What it means for a patient
- A deep-plane facelift lifts the skin, cheek fat and platysma together as one layer instead of separating the skin from the deeper tissue.
- The method was designed to improve the fold from the nose to the mouth corner, an area earlier facelifts did not improve much.
- The dissection extends up over the cheek muscles and in past the nasolabial fold, releasing all SMAS attachments. Ask your surgeon how often they perform this technique.
- Results come from the author's own series. The abstract gives no complication rates or long-term data.
Why this paper matters
It described the deep-plane rhytidectomy, a facelift that releases the SMAS beyond the nasolabial fold to lift a thick composite flap. It targeted the nasolabial fold, a known weak point of earlier facelifts.
Overview
Facelifts had often failed to improve deep nasolabial folds. The author describes the deep-plane rhytidectomy, designed to treat laxity of these folds. The paper sets out the face and neck dissection step by step and reports the author's case count.
Findings
- Aim: treat laxity of the nasolabial folds, which earlier facelifts improved little.
- A Skoog-type dissection under the SMAS is extended upward over the zygomaticus muscles and inward beyond the nasolabial folds.
- All SMAS attachments are released.
- The result is a thick musculocutaneous flap of skin, all the subcutaneous fat of the cheeks, and the platysma muscle.
- 403 patients operated with minimal complications.
- The author shows "dramatic" improvement of the nasolabial folds after surgery.
- Step-by-step face and neck dissection is described.
- The abstract gives no complication rates or measured outcomes.
Terms
- Deep-plane rhytidectomy: a facelift done beneath the SMAS that lifts skin, fat and SMAS together.
- Nasolabial fold: the crease running from the side of the nose to the corner of the mouth.
- SMAS: the layer of muscle and fibrous tissue under the facial skin and fat.
- Sub-SMAS dissection: surgery in the layer beneath the SMAS.
- Zygomaticus muscles: cheek muscles that lift the corner of the mouth when smiling.
- Musculocutaneous flap: a flap that contains both muscle and skin.
- Laxity: looseness of skin or tissue.