The Mastoid Crevasse and 3-Dimensional Considerations in Deep Plane Neck Lifting.

Area of Science:

• Plastic Surgery
• Facial Anatomy
• Surgical Techniques

Background:

• Face and neck lifting advances focus on releasing superficial musculoaponeurotic system-platysma complex tethering points.
• This allows for improved manipulation of the deep natural glide plane in facial and neck rejuvenation procedures.

Purpose of the Study:

• To define a combination of deep plane techniques for comprehensive face and neck lifting.
• To establish a quantifiable endpoint for the gonial angle in these procedures.
• To analyze deep plane tethering and decussation zones.

Main Methods:

• Review of extended deep plane surgery in 79 patients (95% female, ages 30-75) over 3 months.
• Systematic measurements of gonial depth and suspension distances were performed during surgery.
• One-year follow-up was conducted to assess outcomes.

Main Results:

• Pre-intervention mean gonial depth was 9.4 mm (left) and 8.3 mm (right).
• Postoperative gonial depth after the crevasse technique averaged 23.2 mm (left) and 22.5 mm (right), a statistically significant increase.
• Mean advancement of 8.1 mm was achieved, significantly improving the gonial angle.

Conclusions:

• The described deep plane techniques facilitate manipulation of the deep plane and neck space.
• Utilizing the mastoid crevasse provides measurable endpoints and effective fixation.
• Releasing tension and allowing redraping leads to natural and balanced facial and neck lift results.