Scar-Minimizing Full-Face Rejuvenation: A Novel Multiplanar and Multivector Approach Using Combined Forehead, Transoral Midface, and Limited-Incision Lower Face and Neck Lift Techniques.

INTRODUCTION: Facial rejuvenation techniques must meet modern demand for natural results with minimal visible scarring. Traditional facelifts often fail to correct midfacial descent and multivector ptosis, especially in younger patients without significant skin laxity. We describe a multiplanar, triaxial facelift approach combining subperiosteal, subfascial, and sub-SMAS (superficial musculoaponeurotic system)/subplatysmal dissection through hidden incisions. This study aimed to evaluate the clinical effectiveness and safety of a scar-concealing, multiplanar facelift approach that integrates forehead lift, transoral midface lift, and limited-scar lower face and neck lift techniques. The objective was to determine whether this combined strategy provides consistent midfacial elevation and natural facial harmony while maintaining minimal visible scarring and low postoperative morbidity.

METHODS: This retrospective study included 216 female patients who underwent surgery between June 2021 and January 2024. The technique uses intraoral, retroauricular, and scalp incisions to enable multiplanar access. Midfacial repositioning was performed through dual-plane transoral fixation, while lower facial and cervical contouring was achieved via subplatysmal and sub-SMAS dissection.

RESULTS: The mean surgical duration was 167 minutes, with an average follow-up of 18.5 months. Patients demonstrated consistent midfacial elevation, improved contour, and enhanced overall facial harmony on postoperative clinical assessment and standardized photographic comparison. Complications were minimal and transient, including temporary facial nerve weakness and localized dimpling, all of which resolved without permanent sequelae.

CONCLUSION: Our scar-concealing multiplanar facelift approach provides a reliable and anatomically sound option for comprehensive facial rejuvenation, achieving consistent midfacial elevation and natural facial harmony with minimal visible scarring. The technique demonstrated durable esthetic improvement with a low complication rate, supporting its safety and effectiveness for appropriately selected patients.

LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .