Caves Maneuver in Deep Plane Facelift and Necklift Dissection

Introduction: Facelift surgery is a key procedure for facial rejuvenation, with deep plane facelifts providing long-lasting aesthetic improvements. The proposed Caves maneuver is a dissection technique to enhance surgical time efficiency and minimize risks in deep plane facelift procedures. Methods: A prospective study included 123 patients who underwent deep plane facelift and neck lift procedures from January 1, 2023, to December 1, 2024. Sixty-three patients (group 1) underwent the deep plane surgery with Caves maneuver, while 60 patients (group 2) received the traditional deep plane surgery without the Caves maneuver. Demographic data, operative times, and complications were analyzed. Results: Group 1 consisted of 63 patients (87.3% women and 12.7% men), while group 2 consisted of 60 patients (98.3% women and 1.7% men). Group 1 had a significantly shorter deep plane dissection time (9.5 minutes, range = 8-10 minutes) compared with group 2 (23 minutes, range = 20-25 minutes). Complications included 1 case of hematoma in group 2, 8 cases of temporary paresis of the marginal mandibular nerve, and 7 cases of hypertrophic scarring. No infections were reported. Group 1 demonstrated a lower incidence of complications, and in relation to nerve paresis, group 1 (1 case; 1.5%) had a lower incidence compared with group 2 (7 cases; 11.6%). Conclusion: The Caves maneuver significantly reduced dissection time and showed a lower incidence of nerve paresis. Complications were minimal, suggesting that the Caves maneuver is a safe and effective modification. Further studies with larger cohorts are recommended to validate these results.