Superior Vector Plication of the Mobile Anterior Midface: The Delta Facelift
James C Grotting, Maryam Saheb-Al-Zamani, Susie Rhee- General Medicine
- Surgery
Abstract
Background
Traditional plication techniques have been ineffective in addressing the anterior midface compared to sub-superficial musculoaponeurotic system (SMAS) “deep plane” approaches. However, by moving the plication much closer to the mobile medial fat tissues, a more effective and long-lasting plication can be accomplished without releasing the SMAS layer.
Objectives
The authors’ “Delta Facelift” approach combines a rotation- vertical advancement of the midface fat with with a dual-vector platysmaplasty and deep cervicoplasty as indicated for a harmoniously youthful neck.
Methods
A retrospective chart review was performed on all patients who underwent facial rejuvenation with the Delta facelift technique between January 1, 2012 to May 30, 2021 for patient demographics, procedure details, outcomes, and complications.
Results
A total of 283 patients underwent Delta facelifting (273 females, 10 males). The average age was 60.8 years old. Primary facelift was performed in 229 patients, while 54 facelifts were secondary or more. Adjunctive procedures included autologous fat grafting (93%), blepharoplasty (52%), and skin rejuvenating procedures (35%). There were 11 self-resolving neuropraxias, 6 minor hematomas, and 6 infections. Nine patients underwent repeat Delta facelift at an average of 9.3 years.
Conclusions
The Delta rotation vertical advancement of the anterior facial fat counters the descent and deflation associated with facial aging. Dual-vector platysmaplasty, with or without myotomy, effectively manages the jowl and delineates the jawline. Addition of deep cervicoplasty is recommended for patients with oblique necks or those with subplatysmal volume excess.