Awake Rejuvenation With the Deep Plane Face Lift and Extended Deep Neck Contouring

The deep plane face lift corrects progressive soft tissue sagging and neck laxity associated with the aging process. With patients requesting fewer procedures under general anesthetics, trends have turned toward performing minimally invasive procedures under tumescent local anesthesia. Many surgeons are apprehensive about operating on the deep structures of the neck with minimal anesthesia; thus, there is limited published data on the efficacy of more invasive procedures under tumescent local anesthesia, such as the deep plane face lift. This study aimed to illustrate the exceptional results that can safely be obtained when performing the deep plane face lift under tumescent local anesthesia.

Two hundred patients who underwent the deep plane face lift under tumescent local anesthesia between January 2020 and January 2024 were identified, and their charts were retrospectively reviewed. Patient demographics, length of operation, concomitant procedures, and postoperative complications were recorded, and a descriptive analysis was performed.

Seventeen (8.5%) patients experienced complications postoperatively, and there were no mortalities. The most common complications were wound infection (2.0%) and hematoma (2.0%). All patients who experienced complications were treated conservatively with complete resolution. No permanent motor nerve damage, xerostomia, or sialoceles were reported. There were no cases of lidocaine toxicity.

The deep plane face lift provides patients with excellent results compared with other methods of facial rejuvenation. This is an invasive operation that can be performed with minimal pain under tumescent local anesthesia, providing patients with optimal outcomes and decreasing the risk of postoperative complications associated with prolonged anesthesia.