The Evolution of My Extended SMAS-Biplanar Deep Plane Facelift to a Composite Tissue Deep Plane Face and Neck Lift: Similarities and Differences

Abstract

In this article, Dr. Stephen W. Perkins, a seasoned facial plastic surgeon, presents his refined techniques in facelift surgery developed over four decades of practice. His evolution from traditional methods to the current composite tissue deep plane facelift is elucidated. His composite tissue deep plane facelift involves meticulous dissection and repositioning of the superficial musculoaponeurotic system (SMAS) and platysma in the deep plane, as well as incorporating his innovative “Perkins' Kelly clamp anterior platysmaplasty.” This technique, refined through years of experience, aims for natural, enduring results, crucially addressing patient concerns such as jowling and neck laxity. Long-term analysis reveals the advantages of Dr. Perkins' technique, particularly in achieving sustained cervicomental angle improvement for over a decade postoperatively. This article underscores the importance of understanding deep plane facelift techniques, distinguishing between different approaches, and tailoring surgical interventions to individual patient characteristics. Dr. Perkins' comprehensive approach, incorporating advancements in surgical technique and meticulous patient care protocols, exemplifies the goal of achieving natural, long-lasting facial rejuvenation.

Keywords

facelift - deep plane - rhytidectomy - SMAS - neck lift

Publikationsverlauf

Accepted Manuscript online:
24. April 2024

Artikel online veröffentlicht:
03. Juni 2024

• References

• 1 Albucker SJ, Lipner SR. “Weekend facelifts” gone wrong: retrospective analysis of the MAUDE database on thread-lifting complications from 2003-2023. J Cutan Med Surg 2023; 27 (06) 647-648
• 2 Van Pham T, Truong KHTN. Short or minimum incision deep plane/extended deep plane facelift/rhytidectomy. Facial Plast Surg 2020; 36 (04) 376-385
• 3 McCollough EG, Perkins SW, Langsdon PR. SASMAS suspension rhytidectomy. Rationale and long-term experience. Arch Otolaryngol Head Neck Surg 1989; 115 (02) 228-234
• 4 Hu S, Perkins SW. The extended superficial musculoaponeurotic system deep plane facelift. Facial Plast Surg 2022; 38 (06) 575-583
• 5 Baker SR. Deep plane rhytidectomy and variations. Facial Plast Surg Clin North Am 2009; 17 (04) 557-573 , vi
• 6 Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 1976; 58 (01) 80-88
• 7 Skoog TG. Plastic surgery: the aging face. In: Skoog TG. ed. Plastic Surgery: New Methods and Refinements. Philadelphia, PA: W.B. Saunders; 1974: 300-330
• 8 Kamer FM, Mingrone MD. Deep plane rhytidectomy: a personal evolution. Facial Plast Surg Clin North Am 2005; 13 (01) 115-126
• 9 Adamson PA, Litner JA. Evolution of rhytidectomy techniques. Facial Plast Surg Clin North Am 2005; 13 (03) 383-391
• 10 Jacono AA. A novel volumizing extended deep-plane facelift: using composite flap shifts to volumize the midface and jawline. Facial Plast Surg Clin North Am 2020; 28 (03) 331-368
• 11 Feldman JJ. Neck lift my way: an update. Plast Reconstr Surg 2014; 134 (06) 1173-1183
• 12 Marten T, Elyassnia D. High SMAS facelift: combined single flap lifting of the midface, cheek, and jawline. Facial Plast Surg 2022; 38 (06) 593-612
• 13 Marten TJ. High SMAS facelift: combined single flap lifting of the jawline, cheek, and midface. Clin Plast Surg 2008; 35 (04) 569-603 , vi–vii
• 14 Perkins SW. Book review: “The Art and Science of Extended Deep Plane Facelifting.” by Andrew Jacono MD. Fac Plast Surg Aesthet Med 2021 (e-pub ahead of print).
• 15 Tonnard P, Verpaele A. The MACS-lift short scar rhytidectomy. Aesthet Surg J 2007; 27 (02) 188-198
• 16 Jacono AA, Bryant LM, Alemi AS. Optimal facelift vector and its relation to zygomaticus major orientation. Aesthet Surg J 2020; 40 (04) 351-356
• 17 Jacono AA, Alemi AS, Harmon JJ, Ahmedli N. The effect of a novel platysma hammock flap during extended deep plane facelift on the signs of aging in the neck. Aesthet Surg J 2022; 42 (08) 845-857
• 18 Brobst R, Sufyan A, Perkins SW. Kelly clamp technique for submental platysmaplasty: evaluation of long-term outcomes. Paper presented at: American Academy of Facial Plastic and Reconstructive Surgery Fall Meeting,. September 5–8, 2013; Washington, DC
• 19 Caniglia RJ, Pollei TR. Evaluation of fibrin sealant and postoperative hematoma/seroma rates in rhytidectomy. Paper presented at: American Academy of Facial Plastic and Reconstructive Surgery Fall Meeting, October 19–21, 2013 ; New Orleans, LA
• 20 Kamer FM, Markarian A. Deep-plane technique. Arch Facial Plast Surg 2006; 8 (03) 193-194