Deep Plane Facelift Research Articles

The zygorbicular dissection in composite rhytidectomy: an ideal midface plane.

Composite rhytidectomy added the repositioning of the orbicularis oculi muscle to the deep plane face lift to achieve a more harmonious appearance of the face by adding periorbital rejuvenation. By not separating the orbicularis oculi from the zygomaticus minor and by extending the dissection under medial portions of the zygomaticus major and minor muscles, a more significant improvement in composite rhytidectomy can now be achieved. A thin nonrestrictive mesentery between the deep plane face lift dissection and the zygorbicular dissection still allows vertical movement of the composite face lift flap without interrupting the intimate relationship between the platysma, cheek fat, and orbicularis oculi muscle. This modification eliminates the occasional prolonged edema and occasional temporary dystonia previously observed. It allows the continuation of the use of the arcus marginalis release, which has also been modified by resetting the septum orbitale over the orbital rim. These two modifications allow a more predictable and impressive result. They reinforce the concept of periorbital rejuvenation as an integral part of facial rejuvenation, which not only produces a more harmonious immediate result but prevents the possible unfavorable sequelae of conventional rhytidectomy and lower blepharoplasty.

The New Deep Plane Face Lift Dissections versus the Old Superficial Techniques: A Comparison of Neurologic Complications

The New Deep Plane Face Lift Dissections versus the Old Superficial Techniques: A Comparison of Neurologic Complications

One hundred consecutive deep plane face-lifts.

A subplaytysmal face-lift technique in a deeper anatomical plane of the face was described in the 1970s. The deep plane rhytidectomy is based on sound anatomical principles of tissue mobilization, advancement, and repair. Wide undermining is accomplished in a subplaytysmal plane and continued, extending over the zygomatic muscle to the melolabial fold. This large compound cheek flap of skin, muscle, and fat is then advanced and tightened to dramatically influence the jowl and melolabial fold. A prospective study was undertaken to evaluate the results of 100 deep plane face-lifts using this technique. Postoperative observations and evaluations were made at 1 week, 1 month, and 6 months. A questionnaire response and photographic analysis were obtained after 6 months. The rate of hematomas was low, with none occurring beneath the thick cheek flap. There were no persistent problems, facial irregularities, paralysis, or paresis. Ninety-seven percent of the patients were pleased with the aesthetic results. In conjunction with wide cervical undermining and an anterior platysmal plication, the deep plane face-lift affords a predictable improvement for the aging face and neck.

Endoscopy, KTP Laser, and Facial Plastic Surgery

Educational objectives: To understand the anatomy of the deep plane facelift and the theory of its usefulness and to decide whether endoscopic laser surgery offers new and usable additions to the present surgical armamentarium.

Rhytidectomy: The multiplane approach

This paper addresses the technique and experience of the multiplane face-lift. It discusses the multiplane approach as a modification of the deep-plane face-lift, combining the subSMAS dissection with wide subcutaneous undermining. This technique allows for the development of separate SMAS and skin flaps that can be treated individually as opposed to advancement as a single unit. A discussion of the anatomy with regard to the SMAS and retaining ligaments of the cheek describes how the underlying muscles affect the appearance of the nasolabial fold and why the multiplane face-lift results in superior treatment in this area. A step by step description outlines treatment of the neck, face and forehead, and use of wide MicroFoam for the final dressing.

Deep-Plane Cervicofacial Rotation-Advancement Flap for Reconstruction of Large Cheek Defects

The blood supply and reliability of cervicofacial rotation-advancement flaps for cheek reconstruction can be improved significantly by dissecting the flap in the deep plane (i.e., below the superficial musculoaponeurotic system and the platysma). This modification, similar in technique to that used in composite or deep-plane face lift, was used successfully in seven patients, including several heavy cigarette smokers who were unlikely to have achieved a successful outcome with a conventional cervicofacial flap. No facial nerve weaknesses were observed. We now believe that the deep plane is the level of choice for dissection of cervicofacial flaps when used for reconstruction of cheek or other facial defects.

Combining Chemical Peels and Face Lifts

Is it safe to perform deep-plane face lift and 35% trichloroacetic acid peel simultaneously? Most expert dermatologists and plastic surgeons have

Combined Endoscopic Brow Lift, Deep-Plane Face Lift, and Neck Lift

6 Reprinted from Bostwick J III, Eaves FF III, Nahai F. Endoscopic Plastic Surgery. St. Louis: Quality Medical Publishing, 1995, pp 242–263.

Simultaneous Deep-Plane Face Lift and Trichloroacetic Acid Peel

Many patients seeking facial rejuvenation require a combination of face lift and chemical peel to achieve optimal results. These procedures traditionally have been separated in time because of fear of skin slough after simultaneous peel and face lift. The recent evolution to deep-plane face lift and peeling agents other than phenol led to this reexamination of the subject. Forty-seven porcine flaps were treated with a variety of chemabrasion agents. As a result, 35% trichloroacetic acid was determined to be a safe agent for use on thick flaps. Thirty-five patients underwent simultaneous modified deep-plane face lift and immediate trichloroacetic acid peel, with 35% being the maximum strength used on undermined areas. This combination proved to be successful, with no complications related to the combination treatment.