On a Deep Plane Facelift...is Facial Nerve Injury Risk Very High?

Doctor Answers 27

Facial nerve injury with a face lift

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Every face lift technique has a chance of facial nerve injury although very small. A deep plane facelift has dissection in the plane that the facial nerve traverses. This gives it a slightly higher chance of having facial nerve injury (still very small).

The more important factor is not so much the technique that is used but the overall skill and experience of the surgeon. Do your research and go to a reputable and board certified surgeon.




El Paso Plastic Surgeon

On a Deep Plane Facelift...is Facial Nerve Injury Risk Very High?

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Hi Lacey,

Deep Plane facelifts, if performed properly, do expose the facial nerve branches more so than say a short flap SMAS lift. However, the risk of nerve injury lies more with the skill and experience of the surgeon. Overall, the risk of nerve injury is less than 1%.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Deep Plane Facelift and the Facial Nerve

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The facial nerve provides motion to the muscles of the face and some in the neck as well. Since the facial nerve runs in the region of any facelift surgery, injury is possible. Fortunately, the risk of injury is lower the 1% and any injury is usually temporary.  Risk is similar for deep plane facelift surgery and also very unlikely to have any permanent injury.

At the end of the day, the person performing your surgery is more important then the technique used. It is important that you choose a skilled facelift surgeon who performs deep plane facelifts often (every week).  Most surgeons that perform a Deep Plane Facelift surgery have significant experience performing surgery of the face, which minimizes the chance of risk.  During your consultation ask your surgeon how often they perform facelifts and ask them if they have ever had a facial nerve injury.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 71 reviews

Deep plane lift and nerve injury

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In experienced hands the deep plane face lift is quite safe and has very risk of nerve injury.  if a nerve injury occurs, it is almost always temporary.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Minimal risk of facial nerve injury in deep plane facelift

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The risk of facial nerve injury is low with practically all facelift techniques, with most reports stating this to be less than 1%.  The risk of facial nerve injury is more surgeon-dependant than it is technique-dependant.  That said, it would seem more likely in theory that techniques that expose more of the facial nerve branches also put the nerve branches at greater risk.  A perhaps more valid criticism of the deep plane facelift is the prolonged swelling that is often associated with this technique.

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

The facial nerve is a risk during facelift, approximately 1% at risk.

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Whether it is a deep plane or a superficial plane facelift, the risk of injury to the facial nerve is directly related to the skill and experience of the surgeon who performs the surgery.  Do your homework and select an experienced board-certified plastic surgeon.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Risk of Facial Nerve Injury in Deep Plane Facelift

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There is a slight increased risk of facial nerve injury with a deep plane facelift, but this is very rare. There are advantages to this technique, such as less post-op bruising and longer lasting results, in some patients when done by an experienced surgeon. The surgery should be individualized to meet the needs of each patient.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Face lift technique and nerve injury

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It is highly unlikely that the facial nerve will get injured in a deep plane facelift, provided that the surgeon has skills, talent and lots of experience.  Since the deep plane dissection exposes the nerves, at least in theory the chance of injury is higher, but practically speaking this rarely happens.  Much more important it the selection of appropriate technique for each unique face.  In my practice, I custom tailor facial procedure based on the patients individual anatomy and aging.  This could include deep plane dissection, short scar with plication, etc. Make sure your surgeon discusses with you his plan for you and explains to you why he/she chose this technique in your case. 

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

Deep plane facelift and nerve injury

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in unexperienced hands - yes.  fortunatley most people who do not have sufficient expereince with this technique offer a different type of face lift.  many plastic surgeons now are getting extra training in these advanced techniques in cosmetic surgery fellowships.  get to know your surgeon and his/her expreince.  generally abps certified plastic surgoens are going to be honest with you and theirselves and not offer you something beyond their skill level.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 62 reviews

Deep Place Facelift and the Facial Nerve

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You can tell who does this lift and who doesn't.  Each facelift is individualized.  I have found that the deep plane facelift allows the SMAS to be rotated and elevated more so than any of the superficial techniques.  It's the only technique that really fully addresses severe jowling.  During the procedure the facial nerve is easily visualized lying in a beautiful plane starting initially between the two lobes of the parotid gland and extending below the SMAS. It's an easy plane of dissection as you can see the nerve branch the entire time.  Can the nerve be injured?  Yes, but it is extremely rare and if it does the injury usually involves the buccal branch.  Facial muscle weakness is very limited and return to normal function is relatively fast if it does occur.

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.