Deep plane rhytidectomy and variations.

The extreme interest in developing new surgical approaches to rhytidectomy and to refining those techniques over the last two decades has resulted in considerable improvement in surgical results. This has taken the form of a more natural and youthful restoration of the face by together lifting forehead, midface, and lower face. This approach produces a more harmonious balance of the upper and lower portions of the face than was possible before the introduction of mid-facelifting techniques. Added to this has been the emphasis by some surgeons of restoring tissue volume to the face by using autogenous fat injections. One can conclude that the most favorable results in facelifting occur when the lower cheek is rejuvenated by dissecting beneath the superficial musculoaponeurotic system to create an advancement flap together with the lifting of the cheek fat of the midface posterosuperior.