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Tunneled Deep-plane Lift: A Novel Approach to Lower Facial and Neck Laxity

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Plastic and Reconstructive Surgery Global OpenLast synced 9/11/2026Status: syncedPMID: 42719910 pmidDOI: 10.1097/GOX.0000000000007987

Background: Facial and neck lift procedures are gaining relevance worldwide, as patients have an increasing interest in maintaining a youthful appearance and reversing facial aging changes; this has led to the development of the tunneled deep-plane lift (TDL), a surgical intervention that corrects laxity of the lower third of the face and the neck. Methods: A retrospective study of the TDL technique was conducted among patients in Colombia with a follow-up of 1 year. To assess the aesthetic and morphological changes, we compared the facial and neck laxity scale results before and after surgery; we also measured the excess skin after the suspension of the superficial muscular aponeurotic system and platysma; procedure satisfaction was evaluated through FACE-Q scale results. Results: Among 93 patients, the average age was 52.9 years. Preoperatively, patients had facial laxity of grade 4 (52.68%) and grade 3 (32.25%), and neck laxity of grade 2 (50.53%) and grade 3 (38.70%); after the procedure, patients’ facial and neck laxity improved to grade 1 in most cases (80%). Conclusions: TDL is a technique that corrects laxity of the lower third of the face and the neck. This approach manipulates deep facial tissues using the deep-plane technique and involves plication of the superficial muscular aponeurotic system and platysma, providing immediate and noticeable results that are sustained for up to 1 year. The technique is suitable for patients aged 30–50 years, and the adjunctive use

Abstract

Background: Facial and neck lift procedures are gaining relevance worldwide, as patients have an increasing interest in maintaining a youthful appearance and reversing facial aging changes; this has led to the development of the tunneled deep-plane lift (TDL), a surgical intervention that corrects laxity of the lower third of the face and the neck. Methods: A retrospective study of the TDL technique was conducted among patients in Colombia with a follow-up of 1 year. To assess the aesthetic and morphological changes, we compared the facial and neck laxity scale results before and after surgery; we also measured the excess skin after the suspension of the superficial muscular aponeurotic system and platysma; procedure satisfaction was evaluated through FACE-Q scale results. Results: Among 93 patients, the average age was 52.9 years. Preoperatively, patients had facial laxity of grade 4 (52.68%) and grade 3 (32.25%), and neck laxity of grade 2 (50.53%) and grade 3 (38.70%); after the procedure, patients’ facial and neck laxity improved to grade 1 in most cases (80%). Conclusions: TDL is a technique that corrects laxity of the lower third of the face and the neck. This approach manipulates deep facial tissues using the deep-plane technique and involves plication of the superficial muscular aponeurotic system and platysma, providing immediate and noticeable results that are sustained for up to 1 year. The technique is suitable for patients aged 30–50 years, and the adjunctive use of subdermal radiofrequency enhances results by improving laxity and signs of skin aging.

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