The temporal incision allows an easy undermining of the crow's-feet area, a meticulous hemostasis, and the downward flap permits the hairline to be maintained in the in proper position. But sometimes, especially in smokers, there is a partial transient alopecia in front of the incision, or even a skin slough.
Therefore, in smokers or when the expected elevation of the skin cheek flap is moderate, one can avoid putting the temporal area at risk by using two separate incisions:
The undermining is on the fascia and then subcutaneous and connects with the cheek incision. A lighted retractor is useful to check the dissection and the he-mostasis.
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