Deep plane facelifting for facial rejuvenation

Area of Science:

• Plastic Surgery
• Anatomy
• Embryology

Background:

• Facial aging is primarily influenced by gravity's effect on the superficial soft tissue envelope.
• The superficial soft tissue envelope is poorly anchored, while the deep cervical fascia supports facial structures.
• Understanding the distinct fascial layers is crucial for effective facial rejuvenation.

Purpose of the Study:

• To provide anatomical and embryologic evidence supporting the deep plane technique for facial aging.
• To detail the deep plane procedure for safe and consistent surgical performance.
• To offer insights into anatomical landmarks, technical nuances, and variations for facial procedures.

Main Methods:

• Dissection along the embryologic cleavage plane between superficial and deep cervical fascias.
• Utilizing the deep plane to access and treat the buccal fat pad for jowling.
• Employing flap advancement techniques for enhanced soft tissue mobilization.

Main Results:

• The deep plane technique allows for maximal soft tissue mobilization and access to the buccal fat pad.
• Flap advancement creates tension at the fascial level, enabling natural, tension-free skin closure.
• The deep plane advancement flap demonstrates good vascularization and resistance to complications.

Conclusions:

• The deep plane is the optimal plane for facial dissection due to its anatomical and embryologic basis.
• This technique facilitates effective treatment of facial aging, including jowling.
• The deep plane advancement flap provides durable and aesthetically pleasing outcomes with a low complication rate.