The Concept of Surgical Planes
The face is organized in layers, like an onion. Each “plane” represents a different dissection depth, with distinct implications for result and safety.
Subcutaneous Plane (Superficial)
Dissection only below skin. Oldest technique, short-lasting results, tension on skin.
Supra-SMAS Plane
Dissection above SMAS with plication or SMASectomy. Improvement over subcutaneous, but still limited.
Sub-SMAS Plane (Deep)
Dissection below SMAS. Allows mobilization of deep structures. Base of modern techniques of excellence.
Subperiosteal Plane
Dissection close to bone. Used in specific cases, greater morbidity.
Why Is Deep Plane Superior?
Advantages
- • Lasting result — structures support traction
- • Naturalness — mobilizes facial unit
- • Less tension on skin — better scar
- • Possible vertical vector — corrects real ptosis
- • Complete rejuvenation — not just skin
Historical Challenges
- • Proximity to facial nerve
- • Steep learning curve
- • Longer surgical time
- • Risk in fibrous faces
- • Equipment dependency (some techniques)
“Deep plane taught us that we need to go beyond skin. The evolution of techniques teaches that we can go deep safely.”
- — Dr. Robério Brandão
Evolution: From Deep Plane to Endomidface Traditional Deep Plane demonstrated the value of deep plane. Direct Vision Endomidface represents its evolution, maintaining benefits and reducing risks.
Aspect Traditional Deep Plane Endomidface
Plane Sub-muscular Sub-SMAS areolar
Visualization Variable Direct vision
Injected face High risk Safe
Recovery 21-30 days 7-10 days
Frequently Asked Questions
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