The periorbital dissection in rhytidectomy: How deep?

In the classic rhytidectomy procedure, upward and lateral progress of the skin is hindered by strong fascial attachments of the SMAS to the zygoma. To counteract these tethers, surgeons can go below them in a subperiosteal dissection or above them by dissecting subcutaneously. The author believes a superficial approach to the periorbital area is safer and simpler than a subperiosteal dissection and permits a similar amount of skin advancement.