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CC BY-NC-ND 4.0 · Facial Plast Surg
DOI: 10.1055/a-2204-8798
Original Article

Endoscopic, “Scarless” Composite Flap Face and Neck Lift

Marc Mani
1   Private Practice, Aesthetic Plastic Surgery, Beverly Hills, California
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Abstract

Deep-plane or composite flap facelift techniques allow deep structural rejuvenation of the face by release of retaining ligaments in the subsuperficial musculoaponeurotic system (sub-SMAS) plane with elevation and fixation of the SMAS/platysma/skin flap as a single, “en bloc” unit. This means that in the cases with mild to moderate skin laxity, the preauricular incision serves the purpose of access only. The author therefore developed an endoscopic-assisted, en bloc composite flap face and neck lift without a preauricular incision. The technique uses the prezygomatic and premasseteric (facial) and subplatysmal (neck) spaces as ideal optical cavities for endoscopic dissection and ligament release. Verticalization of fixation vectors and modified concho-mastoid traction sutures are used to minimize preauricular skin redundancy. The surgical procedure is described in detail. Clinical experience in 41 consecutive cases and comparison to other techniques with respect to relevant anatomy are also presented. This endoscopic en bloc composite flap facelift technique consistently and safely produced results comparable to conventional, “open” composite flap facelifts done by the same surgeon on similar candidates during a prior period.

Keywords

deep plane - composite flap - facelift - endoscopic facelift

Patient Consent

Patients provided written informed consent for the use of their images.


Previous Presentations

International Society of Aesthetic Plastic Surgeons (ISAPS) World Congress, Vienna, Austria, September 2021; ISAPS World Congress, Istanbul, Turkey, August 2022; American Association of Facial Plastic and Reconstructive Surgery (AAFPRS) Rhinoplasty and Facial Rejuvenation Meeting, San Diego, California, United States, April 2023; and AAFPRS Annual Meeting, Las Vegas, Nevada, United States, October 2023.




Publication History

Accepted Manuscript online:
06 November 2023

Article published online:
13 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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