Some generalizations regarding this 30-year evolution became apparent to us on review of the literature and previous textbooks on the subject. Perhaps an oversimplification of this change over time can be summarized as follows. The 1970s was dominated by a concept of "beauty is only skin deep," which symbolized the general usage of cutaneous skin resectional procedures for facial reconstruction. At this time direct and coronal browlifting with large resections of scalp and frontal tissue was utilized. Reconstruction of the eyelids was characterized by a skin-only plane dissection with resection of both upper and lower eyelid skin. Midfacial and lower facial reconstruction was dominated by skin flap facelifting. The procedures were characterized by large skin resections and lateral tension. 

The 1980s brought the "age of fascial awareness" with careful identification of the musculocutaneous fascial planes of the facial region and the evolution of fascial-based surgery, which took advantage of the intrinsic anatomy of the facial structures. Examples can be found in a change of blepharoplasty technique utilizing myocutaneous flaps, and the increased utilization of the underlying deep structures of the eyelid and orbit, including the lid retractors. In the upper lid, levator aponeurosis isolation and fixation and lower lid transconjunctival and lid retractor and capsulopalpebral fascial-based surgery became the standard. In the mid and lower face, facelifting procedures became SAS-based. Thus, the age of the deep plane facelift was born, enabling surgeons to mobilize large composite areas of the facial musculoskeleton, musculocutaneous infrastructure to allow for greater mobilization of tissue, enhanced natural aesthetic effect, and a decreased reliance on skin resection procedures.

The 1990s brought the "subperiosteal revolution." The introduction of endoscopic surgical technique and utilization of subperiosteal planes revolutionized surgery with the creation of the endoscopic forehead, browlift, and face. The revolution continued with the increased utilizatoin of the subperiosteal midface and cheeklift used alone and in combination with endoscopic upper and midfacial subperiosteal planes for midfacial rejuvenation. Endoscopic technique also allowed the surgeon to use minimal incisions and to avoid of skin or tissue resectional techniques, with a greater emphasis on natural resuspension and natural rejuvenation of upper, middle, and lower cervical facial structures.

Finally, as we head toward the millenium, fantastic changes in technology allow for adjunctive procedures to further enhance and to increased safety. The introduction of multiple new laser modalities, the user of pharmocologic agents such as botulinum, and the emergence of myriad of bioactive and biocompatible materials for the three-dimensional tissue augmentation and facial implants have increased the efficacy of surgical reconstruction. Finally, liposuction technique and technology has improved dramatically with the introduction of very small caliber cannulae and ultrasonic techniques to allow for manipulation of the unerlying lipoadipose tissue of the face and neck, further allowing the surgeon to sculpt and fine tune his or her aesthetic technique.

The last and perhaps most important evolution in facial surgery, and that which is most specifically address by this textbook, is the interdisciplinary synery that has evolved in the last decade. A number of surgical specialities, including facial plastic, Oculo-Facial, plastic, dermatologic, and oral maxillofacial fields, have brought tremendous expertise to bear on the subject of facial rejuvenation. Each regional specialty has introduced unique training, surgical expertise, and companion technology toward various areas of facial aesthetic surgery to create a broad and expansive array of surgical specialists whose whole is certainly greater than the sum of its parts.

Finally, the multiauthored format of this textbook has many strengths, although some weaknesses. The reader is urged to read the textbook as a whole, as the editors have taken great care to include a broad array of subjects. We have attempted to bring together authors who truly represent the pioneers and leaders in their various fields of aesthetic facial surgery. We have assigned each topic in general to two authors of two differing orientations or specialities. This allows at least two viewpoints to be published on a given subject. We have taken great care to try and minimize overlap and redundancy, although some element of repetition is both proper and unavoidable. Most importantly, every surgical specialty has much to learn from the others and we hope that this textbook allows that synery of technique and expertise to come together under one cover.

As we enter the new millenium it is a most exciting time to be alive and to be a facial surgical specialist. The rapid changes in technique and its infrastructure of technology, bioengineering, and biomaterials have given the surgeon greater control, power, and efficacy to achive unparalleled aesthetic results with greater levels of consistency and safety than ever before in the modern epoch. We hope you find this textbook as illuminating and worthwhile as it was to bring together.