Deep Plane Facelift: An Evaluation of the High-SMAS versus Standard Incision Points

Sand, Jordan P.; Amodeo, Chiara Andretto; Nabili, Vishad; Keller, Gregory S.

doi:10.1055/s-0038-1675634

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…On the contrary, photographs of less beautiful exaggerated malar augmentation abound in lay magazines and social media. Sand et al 39 reported objective intraoperative measurement of tissue movement at 3 points along the jawline in comparing deep-plane facelift with 2 different SMAS entry point suspension. Though this type of objective measurement is valuable to assess different vector lifts, its significance in determining aesthetic clinical outcome is doubtful.…”

Section: Resultsmentioning

confidence: 99%

Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery

Atiyeh

Chahine

2021

Journal of Craniofacial Surgery

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Aesthetic plastic surgery is a most unusual and unique subspecialty. Unlike other medical and surgical specialties driven primarily by objective medical diagnosis and outcome, aesthetic surgery is patient driven; it represents a special exercise in professional competence by adapting objective medical standards to a mostly subjective field. Given the subjectivity of facial beauty and of the projected aesthetic intervention outcome, in addition to be able to determine beauty of the final result as precisely and objectively as possible, it is also essential to be able to assess patient's satisfaction. However, lack of standardized facial measurements and clear definition of aesthetic outcome and beauty are still major obstacles preventing real change in the consultation dynamics to help better serve patients' expectations. Because of the tremendous increase in demand for all types of facial aesthetic procedures, an objective understanding of aesthetics and beauty is becoming of utmost importance. Recognition of the importance of science and evidence-based medicine is long overdue in our specialty. This study aims at identifying the most recently available evidence-based measures to quantitatively assess beauty and measure outcome of rhytidoplasty that can be useful in everyday aesthetic practice.

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Section: Resultsmentioning

confidence: 99%

Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery

Atiyeh

Chahine

2021

Journal of Craniofacial Surgery

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Advances in Face-Lift Surgical Techniques: 2016–2021

Wei

Duan²,

Xie³

et al. 2022

Aesth Plast Surg

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The Deep Fascia of the Infraorbital Region, Deep Plane, and Suprafibromuscular Facelift: New Anatomy for Safer Facelifting

et al. 2022

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Deep-plane rhytidectomy, first described by Skoog, has had a resurgence in popularity and is in high demand today. We describe anatomical findings that establish the presence of a true deep fascia in the midface, we named as Chiara's fascia, like the first author's first name, which helps to form the facial ligaments and is contiguous with the superficial layer of the deep temporal fascia. This fascia inserts on the periosteum of the inferior orbital rim at the arcus marginalis and separates the suborbicularis oculi fat (SOOF) from the preperiosteal fat. This distinct fascial layer lies under the superficial fascia or superficial musculoaponeurotic system (SMAS) and represents the floor of what is commonly termed the “deep plane.” When this fascial highway is identified intraoperatively, blunt dissection immediately superficial to this layer will protect facial nerve branches overlying the muscles lifting the upper lip such as the zygomaticus. Subsequent dissection over the middle and lower face can usually be performed bluntly. Over a 10-year period, a total of 100 hemifaces were dissected with a 100% success rate of identifying this fascia in all specimens. This work was further validated by examining histologic specimens that clearly demonstrate this unique fibrofatty fascial layer. These dissections and new anatomical findings were then correlated to over 300 intraoperative deep-plane facelift cases by the primary and senior authors. We term this operative technique as the suprafibromuscular facelift. Dissection in this plane allows for safe release of facial retaining ligaments with protection of facial nerve branches.

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Deep Plane Facelift: An Evaluation of the High-SMAS versus Standard Incision Points

Cited by 4 publications

References 15 publications

Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery

Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery

Advances in Face-Lift Surgical Techniques: 2016–2021

The Deep Fascia of the Infraorbital Region, Deep Plane, and Suprafibromuscular Facelift: New Anatomy for Safer Facelifting

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