I'm considering a deep plane facelift. What is the percentage of patients who experience nerve damage? Is it true that in some areas, it should be banned?
What Are the Side Effects of Deep Plane Facelift?
Doctor Answers (12)
Deep plane facelifts and nerve damage
No, this should not be banned. It remains a viable option. The deep plane facelift is an operation in which the surgical plane of dissection comes quite close to the nerves which control facial movement. If not performed properly risks for nerve damage in deep plane facelifts can range from 1-20%.
Deep Plane Facelift Side Effects
A technique is only as good as the surgeon who uses it. Deep plane facelifts have an excellent track record of safety, in the right hands. Side effects which are possible with any facelift include but not limited to the following:
- Motor Nerve Damage- Should be an exceedingly rare complication after any type of facelift. Knowledge of facial anatomy is critical here. (Attached is an article making the deep plane facelift a safer procedure).
- Sensory Nerve Damage- Again, exceedingly rare in the right hands. Almost all patients will have some early sensation lost, however it should return in every patient by 6 months to a year.
- Hematoma- A collection of blood which can occur if the patient takes blood thinners, has high blood pressure. Should be less than 3% of all cases.
- Infection- Exceedingly rare with a facelift but can occur.
Nerve Damage is Rare
The Deep Plane Facelift as described by Dr. Hamra is probably utilized far less today than several years ago. However, it is important to understand that elevation under the SMAS is used in a variety of Facelift procedures. True mobilization of the SMAS via a SMAS flap puts the Surgeon in greater proximity to branches of the facial nerve. However, it is important to understand that these branches of the facial nerve lie beneath another layer of tissue (parotido-masseteric fascia) that most experienced Facelift Surgeons know how to negotiate.
I would venture to guess that the majority of Surgeon's who write about Facelift on this website have never had a facial nerve injury, including those that utilize a deep plane approach. Unless a patient has had a parotidectomy in the past, has some form of congenital ear malformation, or branchial cleft anomaly, the facial nerve is in a very predictable, deep location from the temporal bone to its peripheral course. The task of an experienced Facelift Surgeon is to address your cosmetic concerns, while avoiding potential danger areas that would compromise your facial function.
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Deep plane facelift
There are many types of facelift. Your best results will come from an expert facelift surgeon, not from any one technique.
While the deep plane facelift was popular many years ago, many surgeons have changed their technique to multivector facelifts with volume augmentation. The theory that great tightening produces great results is not necessarily true. Smart tightening with volume readjustment with hairline and sideburn sparing techniques are now more highly prized.
In our practice, the deep plane facelift still has a place in patients who have smoked and need the extra circulation that this technique inherently gives. However, we do not use it routinely because of the limitations in the ability to perform a multivector facelift.
Nerve damage is possible with any facelift technique, more with some than others, even in skilled hands (especiallly for patients with underlying disease, previous facelifts, history of Bell's palsy, etc). However a top facelift expert should have a nerve injury incidence approaching zero with whatever technique they do.
Side Effects of Deep Plane Facelift more common than other techniques
There is a good reason most facelift surgeons do not use the deep plane technique: long recovery, increased complication rate, and many other negative factors. It is however a great technique in the right hands but losing popularity because other facelift procedures also give great results with less risk and morbidity. The tingling and numbness can occur after many different types of face lifts, but prolonged swelling seems to be part of the recovery process in a deep plane technique that can last several weeks. The amount of potential complications differs with the Plastic Surgeon's experience so always pick the most qualified board certified Plastic or Facial Plastic Surgeon that specializes in face lift procedures.
No the deep plane facelift technique should not be banned as it is a good technique in the right hands.
Deep Plane facelift
It should not be banned and it isn't as far as I know. The danger in this facelift is the potential for nerve injury. However, done in experienced hands it is safe. Make sure you speak with a plastic surgeon who has done many dep plane face lifts.
Deep Plane Facelift Complications
Dear Deep Plane Facelift Patient from Temecula, CA
Deep plane facelift is more prone to nerve injuries and prolonged swelling. A board certified surgeon specializing in deep plane facelift can produce an excellent result with low complications. Good luck
Nerve injuries and deep plane facelift
The technique is only as good as the surgeon. If the surgeon is careful, the risk of nerve innjury is very low.
Deep Plane Facelift Side Effects
Face lift surgery is not one operation, but many potential operations. Good plastic surgeons tailor the facelift operation to the needs of the specific patient. Some patients are better served with a mini lift or short scar lift, while other patients would benefit from full face lifts. In addition to the depth or extent of the procedure, the cosmetic surgeon alters the face lift incision accordingly.
Deep plane face lift is one type of cosmetic surgery which is becoming less common, as plastic surgeons have enhanced facial surgery. As other surgeons have already mentioned, face lifts are now multiple vectors or directions of pull. In addition, volume augmentation with fat grafting is also used to enhance the face lift result.
Any procedure has associated risks. Speak to a face lift surgeon to determine the appropriate options for you.
Injury to facial nerve after deep plane facelift should be 0
I have been doing a modification of the deep plane or composite facelift for years. I don't believe I have ever witnessed permanent facial nerve damage. As long a the surgeon stays in the proper plane of dissection, the branches of the facial nerve will remain safe.
The composite facelift maintains excellent blood supply to the skin through the distribution network in the SMAS that remains attached to the skin. The lift allows for a great number of variations of tissue movement and placement tailored to specific needs.
I think it is an excellent way to get a good result.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.