Superficial liposculpture of the face and neck. 
The capacity to benefit from scar tissue retraction beneath the intact skin has been demonstrated by a number of surgeons working in the superficial fat over the past decade.  The efforts to achieve predictable skin retraction have largely overlooked the importance of the mechanism of removal of fat, focusing instead on the depth of the surgical plane and the vacuum pressure utilized.  Recent experimental and clinical evidence has pointed out the role of mechanical dislodgment as a key factor in fat removal.  A modification of an existing cannula design has been utilized to achieve predictable skin retraction in the face and neck in a series of 75 patients with follow-up from 3 months to 3 years.  Facial and cervical flap elevation with this instrument (with or without deep tissue tightening and skin excision) has consistently enhanced results, improving skin tone and facial contours and at the same time diminishing both recovery and operative time.  The combination of the technique described and existing techniques such as endoscopic and composite lift approaches may offer enhancement of achievable results.