The deep-plane rhytidectomy

Lack of significant improvement in redundant nasolabial folds has always been a problem in face lift procedures. The purpose of this paper is to describe the deep-plane rhytidectomy, which addresses the problem of laxity of the nasolabial folds. A Skoog-type sub-SMAS dissection is extended superiorly over the zygomaticus muscles and medially beyond the nasolabial folds, totally releasing all SMAS attachments and creating a thick musculocutaneous flap comprised of skin, all subcutaneous fat of the cheeks, and the platysma muscle. Four-hundred and three patients have been operated on with minimal complications. Dramatic postoperative improvements in the nasolabial folds are demonstrated, and the step-by-step techniques for the face and neck dissection are described.