Semin Plast Surg 2002; 16(4): 359-374
DOI: 10.1055/s-2002-37454
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

The ESP (Extended Supraplatysmal Plane) Facial Sculpting Technique: Creating a Natural, Youthful, and Attractive Face

Steven M. Hoefflin
  • Division of Plastic Reconstructive Surgery UCLA School of Medicine Los Angeles California
Further Information

Publication History

Publication Date:
26 February 2003 (online)

ABSTRACT

The ESP (Extended Supraplatysmal Plane) facial sculpting technique uses a deeply extended, single layer surgical plane located directly on the SMAS (superficial musculoaponeurotic system). It lifts all fat and arcuate vasculature up and leaves the SMAS/ platysma aponeurosis down. In the author's opinion, the SMAS is not used for tension, as it is important in coordinating fine facial mimetic muscle animation. A significant contribution to facial attractiveness and aging is the location and volume of facial bony and fatty highlights, therefore the ESP technique is based more on shaping than tightening the face.

Facial aging is defined by the theorem of SAG: skin aging alterations, avoluptosis (the aging-hormonal volume changes and translocation of fat), and groove formation (central facial ligament tightening and peripheral ligament relaxation). Facial attractiveness is defined by the Formula of AH: seven elevated "angles." Also included are measurements of the seven full egg-shaped "highlights." The ESP technique's hallmark is a sculpting and repositioning procedure. It releases all facial ligaments, re-elevates ptotic facial angles, augments and repositions the youthful fatty pad highlights, and reduces or modifies the nasolabial jowl and sub-mental fat pads.

In over 1700 cases, this technique has given the patients and the surgeon a high degree of satisfaction and a minimal rate of complication to date.

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