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The deep plane facelift: a 20-year evolution of technique.
H I Baylis1, R A Goldberg, N Shorr
1Orbital and Ophthalmic Plastic Surgery Division, Jules Stein Eye Institute, Los Angeles, California, USA.
Ophthalmology
|March 11, 2000
Summary
Oculoplastic surgeons evolved facelift techniques, moving from limited skin flaps to deep plane facelifts. The deep plane technique offers improved rejuvenation and patient acceptance for neck, jowl, and midface lifting.
Area of Science:
- Plastic Surgery
- Oculoplastic Surgery
- Facial Rejuvenation
Background:
- Facelift surgery has evolved significantly over time.
- Oculoplastic surgeons have contributed unique innovations to facelift techniques.
- Analyzing this evolution provides insights into improving surgical outcomes.
Purpose of the Study:
- To review oculoplastic innovations in facelift surgery.
- To analyze the evolution of facelift techniques at a university program.
- To assess the impact of different techniques on patient outcomes.
Main Methods:
- Retrospective analysis of 313 facelift patients from 1980-1997.
- Identification of three distinct surgical eras: limited skin flap, extended skin flap with superficial musculo-aponeurotic system (SMAS) plication, and deep plane facelift.
- Evaluation of surgical steps designed to enhance rejuvenation and minimize adverse signs.
Main Results:
- The deep plane facelift technique demonstrated improved vertical repositioning of midface, jowl, and neck tissues.
- Complications were minimal across all techniques, with one case of mandibular paresis and one parotid duct laceration in advanced techniques.
- The evolution aimed to reduce "tattletale signs" like scarring and unnatural pulling.
Conclusions:
- The deep plane facelift represents a logical advancement in mid-facelifting techniques pioneered by oculoplastic surgeons.
- This technique offers superior vertical elevation and repositioning compared to older methods.
- Patient and physician acceptance was higher for the deep plane technique versus cutaneous undermining with SMAS plication.