Despite the variety of novel facial rejuvenation technologies available today, the reference standard for correction of the senescent jaw line and neck remains rhytidectomy. This article describes the purse-string facelift, a vertical facelift that moves away from traditional techniques that use a horizontal vector of subcutaneous muscle-aponeurotic system repositioning. The vertical facelift can counterbalance the effects of gravity and natural facial aging and can reposition the facial soft tissues into a more youthful position more directly and correctly. Rather than multiple, separate sutures to support the suspended tissues, the purse-string technique offers two distinct advantages: operative expediency and a tenacious suture anchor based on the periosteum of the posterolateral zygomatic arch.
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