A Comparison of the Full and Short-Scar Face-Lift Incision Techniques in Multiple Sets of Identical Twins

Background: Choosing the ideal face-lift technique for a patient presents an added challenge for the plastic surgeon. With the multitude of well-established variations of this procedure, it would be beneficial to define which facioplasty technique produces the optimal result. By comparing the postoperative results from two of the most popularized face-lift incision techniques in monozygotic twins, it is hypothesized that the "best" technique may be determined. Methods: Four sets of identical twins and one set of identical triplets underwent face-lift surgery performed by the senior author (D.E.A.). Incision technique selection was randomized, with the first-born twin undergoing the full-incision operation. Short- and long-term postoperative photographs were taken at approximately 1 and 5 years and subsequently graded by eight board-certified plastic surgeons with over 100 years of combined experience. Results: Data obtained from this study suggest that no difference between these incisions exists at the shorter term follow-up. However, analysis of the long-term follow-up revealed a significant difference between the average scores assigned to the neck region, with the full-incision technique receiving a higher score. Conclusions: These findings suggest that at the short-term follow-up, both the short-scar and full-incision techniques yield comparable results. However, at the longer term follow-up, a significant difference appears between the two procedures exclusively in the neck region. Although a shorter incision is appealing to the patient and surgeon, this study suggests that the full incision may offer a superior long-term result in the neck.