Temple and Postauricular Dissection in Face and Neck Lift Surgery

Area of Science:

• Plastic Surgery
• Facial Anatomy
• Nerve Protection

Background:

• Facelift and neck lift surgeries involve dissection near key nerves.
• Potential nerve damage can lead to prolonged periauricular paresthesia.
• Understanding anatomical landmarks is crucial for surgical safety.

Purpose of the Study:

• To identify critical anatomical structures and planes for nerve preservation during facelift surgery.
• To provide surgical guidelines to minimize nerve injury and associated complications.
• To enhance patient outcomes by reducing post-operative sensory disturbances.

Main Methods:

• Review of anatomical}$ relationships between surgical dissection planes and the auriculotemporal, great auricular, and lesser occipital nerves.
• Analysis of fascial layers and tissue planes relevant to nerve proximity.
• Identification of specific surgical maneuvers to safeguard nerve territories.

Main Results:

• Dissection planes must be carefully chosen to avoid direct contact with the auriculotemporal nerve, especially in the prehelical area.
• Maintaining adipose tissue over the deep fascia protects the great auricular nerve near the McKinney point.
• Elevating the posterior auricular skin flap above the auricularis posterior muscle shields posterior great auricular nerve branches.
• Superficial muscular aponeurotic system flap fixation techniques can protect the lobular branch of the great auricular nerve.
• Preserving adipose tissue at the deep fascia level reduces risk to the lesser occipital nerve during mastoid dissection.

Conclusions:

• Precise dissection planes and strategic flap elevation are essential for preventing nerve damage during face and neck lifts.
• Adherence to described techniques can significantly reduce the incidence of periauricular paresthesia.
• Protecting these nerves ensures better functional and aesthetic outcomes for patients undergoing rhytidectomy.