Deep Plane Facelift "Bucket Handle" Technique Video.

The deep plane facelift isolates the superficial musculoaponeurotic system (SMAS) by direct lysis of retaining ligaments, allowing greater mobilization of the vascularized composite flap of skin and SMAS. The authors of this study describe a modification to the deep plane facelift, termed the "bucket handle" technique. This technique involves creating a triangle of SMAS tissue extending from the angle of the mandible posteriorly to the anterior aspect of the sternocleidomastoid muscle. The intact SMAS flap, which is not divided or myotomized, is draped over the angle of the mandible, augmenting the gonial angle, whereas the triangular bucket handle of the SMAS flap is sutured back to the mastoid crevasse, enhancing the posterior medial vector of the neck lift, providing a more sculpted, defined jawline. Level of Evidence: 5 (Therapeutic).