Facial Danger Zones: Avoiding Nerve Injury in Facial Plastic Surgery

Abstract

BR Seckel. Facial danger zones: Avoiding nerve injury in facial plastic surgery. Can J Plast Surg 1994;2(2):59-66. with today's new emphasis on more aggressive and deeper facial dissection during rhytidectomy, the peripheral nerve branches of cranial nerves V and VII in the face are more often exposed closer to the plane of dissection and more likely to be injured in the course of composite, extended sub-submuscular aponeurotic system (sub-SMAS), and subperiosteal rhytidectomy. It is important to have a keen and thorough understanding of the location of these nerves to avoid injury. I divide the face into seven facial danger zones based on known anatomic locations of the branches of the peripheral nerves of the face and the location in which they are most easily injured in the course of facial dissection. A description of the nerve and consequence of injury, the anatomic location of the zone, and the technique for safe surgical dissection for each facial danger zone is presented.