Clinical evaluation of complications and the learning curve in deep plane facelift surgery: A single-surgeon...

Deep plane facelift surgery has gained increasing popularity owing to its ability to provide natural and long-lasting rejuvenation results. This study aimed to analyze the incidence, management, and clinical outcomes of complications following deep plane facelift surgery and assess the relationship between surgical experience and complication rates.

This retrospective, single-surgeon study included 240 patients (206 women and 34 men; mean age 53.3 ± 8.2 years) who underwent extended deep plane facelift surgery between 2021 and 2025. Early (≤14 days) and late (>14 days) complications were recorded, categorized, and statistically analyzed. The learning curve was evaluated in consecutive groups of 60 cases.

Complications occurred in 30 patients (12.5%). The most frequent complication was transient facial nerve dysfunction (n = 14; 5.8%), followed by skin necrosis (n = 6; 2.5%), alopecia (n = 4; 1.7%), suture reaction (n = 2; 0.8%), keloid (n = 2; 0.8%), hypertrophic scar (n = 1; 0.4%), hematoma (n = 1; 0.4%), and salivary fistula owing to Stensen's duct injury (n = 1; 0.4%). The overall complication rate declined progressively with experience: 16.7% in the first 60 cases versus 8.3% in the last 60 cases. Skin necrosis incidence similarly decreased from 6.7% to 0%.

Deep plane facelift surgery is a safe and effective facial rejuvenation technique when performed by experienced surgeons. The transient nature of most complications and observed decline in complication frequency with increasing surgical experience highlight the importance of anatomical precision and operative refinement.