Deep Plane Facelift

The goals of face and neck lift procedures are to surgically address the structural aging changes in the facial skin, fat, and muscle, restoring a more youthful-looking and refreshed appearance.

These procedures aim to enhance facial contours by repositioning underlying tissues and removing excess tissue, creating a smoother and more defined jawline and neck. Additionally, the procedure seeks to improve the harmony between facial features, achieving a balanced and rejuvenated appearance. Clinical studies show that achieving such effects can lead to increased confidence and greater self-esteem.

A skin-only facelift technique is rarely able to address the complexity of facial aging. Most sophisticated surgeons now use the SMAS or deep plane facelift techniques to achieve exceptional results. The SMAS (superficial musculoaponeurotic system) approach targets the supportive layer of the face that holds and suspends the soft tissues, effectively addressing sagging and enhancing facial structure.

The deep plane facelift goes a step further by targeting the deeper tissue layer beneath the SMAS and superficial muscles. This advanced technique allows for a more thorough lift and repositioning of facial tissues, resulting in a naturally youthful-looking appearance and long-lasting results.

Optimal deep plane facelift results are achieved when you and your surgeon have a shared understanding of your goals and expectations. When discussing your goals for a deep plane facelift, be honest, be open, and do not be afraid to discuss any topic that can help clarify your aesthetic goals. Here are few pieces of advice for making sure you and your surgeon are aligned in your expectations:

• Bring photos of yourself from a younger age when you were happy with the appearance of your face. This can be a very helpful reference point.
• Use clear, descriptive language to express what you hope to achieve. Phrases like “restore my youthful appearance,” “redefine my jawline,” or “I’d like to look less tired” can give your surgeon a good sense of your desired outcome.
• Ask about complementary procedures such as browlift, blepharoplasty, fat grafting, buccal fat repositioning, lip lift, chin augmentation, deep neck contouring, and laser resurfacing.  Ask your surgeon if they will be addressing the “buccal fat pad” (a deeper fat pocket in cheeks that can cause fullness and exaggerate jowling) or submandibular glands (salivary glands under the jawline that can droop and impact the jawline).  A balanced and comprehensive approach to facial rejuvenation is often required to get the best and most natural-looking results.

One particular consideration for most individuals is whether to have a neck lift performed at the same time as a deep plane facelift. The deep plane facelift can be very effective independently, allowing your surgeon to reposition the sagging skin and superficial muscles of the neck (referred to as platysma). But the face and neck are also a continuum, together a critical region for sending signals about your biological age. As a result, many surgeons will want to address both areas at the same time, to achieve a seamless and consistent look.

In addition, you may want to consider other neck contouring procedures, such as the tightening of the platysma muscles (platysmaplasty), modification of submandibular glands, removal of the deeper fat compartments, submental liposuction or improving the chin position with an implant.

Be sure to discuss all your options, along with attendant benefits and risks, in a thorough consultation with your surgeon.

Before you go

Before proceeding with a deep plane facelift, it is imperative to ensure that your surgeon possesses both the technical expertise and artistic vision necessary to achieve optimal results. Take the time to carefully review their before and after photos, paying close attention to the naturalness, symmetry, and overall harmony of the outcomes. Don’t hesitate to ask questions and express your goals and concerns during the consultation process to ensure that you and your surgeon are aligned in your expectations.

Every surgeon performs facelifting slightly differently and may brand their technique with a unique trade name. Regardless of the name associated with your surgeon’s facelift method, it is crucial to ask whether they use a skin-only, SMAS, or deep plane face and neck lift techniques. Elite surgeons should customize your facelift procedure based on your specific anatomy and goals; however, different techniques can be more or less suitable depending on your age and desired results. For instance, some variations are ideal for individuals seeking more dramatic changes, while others are better suited for younger patients showing early signs of aging.

Remember to mention any medical conditions to your surgeon, as they can affect outcomes and recovery. Be honest about your lifestyle and daily habits, whether you love the sun, have a history of smoking or vaping, or are an avid outdoor enthusiast, all of which can influence both your surgical goals and the approach your surgeon might take.

In addition to discussing any prior facial or eyelid surgical history, you should note your prior use of non-invasive facial rejuvenation treatments. Energy-based devices such as ultrasound (Ultherapy®) and radiofrequency (Sylfirm® or Morpheus8®), and collagen stimulating agents (such as Sculptra® and Radiesse®), affect the deeper tissue layers involved in a facelift, introducing a degree of complexity for your surgeon to navigate.

It is also crucial to inform your facelift surgeon if you have had significant amounts of hyaluronic acid fillers such as Restylane® or Juvéderm® injected into your cheeks or jawline, as these can alter your facial volume and contours, potentially influencing the surgical plan and outcomes.

During the procedure

During the procedure, you’ll be under general anesthesia or sedation, ensuring you feel no pain. The incisions for a deep plane facelift vary depending on surgeon preference and your personal goals. Typically, incisions will be just under the chin and around ears in well-camouflaged contours.

The surgery can take several hours, depending on the complexity and whether complementary procedures such as a neck lift, eyelid lift,  lip lift, laser resurfacing, or fat grafting are being performed.

Temporary drains—thin, flexible tubes—are often placed under the skin to prevent the accumulation of blood or fluid following a facelift. This is a common practice to minimize the risk of complications such as hematomas and excessive swelling. Some surgeons, however, may prefer alternative techniques like tissue adhesives or compression dressing. Ultimately, the decision to use drains or alternative methods should not be the sole basis for choosing your surgeon. Trust in your surgeon’s expertise and allow them the discretion to employ the techniques they believe will yield the best possible outcome for you.

Deep Place Facelift Aftercare 

Post-procedure, it’s normal to experience bruising, swelling, and a feeling of tightness in your face and neck. These are temporary and part of the healing process. Pain management involves using acetaminophen (extra strength Tylenol) and prescribed medications to keep you comfortable.

Stitches are usually removed after a week or so. While you’ll see changes immediately after surgery, a more complete outcome emerges over a few weeks as the swelling subsides and the tissues settle. The final outcome is typically apparent between six and twelve months.

You will be able to resume everyday activities at around one to two weeks after surgery and exercise at around three weeks after surgery. Remember that every individual’s healing process is unique, and patience is your ally. Also, your surgeon will provide detailed aftercare instructions and will be there to guide you throughout your recovery journey.