From the Research
Facial nerve injury is a potential complication of deep plane facelift surgery, occurring in approximately 0.5-3% of cases, and the risk can be minimized with a thorough understanding of facial anatomy and careful execution of surgical steps 1. The deep plane technique, while offering superior aesthetic results, carries a slightly higher risk of nerve injury because dissection occurs closer to facial nerve branches, particularly the marginal mandibular and temporal branches which control lower lip and forehead movement respectively. Some key points to consider when evaluating the risks of facial nerve injury during a deep plane facelift procedure include:
- The importance of preserving the facial nerve during surgery, which can be achieved by identifying and protecting the nerve branches, particularly in areas where they are more superficial in the dissection plane 2.
- The use of techniques such as blunt dissection and careful release of facial retaining ligaments to minimize the risk of nerve injury 3.
- The potential for temporary neuropraxia (nerve bruising) or more severe injuries like nerve transection, and the need for prompt treatment and management to optimize outcomes 4.
- The role of oral corticosteroids, eye protection, and physical therapy in managing facial nerve injuries and promoting recovery 4, 1. It is essential to weigh the potential benefits of the deep plane technique against the risks of facial nerve injury and to take steps to minimize these risks, including careful patient selection, thorough preoperative evaluation, and meticulous surgical technique 5. In cases where facial nerve injury is suspected, immediate consultation with the operating surgeon is essential, and treatment should be tailored to the type and severity of the injury, with a focus on minimizing morbidity, mortality, and optimizing quality of life 4, 1.