How common is permanent nerve damage with SMAS/deep plane facelift?

Question

I'm planning on having a deep plane face lift and want to know how common/uncommon permanent nerve damage is with this procedure. I believe I have an excellent facial plastic surgeon, but reading about the biggest dangers of this surgery and feel I must ask the question. How do the surgeons know where that nerve is exactly so that they don't cut or injure that important nerve? Can they see it?

William Portuese, MD · Answer

In our practice, we have never had a permanent facial nerve paralysis from a facelift procedure in over 25 years.  There are many different variations  in facelifting techniques.  In our practice, we perform a high-SMAS lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing any fatty deposits in the neck including a platysma plasty.  For more information and many before and after examples, please see the link and the video below

Michael R. Whetstone, MD (retired) · Answer

Those are great questions. First, I recommend consulting with several different Board Certified plastic surgeons that do a large volume of facial procedures. Find someone you feel comfortable with. In answer to your question of how we know where the nerves are, anatomy tells us and we can see them. In my practice in over 30 years, I have never had a patient suffer permanent nerve damage. I do SMAS procedures with excellent results. Best wishes to you!

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type SMAS facelifts.  There are many ways to perform SMAS facelifts and "deep plane" variations are more invasive with means added possibility of unwanted side effects, including nerve injury.  Overall, in the hands of an experienced Facelift Surgeon, nerve injury should be very uncommon.  Additionally the increased tissue dissection associated with more aggressive facelifts adds recovery time due to more swelling and bruising.  For these reasons, the minimally invasive SMAS facelift has become my most popular SMAS facelift.  
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 "Jowls” are sagging facial tissues and the primary indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 The minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 In my experience, no facelift technique alone can properly shape all of the "key" aesthetic facial features.  For this reason, I always aesthetically shape the face when performing facelifts in order to make the face more naturally attractive.  The facelift is designed to lift the sagging SMAS muscle layer (and jowls) as well as remove excess skin from the face and neck.  Other procedures must be applied to properly shape the cheeks, chin, lips, chin and jaw line as needed.  Hope this helps.

How common is permanent nerve damage with SMAS/deep plane facelift?

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How common is permanent nerve damage with SMAS/deep plane facelift?

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Everything you need to know about SMAS Facelift

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