What are the risks of current deep plane facelift techniques ?

Every type of face surgery carry some risks. There is always a risk of injury to one of the branches of the facial nerve as there is with a SMAS implication facelift.

Deep plane, SMAS or extended SMAS or High SMAS or even Foundation Face lift  or mini face lift, there is always a risk of injury to one of the branches of the facial nerve

The important issue is what you need. And second in which technique is your surgeon will feel better. 

That is why I think choosing the surgeon you can trust and  whose decision you can rely on, should be prior to choosing surgical method. 

Best 

As with any surgery there are risks. There is always a risk of injury to one of the branches of the facial nerve as there is with a SMAS implication facelift. As a very experienced facial plastic surgeon with almost 25 years of doing facelift surgery, I personally prefer the deep plane technique for patients who have heavy jowls and/or a heavy neck. The surgery takes a little longer and is technically more demanding but I believe I am able to achieve better long term results and a better lift. I hope this answers your question and as always you should seek consultation with someone who specializes in facial rejuvenation surgery and is experienced.

The deep plane is the same as a SMAS facelift but the skin flap and the SMAS flaps are raised as one flap.  So the plane of dissection is the same in both, only that in a typical SMAS flap lift the  skin flap is elevated separately from the SMAS flap.  As long as your surgeon is experienced with the anatomy, this should be safe.  It is commonly indicated in smokers in order not to create a very thin skin flap that can have difficulty healing.   Best wishes, Dr. T.

Dear milliemills9Thank you for your question!  The Deep plane face lift and the SMAS facelift both have more risk of nerve injury than a SMAS plication.  That being said- it is a good technique - and as with all procedures and aesthetics, there is variation in results with surgeons.With Warm RegardsTrevor M Born MD

The deep plane technique is an effective method of repositioning the soft tissues of the face. It is particularly useful at improving the midface region in addition to the lower face and neck. It is considered a more invasive or aggressive approach due to the deeper layer of dissection, however, in experienced hands the risks are no greater than other methods, and often the results are more natural and longer lasting.

The deep plane facelift is an excellent way to release and mobilize the deep retaining structures of the face and reposition them to a more youthful appearance.  Doctors use this technique to lift a "composite flap" of skin, muscle and soft tissue as one layer.  There is only minimal skin undermining (only to the deep plane entry point).  The SMAS layer is actually still dissected out and that is the tissue layer that is resuspended for the facelift.  While it is very common to see the facial nerve branches as they exit the anterior parotid gland, an experienced facial plastic surgeon who utilizes this technique should know and understand the anatomy.  A lot of research has been done on this topic and the results have shown that there is no higher risk of nerve injury with a deep plane technique that with standard lateral SMAS methods.  I would talk to a board certified facial plastic surgeon for a consult in order to completely understand the techniques that he/she will be used and the risks to the procedure.

i prefer the SMAS technique. I feel that I have more control of movement of the soft tissues and then redraping the skin separately.

There are different levels or planes of dissection.  Briefly, they include, a skin lift (subcutaneous), sub-muscular (deep plane/SMAS) and on the bone (subperiosteal).  A surgeon may choose one of these or any combination to achieve the results you desire.  Since our nerves come from deep to superficial, the deeper routes may have increased risks.  The next consideration would be the extent or distance of the dissection from the ear.  As one dissects more medially, towards the nose and lips the risks of nerve injury increase in a deeper plane of dissection.  The experience and training of your doctor are important.  Most doctors do a limited form of deep plane dissection and most will agree this allows for the best support and re-draping of the skin, Also, the deep plane allows for less tension on your skin closure, improving your chances for a better appearing scar.  So, while there may be increased risks of nerve injury, the results may be more natural and longer lasting.  I hope this helps.

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. Following the beauty principles outlined in my book on face and body beauty, 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.If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. If you have "jowls” these are sagging facial tissues and an 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.My most popular facelift is the minimally invasive, short incision SMAS 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 incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.In my opinion the risk of skin injury, nerve injury, infection, prolonged bruising and prolonged swelling (lasting months) are all exponentially greater with any of the more invasive type facelifts. The deep plane facelifts also has the aesthetic issue of raising the outer corners of the eyebrows and mouth that can give the face a "joker" look.  Additionally based on the direction of the tissue elevation, the deep plane facelift can create cheeks that are wide and broad, towards the outside, which is not a feminine cheek shape or feature. For these reasons, I have never liked the deep plane facelift technique.Hope this helps.

I do believe the risk of facial nerve injury is greater using the deep plane technique. In addition in some cases the procedure can create an unusual pull on the mouth. In my opinion the SMAS plication technique is safer and produces equally good results.