Use of Nerve Integrity Monitoring (NIM) in Facelifts.

The growing popularity of filler injections, thread lifts, and energy-based devices for facial rejuvenation poses new challenges for deep plane or subSMAS facelifts. The use of a nerve integrity monitor (NIM) may help address these challenges. However, data on the application of NIM in facelift procedures remains limited. This study aims to describe the use of NIM in facelifts and to compare outcomes between procedures performed with and without NIM assistance. This was a prospective study conducted from January 2024 to August 2025. Patients undergoing extended subSMAS facelift who had previously received filler injections, thread lifts, or facelifts were eligible for inclusion. Participants were divided into either the NIM or non-NIM group. A step-by-step dissection algorithm using NIM during facelift surgery is presented. A total of 200 patients were included in the final analysis. The incidence of neurapraxia was significantly lower in the NIM group 0 (0%) compared to the non-NIM group 6 (6%), p = 0.029. Dissection time was also significantly reduced in the NIM group (32.86 [26.25, 38.00] minutes) compared to the non-NIM group (63.5 [55.0, 75.0] minutes), p < 0.001. The use of a nerve integrity monitor in facelift surgery was found to reduce both the rate of neurapraxia and operative time.