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Deep Plane Facelift Guide

This document provides the steps for performing a deep plane facelift. It begins with positioning the patient and administering anesthesia. It then describes making incisions in specific areas to create skin flaps and elevate tissue planes. Key steps include dissecting in the sub-SMAS plane to release ligaments and resuspend the SMAS and platysma muscles. Skin is excised and closed with sutures, and a drain is placed, completing the procedure.

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372 views2 pages

Deep Plane Facelift Guide

This document provides the steps for performing a deep plane facelift. It begins with positioning the patient and administering anesthesia. It then describes making incisions in specific areas to create skin flaps and elevate tissue planes. Key steps include dissecting in the sub-SMAS plane to release ligaments and resuspend the SMAS and platysma muscles. Skin is excised and closed with sutures, and a drain is placed, completing the procedure.

Uploaded by

Chaoja
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Deep Plane Facelift

Positioning
 Supine with knees bent
 Normotensive anesthesia
 Donut pillow
 Shoulder roll
 GETA
 2g Ancef

1. Infiltrate subcutaneous tissue with tumescence. Saline and epi.


2. Start incision post-auricularly (most dependent) and raise sub-cutaneous plane with
scalpel. Place lights so it helps transluminate skin (one behind right shoulder and one
directly through skin flap). Leave some fat on skin but make sure above platysma. Switch
to facelift scissors anteriorly. Stop at anterior border of SCM.
3. At hairline incision, bevel away from hair follicles. Carry anterior incision around ear to
connect posteriorly. Use knife to create sub-cutaneous plane. Use double skin hooks
and light illumination. Can transition to bent malleable. Stop at deep plane line
(between malar eminence and angle of mandible). Hemostasis with bipolar.
4. Mark zygomatic arch and deep plane on SMAS with marker.
5. Enter platysma over SCM with knife and two double skin hooks. Use scissors to create
platysma flap.
6. Incise deep plane with knife to sub-SMAS plane. Dissect bluntly to connect with sub-
platysmal plane. Cut ligaments with facelift scissors. Carry deep plane dissection to mid-
pupil line. Visualize zygomaticus major. Use facelift claw for retraction.
7. Resuspend SMAS first in vertical vector using 2-0 vicryl to zygomatic arch in front of
tragus (deep bite of periosteum) as a key stitch. Bury knot. Suspend superior SMAS flap
down with 3-0 vicryl to contour face.
8. Cut platysmal tongue below lobule to advance platysma posteriorly. Resuspend
platysma with 2-0 vicryl for key-stitch. Rest with 3-0 vicryl over SCM.
9. Mark skin excision with only tension at root of helix by grabbing with forceps.
10. Place taking suture at point of tension with 2-0 prolene at root of helix and post-
auricular angle.
11. Place JP drain through post-auricular incision
12. Close skin with running segments of 5-0 prolene.

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