Using a Novel Method to Quantify and Confirm the Variable Vertical Vector of the Deep Plane Facelift

Background: In deep plane rhytidectomy, it is accepted that a more vertical vector will lead to a more natural rejuvenated look than a horizontal vector of pull. Objective: Among patients undergoing deep plane rhytidectomy, can skin angle measurements designed by the authors be used as a proxy for vector of tension to confirm a vertical vector? Methods: Case series measuring the rhytidectomy vector of pull for a series of patients performed by a single surgeon. Results were compared between the vectors of the pre- and postauricular flaps as well as comparing the vector of pull in male versus female patients, patients undergoing facelift alone versus in conjunction with other rejuvenation procedures, and between primary versus revision rhytidectomy patients. Results: Patient characteristics: Average age 64.4 (range 47-79), predominantly female (26/28, 92.9%), primary rhytidectomy (24/28, 85.7%), with concomitant brow lift (12/28, 42.9%). Results reveal a more vertical than horizontal vector of pull on both the pre- and postauricular superficial musculoaponeurotic system flaps with the vector of the anterior flap being more vertical than that of the posterior flap. Conclusion: Utilizing a novel proxy measurement, the vector of pull of the deep plane facelift was more vertical than horizontal.