Endoscopic facelift of the frontal and temporal areas in multiple planes.

INTRODUCTION The detachment planes used in endoscopic facelifts play an important role in determining the results of facial rejuvenation. In this study, we introduced the use of multiple detachment planes for endoscopic facelifts of the frontal and temporal areas, and examined its outcome. METHODS This study included 47 patients (38 female, 9 male) who requested frontal and temporal facelifts from January 2009 to January 2014. The technique of dissection in multiple planes was used for all 47 patients. In this technique, the frontal dissection was first carried out in the subgaleal plane, before being changed to the subperiosteal plane about 2 cm above the eyebrow line. Temporal dissection was carried out in both the subcutaneous and subgaleal planes. After detachment, frontal and temporal fixations were achieved using nonabsorbable sutures, and the incisions were closed. During follow-up (ranging from 6-24 months after surgery), the patients were shown their pre- and postoperative images, and asked to rate their satisfaction with the procedure. Complications encountered were documented. RESULTS All 47 patients had complete recovery without any serious complications. The patient satisfaction rate was 93.6%. Minor complications included dimpling at the suture site, asymmetry, overcorrection, transitory paralysis, late oedema, haematoma, infection, scarring and hair loss. These complications resolved spontaneously and were negligible after complete recovery. CONCLUSION Dissection in multiple planes is valuable in frontal and temporal endoscopic facelifts. It may be worthwhile to introduce the use of this technique in frontal and temporal facelifts, as it may lead to improved outcomes.