A facelift is a surgical procedure designed to address the visible signs of facial aging. Unlike injectable treatments, which may sometimes create an overfilled or unnatural appearance a well executed facelift does not fill the face up or plump the cheeks. A well executed facelift makes the jawline more defined and sharpens the cervicomentohyoid angle.
Evolution of the Facelift
Over time, facelift techniques have evolved substantially. Early facelifts focused solely on tightening the skin, which often resulted in an overly taut, unnatural look. Subsequent advances revealed that a more lasting and authentic outcome could be achieved by tightening a deeper facial layer known as the Superficial Muscular Aponeurotic System (SMAS).
While the SMAS facelift remains effective and widely practiced, the Deep Plane Facelift is the procedure which Dr Dan prefers and performs most of the time due to its effectiveness in treating the signs of aging.
What Is a Deep Plane Facelift?
The deep plane facelift targets the fibrous, inelastic layer beneath the skin, offering greater durability than techniques relying solely on skin tightening. Because the skin is highly elastic, traditional methods can result in gradual re-stretching over time. By contrast, the deep plane approach repositions deeper tissues to achieve results that can last 10 years or more
The defining feature of the deep plane facelift is that it elevates the SMAS layer while keeping the overlying skin attached. This ensures that the skin remains smooth and natural, without appearing tight or over-pulled. During the procedure, the surgeon releases key tethering points in the cheeks and along the jawline, allowing the underlying structures to be redraped under minimal tension.
The Role of Facial Ligaments
To achieve optimal movement and repositioning of facial and neck tissues, four key ligament groups are released:
- Zygomatic Ligaments: These anchor the cheek skin to underlying bone. Their release allows the cheeks to be lifted whilst softening nasolabial folds
- Mandibular Retaining Ligament: Located near the chin, releasing this ligament smooths lines along the chin and anterior jawline.
- Masseteric Cutaneous Ligaments: Found near the jaw angle, their release helps refine and tighten the jawline.
- Cervical Retaining Ligaments: Extending the lift into the neck enables redraping of facial and neck tissues, avoiding bunching behind the jawline
Vector in a deep plane facelift
Traditional facelifts often pulled the skin backward toward the ears, sometimes producing an overly stretched appearance and flattening the cheeks. In contrast, the deep plane facelift repositions tissues more vertically lifting them upward usually at an angle of 70 degrees or more rather than backward. This vertical vector increases midface volume, subtly elevates the corners of the mouth, and increases the definition of the jaw line. Dr Dan modifies the vector of lift in all patients.
Platysmaplasty / Necklift
In some cases, a platysmaplasty—a complementary neck procedure—may be performed through a small incision under the chin. This addresses banding caused by separation of the platysma muscle and helps smooth and elevate the neck contour. The decision to perform a platymaplasty is made on an individual basis.
During the procedure of a necklift Dr Dan will often elevate and tighten the skin around the jaw line increasing the definition of the angle of the mandible and the cervicomentohyoid angle [angle under the chin where the neck starts]
Recovery
Following a deep plane facelift, mild bruising and swelling are expected for two to three weeks. Swelling typically peaks within 24 hours and gradually subsides over six weeks. Most patients feel comfortable returning to social or professional activities after about six weeks, once visible signs of recovery have largely resolved. Many patients who feel up to it are able to return to working from home after one week
Because the deep plane technique is performed within a natural tissue layer with minimal blood vessels, it generally results in less bruising and swelling than a traditional SMAS lift. Most patients report minimal discomfort. Dr Robinson keeps all facelift patients in hospital for one night to ensure that pain is under control. There is some swelling after the operation which is to be expected around the site of the operation. This swelling will resolve by itself after approximately 2 weeks with some massage.
Dr Dan asks all of his patients to wear a facial corset for 23 hours per day for the first week after the procedure and then when they are in bed for the next 5 weeks. This corset [which Dr Dan will give you] provides a compressive effect to minimise the swelling and bruising around the site of the operation.
Scarring
The deep plane facelift produces the most discreet scars of any facelift method. Minimal tension on the skin allows fine, nearly imperceptible scars that fade to faint lines over 12 months. This technique also reduces the risk of earlobe distortion or downward pulling.
The scar is hidden behind the ear and then curves around in front of the ear and is hidden inside the ear canal and continued upwards in the hairline. It is very difficult to see the scar after 6 weeks and by 3 months it has faded to a very faint white line.
The scar which is made for a platymaplasty is under the chin and is only visible when patients stretch their head back.
Advantages of the Deep Plane Facelift over traditional techniques
- Avoids the pulled look to the face
- Increases cheek volume
- Incision scars are placed behind the ears [have a look at the gallery]
- Longer-lasting results (10+ years)
- Increased definition of jaw line
- Reduction in wrinkles over cheek
Risks of facelift
All surgery carries risks, the risks of a facelift include:
- Risks of general aneasthetic
- Bleeding in the first 24 hours
- Skin flap failure
- Facial nerve injury
- Pleating – where skin develops a crease post operatively
- Skin discolouration / pigmentation change
- Cosmetic dissatisfaction
Dr Dan feels that these risks are still present when performing a deep plant facelift but substantially less when performing a deep plant facelift as opposed to other techniques.
Candidate Suitability
If you are wondering whether you are a good candidate for a deep plane facelift then make an appointment to see Dr Dan
