Deep plane incision - what is the best option? (Photo)

Thank you for your question.

Incision through the mouth is not a standard part of the deep plane facelift but can be used for the following reasons:

- Reduction of the buccal fat to help with contouring the face and possibly to use the associated fatty tissue for enhancement of the volume of the cheekbone area

- A mid-face lift intervention incorporated with the deep plane technique to produce a stronger impact on the elevation of the facial soft tissues. This has been used also in association with other types of facelift procedures and is not specific to the deep plane.

If your surgeon referred primarily to releasing ligaments through the access inside the mouth, it suggests that they like to use a combination treatment to enhance the impact of their surgery or indeed that for your specific facial configuration they felt that it is advantageous.

It is better to discuss this aspect with your surgeon to get clarity on their treatment before you decide which avenue you prefer to pursue.

Incisions for a deep plane facelift are not made in the mouth. Such incisions are made for an endoscopic subperiosteal mid-face lift, which is almost never necessary when a correctly performed deep plane facelift is performed. A deep plane facelift allows for release, elevation, and repositioning of the mid-face and doesn't require a 2nd procedure to do the same thing.

thank you for posting your question. It is true, that different ligaments of the face play an important role during facelift surgery. Depending on the facelift technique, some of them can be kept, and some of them need to be released to obtain mobility. The same is very true for a deep plane facelift. An additional intraoral approach is unusual. The probably best idea is, to clarify this question with your consulting surgeon. I hope this helps somewhat

There are many variations of facelifts. In my experience releasing any ligaments from inside the mouth will do absolutely no good and it is unnecessary to get a good result

Hello, hope you are well. A standard deep plane approach does not include intraoral incisions--you would have to ask the surgeon who made that recommendation to provide an explanation. There are subperiosteal midface lifts that utilize that approach, but they are very different from a deep plane facelift.
Best,Dr. Tower

There are major and minor ligaments that need to be released to allow a mostly tension free deep plane lift that will last and have minimal scarring. Those ligaments are demonstrated in the attached link to illustrations we have created. Basically the major ones are the zygomatic cutaneous and the mandibular ligaments. We would usually release those from the facelift incision or sometimes the mandibular from an incision beneath the chin. The minor ligaments can be easily released through the facelift incision. We remove buccal fat from inside the mouth but I am unaware of any such incision that could safely and effectively release them. You could release them from where they attach to the periosteum (bone) but there would still be an attachment through the soft tissues of the face. I think the illustrations from our artist will help you understand better.

I think the ligaments the other doctors mention as to be released from an oral incision are the mandibular ligaments. They are normally released through the submittal incision that is also used for midline neck rejuvenation. I do not use any cuts through the mouth.

An intra oral incision for a facelift is not necessary. Facelift incisions are typically placed both in front and behind the ears. There are many different types of facelift procedures, so it's difficult for the consumer to understand the minute variabilities. Study your perspective surgeon's before and after facelift photo gallery to make sure that it is extensive with results that you like, and the results look natural.