Systematic Approach to Deep Plane Facelift.

The senior author has developed a systematic approach to performing Deep Plane Facelift, which allows the procedure to be performed in a safe, efficient and reproducible fashion. This approach evolved over many years of facial rejuvenation surgery practice. The senior author was introduced to Deep Plane Facelift in Dr. Sam Hamra's operating room over 20 years ago. The technique has three distinct dissection steps, and a unique suture fixation method. This method allows for performing Deep Plane Facelift in an efficient and safe fashion. This technique has some novel elements: strict compartmentalized dissection sequence; lateral orbicularis muscle is incorporated into the composite cheek flap; treat the mobilized composite cheek and neck flap as a "monobloc"; the cheek suspension starts at the superior most aspect of the composite cheek flap; the cheek flap is advanced in a more superior vector than traditionally described; the cheek flap is held in pre-determined position with a hook, under moderate tension during suture fixation. The manipulation of the neck is beyond the scope of this article; it can be done by any of the described methods, as indicated by the patient's individual anatomy. Having received positive reports from visiting surgeons that have learned this technique from the senior author, we hope that others will find this technique beneficial. We will present a few representative long-term results. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .