الفهرس 
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Abstract
from prehistoric art to modern times, there has been clear evidence that humans have constantly attempted to improve and perpetuate physical beauty. Studies of the evolution of facial aesthetics over the centuries suggest that 35,000 years ago man possessed no less potential for facial attractiveness than today. Aging has always been the greatest obstacle to eternal youthfulness, and mankind has had to content itself with myriad forms of camouflage and decoration of the body and face. A huge market has been created, offering different means to prolong signs of youth. These include biological methods (when the tissues lost owing to the aging process are replaced), beauty products, aesthetic surgery, and other newly discovered and promising rejuvenation strategies.
Achieving a fresh and natural look, safely, with minimal risks and without visible scars, is the key goal of all facial rejuvenation surgery. Operations centered on the SMAS have been the mainstay of facial rejuvenation procedures for nearly three decades. Since its initial description by Mitz and Peyronie in 1976, the SMAS has been successfully used by plastic surgeons as the foundation for different facelift techniques. Whether a SMAS lift or plication is performed, the basic principle of utilizing the SMAS to restore facial youth has withstood the test of time and has become a reliable technique to achieve facial rejuvenation. Despite the successful use of the SMAS, most plastic surgeons limit their dissection of the SMAS inferior to the zygomatic arch. These operations have not traditionally addressed the changes associated with mid-facial aging. The changes associated with mid-facial aging include: deepening of the nasolabial fold, descent of the malar fat pad with loss of malar prominence, descent of the lower eyelid skin below the orbital rim and deepening of the tear trough. These changes cannot be adequately addressed with an infra-zygomatic operation. Successful use of the supra-zygomatic arch SMAS or high SMAS by Connell and Barton and collaborations with Alpert have encouraged us to make this procedure our mainstay of facial rejuvenation. The high SMAS, above the zygomatic arch, allows for a higher arc of rotation of the mid-face. This translates into a greater rejuvenation of the mid-face by lifting the malar fat pad vertically and softening the nasolabial fold.