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Extended Deep Plane Facelift and Necklift: Indications, Technique, Longevity and Risks

Recorded On: 06/27/2020

In order to better understand the rationale behind medial based deep plane facelifting and how it differs from lateral superficial muscular aponeurotic system (SMAS) facelifting (high SMAS orlow SMAS), this webinar will focus on an advanced understanding of the complex anatomy of the SMAS and soft tissues of the face primarily using surgical videos to enhance learning.  This includes anatomic description of the fixed and mobile SMAS.  Unlike lateral SMAS facelift flap procedures (high or low), the extended deep plane facelift enters the sub-SMAS plane medially at the mobile SMAS giving it a biomechanical advantages when lifting the anterior midface and jowl soft tissue ptosis.    Integral to this procedure is release of four 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 in a vertical vector to volumize the midface and gonial angle along the jawline. Important anatomic considerations during the deep plane dissection are discussed. In the midface, these include the fixed and mobile SMAS, zygomatic and masseteric cutaneous ligaments, facial fat compartments, and facial nerve. In the neck, focus is on extending the deep plane dissection of the platytsma, releasing the cervical retaining ligaments. This course will also discuss modification in platysma myotomies that improve jawline contour, and re-draping the composite deep plane flap to volumize the midface and gonial angle which atrophy with age, thus improving the cheek and jawline contour.   Data on longevity and efficacy will be presented based upon cohort studies of over 1000 patients.  The talk will also focus on mitigating the risks of deep plane surgery, new modified vectoring and creating imperceptible scars.

Andrew Jacono

MD

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Extended Deep Plane Facelift and Necklift: Indications, Technique, Longevity and Risks - Andrew Jacono, MD
Open to view video.
Open to view video. In order to better understand the rationale behind medial based deep plane facelifting and how it differs from lateral superficial muscular aponeurotic system (SMAS) facelifting (high SMAS orlow SMAS), this webinar will focus on an advanced understanding of the complex anatomy of the SMAS and soft tissues of the face primarily using surgical videos to enhance learning. This includes anatomic description of the fixed and mobile SMAS. Unlike lateral SMAS facelift flap procedures (high or low), the extended deep plane facelift enters the sub-SMAS plane medially at the mobile SMAS giving it a biomechanical advantages when lifting the anterior midface and jowl soft tissue ptosis. Integral to this procedure is release of four 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 in a vertical vector to volumize the midface and gonial angle along the jawline. Important anatomic considerations during the deep plane dissection are discussed. In the midface, these include the fixed and mobile SMAS, zygomatic and masseteric cutaneous ligaments, facial fat compartments, and facial nerve. In the neck, focus is on extending the deep plane dissection of the platytsma, releasing the cervical retaining ligaments. This course will also discuss modification in platysma myotomies that improve jawline contour, and re-draping the composite deep plane flap to volumize the midface and gonial angle which atrophy with age, thus improving the cheek and jawline contour. Data on longevity and efficacy will be presented based upon cohort studies of over 1000 patients. The talk will also focus on mitigating the risks of deep plane surgery, new modified vectoring and creating imperceptible scars.
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