Extended Deep Plane Facelift: Incorporating Facial Retaining Ligament Release and Composite Flap Shifts to Maximize Midface, Jawline and Neck Rejuvenation

Abstract

This article describes our extended, deep plane facelift technique. This procedure releases 4 key retaining ligaments in the face and neck, the zygomatic cutaneous, masseteric cutaneous, mandibular cutaneous, and cervical retaining ligaments. Once released, the composite deep plane flap is repositioned to volumize the midface and gonial angle. Important anatomic considerations during deep plane dissection are discussed. In the neck, focus is on extending the deep plane dissection of the platysma, releasing the cervical retaining ligaments, creating a platysmal hammock to support the submandibular gland, defining the inferior mandibular contour, and minimizing the need to open the neck.

Keywords: Deep plane facelift; Face lift; Facial retaining ligaments; Neck lift; Platysma; Rhytidectomy; SMAS.