Description

51 year-old female presenting today in consultation for cosmetic aging face concerns. Patient expresses concerns regarding forehead rhytids, crow’s feet, marionette lines, facial rhytids, jowling, neck laxity

Operation: Deep Plane Facelift and Deep Necklift

The SMAS was sharply incised and a subSMAS plane was developed. The zygomaticus major muscle was identified and care was taken to only dissect superficial to the muscle to protect branches of the facial nerve. The SMAS flap was further elevated medially and inferiorly to include the platysma. The flap was incised horizontally, parallel to the body of the mandible to allow for more mobility. Fat over the sternocleidomastoid was then excised to reduce bulk. The inferior portion of the SMAS flap was advanced posteriorly and secured to the mastoid periosteum with 3-0 PDS. Cervicocutaneous retaining ligament was also released and then secured posteriorly with 3-0 PDS. This created a well defined jawline. Fat was advanced along with this flap to allow for gonion augmentation. The superior portion of the flap was advanced superiorly and secured to the pre-auricular SMAS and fascia with 3-0 PDS. The area was inspected for any bleeding and careful hemostasis obtained. Excess skin was then carefully trimmed to ensure there was no tension on the final closure.