facial-rejuvenationAuthor: Fritz E. Barton, Jr., MD
Publisher:  Quality Medical Publishing – 357 pages
Book Review by: Nano Khilnani

There is much more interest and activity now than in the past on facial rejuvenation techniques, as well as on a whole range of aesthetic and cosmetic surgery procedures on all parts of the human body, from both perspectives: the patient as well as the plastic surgeon.

In a search for the latest statistics, we found that in 2015, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States, according  to a report by the American Society of Plastic Surgeons. This was an increase of a mere two percent from 2014, but a whopping 115 percent rise in overall procedures since the year 2000.

As the demand for aesthetic surgery has grown, so has the number of such procedures, as well as their increasing variety and specialization, sort of like a growing tree with an enlarging network of more and more branches and twigs. Facial rejuvenation is a branch among many others within this tree, and this book is one of many in this specialty.

Dr. Fritz D. Rees writes in his Foreword to this book that his student the author Dr. Fritz Barron Jr. was an iconoclast who did not readily accept what he read at face value, but constantly questioned it, saying “show me,” then went to investigate the details of what he had read, and learn much, much more.

Inquisitive minds such as Dr. Rees and Barton are critical to exploring new vistas of knowledge, especially in medicine where, while so much is already known, much more needs to be discovered to answer the questions we do not yet have answers for. And as we discover the answers, new questions constantly arise.

This book is a valuable addition to the growing store of knowledge, information, and very importantly, the insight provided by the experience of plastic surgeons. It is an essential text to acquire by those aspiring into plastic surgery practice, as well as by established surgeons in the field who want to expand their knowledge so they can become more versatile and valuable.

Below is a list of the components of this book to give you a bird’s eye view, organized around its two basic Parts and detailing into 13 chapter titles:

Introduction: An Annotated History of Surgical Facial Rejuvenation

  1. Part I. Basic Considerations
  2. The Office
  3. Patient Consultation
  4. Clinical Photography
  5. Anatomy
  6. Anesthesia
  7. Procedures
  8. Forehead
  9. Eyelids
  10. The High SMAS Facelift
  11. Neck
  12. Adjunctive Procedures
  13. Postoperative Care
  14. Complications
  15. Skin Care

As we typically do in our book reviews, we take a close look at the outline of an important chapter. In this book, let us focus on chapter 8, The High SMAS Facelift, which is about 75 pages long, or more than a fifth of this book’s length.

SMAS stands for superficial muscular aponeurotic system, and it is the basis of the SMAS facelift technique. It is one of several types of facelift, the medical term for which is rhytidectomy, a combination form of the Greek word rhytis for wrinkle and ektome for excision.

The following topics are discussed and illustrated in this chapter with before-after photos, sketches, and tables:


Basic Principles

Evolution of the High SMAS Technique

Rationale and Surgical Goals

Basic Dissection Technique

Timing of Surgery

Variations in Technique

Plan Modifications for Facial Variations

Facelifts for Men

Recovery Time

Long-Term Results

Secondary Facelift

The chapter on adjunctive procedures discusses techniques on improving the looks of the chin, lips, mouth, and nose.

This is an outstanding book on facial rejuvenation, particularly through aesthetic surgery on facial features including the eyelids, forehead, neck, and skin – for which separate chapters are provided – and importantly, the SMAS facelift technique. It not only presents and discusses the procedures, but also, basic items are considered prior to those discussions.



Fritz E. Barton, Jr., MD is Clinical Professor of Plastic Surgery in the Department of Plastic Surgery at University of Texas Southwestern Medical Center in Dallas, Texas.



Kathy Grey, MA

Marie Sena, MA

Video: Dallas plastic surgeon Dr Fritz Barton discusses the right time for facelift surgery: