).

1970s-1980s

Tord Skoog

• Technique. Superficial fascia and platysma raised as one flap in the sub-SMAS plane.
• First paper. Presented 1973, textbook 1974; not in PubMed (sources in pioneers).
• Changed. Hamra built the deep-plane rhytidectomy as a Skoog-type sub-SMAS dissection carried over the zygomaticus muscles and past the nasolabial fold (PMID 2359803). Barton's 1992 modification of the Skoog lift, 100 patients: marked nasolabial fold improvement at a rate over 80 percent by 6 and 12 months, an effect that seemed to last up to 4 years (PMID 1409995).
• Evidence now. The Skoog flap is studied through its sub-SMAS descendants; see Hamra below.

Vladimir Mitz and M. Peyronie

• Technique. The superficial musculoaponeurotic system (SMAS) as a surgical layer over the parotid and cheek.
• First paper. 1976 (PMID 935283).
• Changed. Gave the layer the name that SMAS plication, SMAS flap, SMASectomy, high SMAS and deep plane techniques are classified by (PMID 30768122).
• Evidence now. Gardetto 2003, by plastination of 22 fetuses and 6 newborn and adult specimens plus 10 fresh cadavers: SMAS present only in the parotid region, thin and undissectable in the cheek, absent in the neck (PMID 12560687). Minelli, van der Lei and Mendelson 2024, 50 cadaver heads: a musculoaponeurotic layer exists only where flat mimetic muscles and the platysma-auricular fascia lie; the "SMAS" is the compound flap the surgeon creates (PMID 37039509). Pessa 2016 described SMAS fusion zones that set the boundaries of fascial spaces and fat compartments (PMID 26906345).

John Q. Owsley Jr.

• Technique. SMAS-platysma flap raised under a skin flap.
• First paper. 1977, platysma-fascial rhytidectomy (PMID 928549); six-year series 1983 (PMID 6828592).
• Changed. Owsley 1983 reported better correction of submental laxity and neck cords than the standard skin face lift, with fewer hematomas than skin lifts combined with neck defatting (PMID 6828592).
• Evidence now. Mortada 2024, 27 studies and 6,086 patients: the SMAS flap had the highest complication rate of six SMAS techniques, 5.75 percent (PMID 38283861). Jacono 2019, 183 studies: skin necrosis 1.57 percent with the SMAS flap, odds ratio 2.29 against plication (PMID 30768122).

Bruce F. Connell

• Technique. Full-width platysma muscle flaps for neck bands (1976, PMID 24173761; 1978, PMID 365042); partial resection of the anterior belly of the digastric muscle.
• First paper. Digastric contouring, Connell and Shamoun 1997: 21 patients with residual submental fullness, no complications reported (PMID 9145126).
• Changed. Added the digastric muscle to the structures treated under the platysma.
• Evidence now. Gray 2026, 452 neck lift patients, 310 with anterior digastric myectomy: no difference in dysphagia, dysarthria or throat pain; neck tightness 4.8 against 13.4 percent; revision neck lift 3.9 against 9.2 percent; retrospective (PMID 41283798).

Sherrell J. Aston

• Technique. Orbicularis oculi muscle flaps for crow's feet; finger-assisted malar elevation (FAME), a finger dissection above the SMAS that frees the malar fat pad.
• First paper. Orbicularis flaps 1980 (PMID 7352162). FAME: Ferreira 2006 states Aston described it in 1996 and that no detailed paper existed before 2006; PubMed has no 1996 Aston paper on FAME; his 1996 record is the Ivy, Lorenc and Aston split-face trial (PMID 16932185; PMID 8942899).
• Changed. Ferreira found the FAME plane relatively avascular in 10 cadavers and reported minor complications in 6 of 253 patients (PMID 16932185).
• Evidence now. Graf 2008: SMASectomy with FAME in 205 patients, uncontrolled (PMID 18506511). Cakmak 2018, 22 cadaver hemifaces: finger dissection of the prezygomatic space releases the zygomatic cutaneous ligaments under direct vision (PMID 29509842). Aston and Hanna 2023, a letter with no abstract, asked whether the platysma hammock and sling differ (PMID 36624072). No randomized trial of FAME found.

1990s

Sam T. Hamra

• Technique. Deep-plane rhytidectomy: release of all SMAS attachments, cheek skin, fat and platysma lifted as one thick flap; composite rhytidectomy adds the orbicularis oculi.
• First paper. 1990, 403 patients (PMID 2359803). Earlier: the 1984 tri-plane dissection, 750 rhytidectomies over 8 years, with the lower face dissected in the sub-SMAS plane (PMID 6721389).
• Changed. "Deep plane" became the name for a family of sub-SMAS releases with new incisions, platysma treatments and fixation points (PMID 38354840). Hamra later argued lateral vector lifts leave a "lateral sweep" and moved to a superomedial vector (see oddities, PMID 9774028).
• Evidence now.
  • Koroma 2026, 45 studies, 10,784 deep plane patients: pooled complications 6.6 percent, no permanent facial nerve injury, temporary nerve injury 1.2 percent, hematoma 1.8 percent (PMID 42576065).
  • Khoury 2025, 21 studies, 2,896 patients, single-arm pooling: satisfaction 94.4 percent deep plane against 87.8 percent SMAS; complications 17.2 against 10.3 percent (PMID 40801931).
  • Vayalapra 2025, 47 studies, 10,766 patients: hematoma 3 percent deep plane against 2 percent SMAS; only one study compared the two directly (PMID 40600822).
  • Schultz 2026, with Stuzin and Rohrich among the authors, 17 studies: medially based deep plane techniques have not been shown to improve the midface or longevity (PMID 41100833).
  • Composite: lowest complication rate of six SMAS techniques, 0.05 percent (PMID 38283861); temporary nerve injury 1.52 percent, odds ratio 2.22 against plication (PMID 30768122).

Joel J. Feldman

• Technique. Corset platysmaplasty, a continuous midline platysma suture (PMID 2304983).
• First paper. 1990; update 2014 with 522 consecutive neck lifts from 2004 to 2013: open submental access, partial submandibular gland excision with a transcutaneous traction suture, digastric and perihyoid fascia changes (PMID 25415087).
• Changed. By 1998 Knize described some variation of corset platysmaplasty with suction lipectomy as the standard anterior neck approach (PMID 9462784).
• Evidence now. Jacono 2016, 10 cadaver hemifaces: adding midline platysmaplasty to a deep-plane lift cut vertical preauricular skin redraping by 40.5 percent (PMID 26846973). Cambiaso-Daniel 2025, 12 articles, 2,106 patients: pooled platysma band recurrence 1.4 percent, nerve damage 0.9 percent (PMID 39406360).

Oscar M. Ramirez

• Technique. Extended subperiosteal face lift; later endoscopic versions, including the SMILE facelift (PMID 8929322).
• First paper. 1991 (PMID 1852815).
• Changed. Ramirez 1996 classified facial rejuvenation techniques by subperiosteal approach and ancillary procedures (PMID 8532805); the 1988 and 1989 subperiosteal lifts of Psillakis and Tessier are in pioneers.
• Evidence now. Case series only: Scheflan 1996, open subperiosteal upper face lifting in 545 patients by four surgeons in four countries, 1986-1992 (PMID 8746468); Heinrichs 1998, 200 patients, complications 5 percent (PMID 9727455); Finger 2001, transmalar subperiosteal lift in 272 patients over 5 years (PMID 11373573). A PubMed search on 2026-09-30 found no systematic review or meta-analysis of the subperiosteal facelift.

James M. Stuzin

• Technique. Concentric layers of the face with facial nerve branches deep to the deep fascia (PMID 1741467); facial shape and skeletal support in planning (PMID 17255694).
• First paper. 1992, with Baker and Gordon (PMID 1741467). Earlier: 1989, 12 cadaver dissections placing the frontal branch along the undersurface of the temporoparietal fascia (PMID 2911626).
• Changed. 2019: the fat compartments set how far the skin flap is raised; deep compartments are filled and superficial fat is moved with the SMAS (PMID 31688754).
• Evidence now. Gandra 2025, 67 publications, 15,404 patients: pooled motor nerve damage 0.66 percent, permanent motor damage 0.047 percent (PMID 40456989).

Bryan C. Mendelson

• Technique. Facial spaces and retaining ligaments as surgical landmarks (PMID 12172155).
• First paper. 1992 SMAS release with periosteal fixation (in pioneers).
• Changed. Minelli, Yang, van der Lei and Mendelson 2023, 49 cadaver heads: the jowl forms in the subcutaneous layer over the posterior mandibular ligament; the mandibular ligament proper lies only under the platysma (PMID 36050569).
• Evidence now. Talei and Ziai 2024, retrospective, 25 against 25 patients, blinded grading: fat grafting of the prejowl sulcus with little or no release corrected jowls more than mandibular ligament release without fat (PMID 39001648).

Alain L. Fogli

• Technique. Orbicularis muscleplasty with face lift; temporal lift by galeapexy; skin and platysma anchoring without a submental incision.
• First paper. 1992: orbicularis oculi muscle surgery for crow's feet, in French (PMID 1307180). 1995: orbicularis fibers cut and included in the cheek flap, 123 patients over 3 years (PMID 7480276). Galeapexy 2003, 270 patients (PMID 14534826).
• Changed. 2008: the platysma is left attached to the skin and the skin-platysma unit is anchored to malar periosteum, parotid fascia and prelobar fibrous tissue, with Lore's fascia as the landmark; no submental approach (PMID 18305986, PMID 18922305).
• Evidence now. Labbé 2006 tested platysma suspension to Lore's fascia in 10 cadavers and 30 patients (PMID 16651976). No comparative trial found.

David M. Knize

• Technique. Limited-incision forehead lift (PMID 8643715); submental lipectomy and platysmaplasty through one submental incision without skin excision.
• First paper. Submental technique practiced since 1981, published 1998 (PMID 9462784).
• Changed. Neck contour treated through one anterior submental incision with no skin excision (PMID 9462784).
• Evidence now. Brow: Karanfilian 2026, 22 studies, 2,127 brows, mean follow-up 20.9 months: lateral brow raised 3.8 mm; no difference between pretrichial and post-trichial lifts; tined implants gave more lateral lift and more dysesthesia than sutures (PMID 40788666).

Sydney R. Coleman

• Technique. Structural fat grafting (lipostructure): fat taken, refined and placed in small amounts through many tunnels.
• First paper. Controlled demonstrations begun 1987, published 1995 (PMID 8526158); lipostructure 1997 (PMID 9142473).
• Changed. Standardized fat collection, refinement and placement (PMID 35666154).
• Evidence now. Molina-Burbano 2021, 15 studies: fat grafting added to facelift improved volume and aesthetic scores (PMID 31907534). Moellhoff 2023: 61 reported arterial embolisms after facial fat grafting; permanent vision loss in all 26 ophthalmic artery occlusions; 6 deaths (PMID 37563433). Lambros 2018 published "Fat Grafting: A Growing Problem?" (no abstract, PMID 29370005).

Joel E. Pessa

• Technique. Skeletal remodeling as part of facial aging; fat compartments with Rohrich; SMAS fusion zones; the anatomy of buccal fat suspension.
• First paper. 1998: CT of 28 subjects showed the lower maxilla at the pyriform becomes retrusive with age (PMID 9655429).
• Changed. 2000: stereolithographic skulls of young and old men confirmed Lambros's theory of clockwise midface rotation (PMID 10946949). 2026: a "buccal sling" found in 20 cadaver hemifaces explains how buccal fat suspension softens the nasolabial fold (PMID 42374830).
• Evidence now. Anatomical and imaging studies; no clinical trial of buccal fat suspension found.

Daniel Marchac

• Technique. Sprayed fibrin glue under the facelift flap, with no drain and no dressing.
• First paper. Marchac and Sándor 1994, 100 glued against 100 unglued consecutive patients: fewer major hematomas and less ecchymosis with glue (PMID 8087367).
• Changed. Marchac's own 2005 split-face randomized trial in 30 patients found mean drainage of 26 against 33.5 ml in the 29 patients without a major hematoma and minimal differences in bruising and swelling (PMID 15731694).
• Evidence now. Chien 2023, 7 randomized trials: less drainage and fewer hematomas with tissue sealants, risk ratio 0.29, upper confidence limit 0.99 (PMID 36260353). Azzi 2026: major hematoma 1.25 percent with sealants in deep plane lifts (PMID 41203255).

Daniel C. Baker

• Technique. Lateral SMASectomy (PMID 9252623); short scar face lift with lateral SMASectomy.
• First paper. 1997; short scar series 2001, 749 cases over more than 10 years (PMID 19331867).
• Changed. Ivy, Lorenc and Aston 1996 classed lateral SMASectomy as a limited SMAS procedure (PMID 8942899).
• Evidence now. Prado 2006, 82 patients, MACS against lateral SMASectomy: SMASectomy took longer, MACS caused more pain (PMID 16641707). Jacono 2019: major hematoma 1.92 percent in the SMASectomy/imbrication group, odds ratio 2.65 against plication (PMID 30768122).

2000s

Ziya Saylan

• Technique. S-lift; purse-string plication of the SMAS fixed to zygomatic periosteum.
• First paper. The 1999 S-lift is cited in history of the facelift. Earliest PubMed record on the S-lift: Fulton, Saylan and colleagues 2001, an S-lift with U- and O-shaped purse-string sutures (PMID 11231235). As first author: 2002, 250 patients (PMID 12142693).
• Changed. One direction of pull, with the plicated SMAS fixed to zygomatic periosteum (PMID 12142693). Tonnard and Verpaele titled MACS a modified S-lift (PMID 11994618); Saylan replied in 2003 (PMID 12655243).
• Evidence now. See MACS below.

Patrick Tonnard and Alexis Verpaele

• Technique. Minimal access cranial suspension (MACS) lift; nanofat grafting.
• First paper. MACS 2002 (PMID 11994618). Nanofat 2013: fat emulsified and filtered, injected through needles as fine as 27 gauge; no viable adipocytes, stem cells present; 67 cases (PMID 23783059).
• Changed. Vertical purse-string suspension with limited skin undermining; retightening revision described 2010 (PMID 20108092).
• Evidence now. Hijkoop 2022, 6 studies, 739 patients: no major complications, limited effect on the neck, low level of evidence in 3 of 6 studies (PMID 34922854). Prado 2006, 82 patients: MACS and lateral SMASectomy did not differ at 1 month or 2 years; over half needed a tuck for jowls or skin at 24 months (PMID 16641707).

Rod J. Rohrich

• Technique. Facial fat compartments, with Pessa (PMID 17519724); lift-and-fill face lift (in pioneers).
• First paper. 2007, 30 hemifacial cadaver dissections (PMID 17519724).
• Changed. Lift-and-fill 2014, 100 patients: fat grafted to the nasolabial, deep malar and high lateral malar compartments during the lift; nasolabial fold improved by at least one grade in 81 percent (PMID 24569422).
• Evidence now. Gierloff 2012 showed the compartments and their aging changes on CT (PMID 21915077). Cotofana 2019, 40 specimens: filler placed in the deep midfacial compartments did not move downward (PMID 30589776).

Val Lambros

• Technique. Long-interval photographic and 3D comparison of the same faces.
• First paper. 2007: photographs taken 10 to 50 years apart; the lid-cheek junction stayed in place (PMID 17898614).
• Changed. Put vertical descent in question as the main cause of midface aging. 2020, 594 subjects in 3D: many age changes run in and out of the face (PMID 32221204).
• Evidence now. Gierloff 2012, CT of 12 cadaver heads: midfacial fat compartments migrate downward with age (PMID 21915077). The two findings have not been reconciled in one study.

Timothy J. Marten

• Technique. High SMAS flap lifting jawline, cheek and midface as one unit (PMID 18922311); short scar neck lift through a submental incision only (PMID 30268244).
• First paper. 2008 for the high SMAS (Barton's 2002 high SMAS and the 1995 Connell and Marten trifurcated SMAS flap are in pioneers). His 1997 technique paper does not name the high SMAS in its abstract (PMID 9142469).
• Changed. Marten and Elyassnia 2022: submental liposuction with skin and platysma tightening leaves subplatysmal fat, large submandibular glands and digastric problems untreated (PMID 36563673).
• Evidence now. High lateral SMAS had temporary nerve injury of 1.85 percent, odds ratio 2.71 against plication (PMID 30768122). Baptista 2026, randomized, 30 women: deep plane, high SMAS and plication all reduced perceived age with no difference between groups (PMID 41061760).

Amir M. Karam

• Technique. Short-scar purse-string facelift; Vertical Restore.
• First paper. Karam, Nayak and Lam 2009: a vertical vector purse-string suture anchored to the periosteum of the posterolateral zygomatic arch (PMID 19900661).
• Changed. Vertical Restore is a registered name; his practice site describes it as a proprietary, vertically based deep plane facelift done under local anesthesia with IV sedation (https://www.drkaram.com/vertical-restore/).
• Evidence now. No PubMed record for Vertical Restore found on 2026-09-30; no published outcome series.

2010s-2026

Andrew A. Jacono

• Technique. Minimal access deep plane extended (MADE) vertical facelift; extended deep plane facelift with a composite rotational flap; platysma hammock flap.
• First paper. Earliest deep plane paper: 2010, 5 cadaver dissections comparing the deep-plane face-lift with the transtemporal midface-lift (PMID 20855777). MADE 2011: 153 patients; deep plane release of the zygomatico-cutaneous ligaments plus a lateral platysmal myotomy; revision 3.9 percent, hematoma 1.9 percent, temporary nerve injury 1.3 percent (PMID 22065880).
• Changed. The platysmal myotomy separates the vertical vector of the midface and jawline from the neck vector (PMID 22065880). 2014, with Talei: vertical neck lifting, an extended deep plane flap carried from the mandibular angle into the neck (PMID 24745389). 2019: 89 patients, mean gonial volume gain 3.5 cc at 19 months (PMID 30418482). 2022: hammock flap in 123 patients (PMID 35446382).
• Evidence now. Golparvaran 2026, 70 patients randomized by one surgeon, blinded raters at 9 months: extended deep plane better than deep plane for marionette lines, neck laxity and jowls (PMID 41348089). Roskies 2024, 3,964 patients from six surgeons, surgeon-reported: hematoma 1.9 percent (PMID 39072376). The 2019 complication meta-analysis is by the technique's author (PMID 30768122).

André Auersvald and Luiz A. Auersvald

• Technique. Hemostatic net, a running transfixing skin suture (PMID 23949130); traction and sealing sutures for partial submandibular gland resection.
• First paper. Net 2014 (in pioneers). Gland tactic 2014, 240 neck lifts: hematoma 8 against 0 percent and sialoma 24 against 0 percent, 25 controls against 215 (PMID 25587508).
• Changed. 2017, 504 patients: subplatysmal work in 430; lower lip depressor weakness 5.7 percent, no subplatysmal hematoma (PMID 27356946).
• Evidence now.
  • Ribeiro 2026, 8 studies, 1,617 patients: hematoma 0.14 per 100; skin marks in 12.7 per 100 that cleared in 2 to 3 months (PMID 41936137).
  • Gonçalves 2026, 11 studies, 3,393 patients: pooled hematoma 0.6 percent; against controls, no significant difference in hematoma (risk ratio 0.15, 95% CI 0.01 to 3.20, very low certainty) (PMID 42154899).
  • Ismail 2025, randomized, 160 deep plane patients: net and drain did not differ for hematoma, seroma or swelling (PMID 40131398).
  • Azzi 2026: major hematoma 1.23 percent with nets in deep plane lifts; no adjunct clearly better (PMID 41203255).

Rafael A. Couto and James E. Zins

• Technique. Tranexamic acid (TXA) mixed into the local anesthetic before the facelift incision.
• First paper. Earliest record in a PubMed search for tranexamic acid with facelift or rhytidectomy on 2026-09-30: Butz and Geldner 2016, no abstract (PMID 27579240). Couto, Charafeddine, Sinclair, Nayak and Zins 2020: 27 patients, hemostasis 6.5 and 6.3 minutes per side (PMID 31504134).
• Changed. Local delivery in place of intravenous dosing, to cut systemic exposure (PMID 37265094).
• Evidence now.
  • Alenazi 2024, 388 participants: minor hematoma odds ratio 0.18; no difference in major hematoma (PMID 39141514).
  • Klimczak 2025, split-face, 70 patients: less bruising on the TXA side at 1 week (PMID 39574336).
  • Yalamanchili 2023: 4 wound healing complications attributed to local TXA (PMID 37265094); Darras 2025, 261 against 261 matched patients: no increase (PMID 40611665).

Benjamin Talei

• Technique. Deep plane face and neck lift with fixation into the mastoid crevasse and patient-specific vectors.
• First paper. Mastoid crevasse 2024, 79 patients: mean gonial depth advancement 8.1 mm beyond standard mastoid suspension (PMID 37767973). Earlier deep plane papers as co-author with Jacono: vertical neck lifting 2014 (PMID 24745389) and midface volume after vertical vector deep-plane rhytidectomy 2015 (PMID 26063830).
• Changed. Vector set in surgery after release: mean SMAS vector 70.8 degrees, platysma 87.0, skin 58.2, in 71 patients (PMID 38657095).
• Evidence now. Single-surgeon measurement series and a six-surgeon chart review (PMID 39072376); no randomized comparison found.

Deep neck innovators

Earlier neck work (Guerrero-Santos, Connell 1978, de Castro, Ellenbogen) is in pioneers; O'Daniel's Carina gland technique and the segmental platysma innervation are in history of the facelift.

• O'Daniel 2021: mean 22.3 cm3 removed per neck, 73 percent from under the platysma; submandibular gland reduction rate 76 percent, anterior digastric reduction rate 70 percent (PMID 33543747).
• Shauly 2026, 51 studies, 2,971 gland reductions: complications 15.1 percent; marginal mandibular nerve injury 9.8 percent (PMID 41092483).
• Sawan 2021, CT at least 7 years apart in 64 adults: gland volume grew mostly before age 40; body mass index change predicted volume change (PMID 33079222).
• Platysma band recurrence and digastric outcomes: Cambiaso-Daniel 2025 (PMID 39406360); Gray 2026 (PMID 41283798).

Comparative evidence 2019-2026

Oddities from the history of face lifting

Vaseline and paraffin injections

• Robert Gersuny of Vienna injected vaseline in 1899 to replace a testicle removed for tuberculosis, then used it as a filler; Eckstein switched to paraffin; uses included facial wrinkles, cheeks and noses; late nodules (paraffinomas) followed (PMID 16860452).
• Gersuny's 1900 paper "Ueber eine subcutane Prothese" was reprinted in English in 1980 (PMID 6987692); Goldwyn's "The paraffin story" ran in the same issue (PMID 6987691).
• Kolle's 1911 textbook dates the first prosthetic use to 1900, describes Gersuny's purely cosmetic vaseline injection for a young girl's saddle nose on 8 May 1900, and lists paraffin for frown lines between the brows, furrows below the eyes and nasolabial folds; its contents list paraffin embolism and air embolism among untoward results (Kolle FS, Plastic and Cosmetic Surgery, Appleton, 1911, chapter XIV; https://archive.org/details/plasticcosmetics00kolliala).
• Miller 1907 used paraffin between the brows and in cheek hollows, warned that paraffin can be shot from a blocked needle into the forehead, and removed unwanted paraffin a particle at a time with a cutting pick (Miller CC, The Correction of Featural Imperfections, Chicago, 1907; https://archive.org/details/correctionfeatu00millgoog).
• Walsh 1911: Lagarde of Paris injected cold paraffin under pressure from 1904; the French claimed priority for Delanger of Tournai, who injected paraffin under the skin of his own arm in 1899; Walsh recommended paraffin to remove frown lines (PMID 29822325; full text https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5222172/fullTextXML).
• The Science Museum Group holds Gault's cold paraffin wax syringe, nickel-plated brass, Down Bros and Luer, France and London, 1910-1935, object A620233, from the Wellcome collection (https://collection.sciencemuseumgroup.org.uk/objects/co138715/gaults-cold-paraffin-wax-syringe-nickel-plated-b-paraffin-wax-syringes).
• Paraffin was abandoned after migration, embolization and granulomas (PMID 19415573). Skin sequelae of Gersuny-type prostheses were still being reported in 1965 (PMID 5295814); a 2013 article traces paraffin through history (PMID 23395503).

Paraffin marks for criminals

• Walsh 1911 reported Icard's proposal to inject paraffin at the inner edge of the right shoulder blade of professional thieves, placed high, middle or low by grade of danger, so police could read it with a finger (PMID 29822325).

Blind muscle cutting for crow's feet

• Miller 1907 described subcutaneous section of the orbicularis muscle with a narrow-bladed knife passed from the outer corner of the eye, with no open exposure (Miller 1907, https://archive.org/details/correctionfeatu00millgoog).

Liquid silicone injections

• The debate over injectable silicone fluids for soft-tissue augmentation has run for over half a century; Chasan 2007 found poor outcomes reported many years after injection and no longitudinal study with follow-up (PMID 18090770). Kontis and Rivkin 2009 record that the FDA banned silicone for this use (PMID 19415573).

Gold thread lifts

• Gold threads implanted in the cheek subcutis of a woman ten years earlier were found during her facelift; histology showed a fibrous capsule around the metal (PMID 25321089).
• Implanted gold threads appear on CT (PMID 29025155) and made a dental panoramic image hard to read, complicating implant planning (PMID 34777877); a 2022 report is titled implant diagnostic imaging impaired by gold thread therapy (PMID 35784125). A 1996 histology letter studied skin with gold threads (PMID 8532801).

Barbed threads and string suspensions

• Sulamanidze 2002: APTOS polypropylene threads cut with dents, 186 patients, follow-up 2 to 30 months, thread failure in 2.5 percent (PMID 12030865).
• Ruff 2013 traced his bidirectional barbed suture, modelled on the porcupine quill, from concept to FDA approval (PMID 24084875). Isse and Fodor 2005 lifted the midface with barbed polypropylene sutures (PMID 19338825).
• Sasaki and Cohen 2002 suspended the malar fat pad with permanent Gore-Tex or Prolene sutures passed through dot incisions in the nasolabial line and tied to deep temporal fascia, 392 patients (PMID 12142689).
• Abraham 2009, 33 patients, blinded raters, mean 21 months: thread-lift alone lost its result; the authors could not justify further use (PMID 19451452).
• Gülbitti 2018 and Atiyeh 2021 found no new evidence for a lasting effect (PMID 29481392, PMID 33471152). Absorbable threads in 2025: 12 studies, 818 patients, longest follow-up 2 years, long-term data lacking (PMID 39662017).

Skin-only tension lifts

• Knize 1998: skin envelope tightening as practiced around 1968 brought submental bands back within months (PMID 9462784).
• Hamra 1998 and 2000: lateral vector lifts, skin-only or SMAS, let the cheek descend over the tightened jawline as a "lateral sweep" (PMID 9774028, PMID 11802570).
• Mowlavi 2005: the "pixie" ear comes from flap tension pulling the earlobe attachment forward and down; the deformity was assessed in 44 rhytidectomy patients, with an incidence of 5.7 percent in the authors' series (PMID 15793461).
• The 1974 and 1977 split-face studies of skin-only against SMAS lifts are in history of the facelift.

Tapes, rubber bands and straps

• Hollywood actresses, Audrey Hepburn among them, wore rubber bands and adhesive tapes under wigs or hats to pull the brows up and out (PMID 40560188).
• Eleanor Adair was granted two British patents in 1902, one for a forehead strap and one for a chin strap; salons sold chin straps for double chins and forehead straps for frown lines (web history page, https://cosmeticsandskin.com/aba/straps.php).

Lay peelers

• From the 1920s, lay face peelers in Hollywood and Miami used phenol and croton oil formulas kept secret; they dominated deep peeling until legal attacks in the 1960s; their formulas contained less croton oil than the Baker formula, a reduction of 80 to 90 percent (PMID 10626997).

Timeline

Entries already in the pioneers timeline are left out.

Open questions

• Gersuny's first injection: 1899 for a testicle (PMID 16860452); cosmetic saddle nose case 8 May 1900, with 1900 as the first prosthetic use (Kolle 1911); Walsh gives 1899 for his first published cases (PMID 29822325).
• Aston's 1996 FAME description has no PubMed record; the date rests on Ferreira 2006 (PMID 16932185).
• Vertical Restore has no peer-reviewed paper found; the description comes from the surgeon's own site (https://www.drkaram.com/vertical-restore/).
• Deep plane against SMAS: the meta-analyses disagree on complication rates (PMID 40801931, PMID 42576065); the 2019 meta-analysis is by the extended deep plane author (PMID 30768122) and the 2026 SMAS review is co-authored by SMAS technique authors (PMID 41100833).
• Descent against volume: Lambros found the lid-cheek junction stable over decades (PMID 17898614); Gierloff found the fat compartments move down on CT (PMID 21915077).
• Saylan's 1999 S-lift and Skoog's 1974 textbook are outside PubMed.
• The strap patents come from a history website, not a patent record or museum page (https://cosmeticsandskin.com/aba/straps.php).