Deep Plane Facelift

Deep Plane Facelift Technique: Deep Plane versus Mini Facelift (Minilift) and MACS Lift

The deep plane facelift is an advanced and refined facial rejuvenation technique that provides natural and long-lasting results. Unlike traditional facelift procedures, which focus primarily on tightening the skin, the deep plane facelift targets the deeper layers of the face. This provides a more thorough lift and rejuvenation. Below is an explanation of the technique, how it differs from other facelift methods, and why it has become so popular.

What is the Deep Plane Facelift?

A deep plane facelift is a surgical procedure that aims to lift and reposition the deeper tissue layers of the face, such as muscle, connective tissue, and fat. This helps to restore a more youthful and refreshed appearance. By addressing the underlying structures of the face rather than just the skin, this method provides natural and long-lasting results.

The five layers of the face

The face consists of five concentric layers, which differ in consistency depending on the region of the face:

1. Skin: Thickest on the cheeks and nose, thinnest on the eyelids and temples.
2. Subcutaneous fat: Prominent in the cheeks, almost absent in the eyelids.
3. SMAS (Superficial Musculoaponeurotic System): The muscle layer responsible for facial expressions such as smiling, talking, and eye movements.
4. Sliding layer: A space containing ligaments, facial nerves, and blood vessels. The ligaments connect the upper three layers to the deeper structures.
5. Bone or deep fascia: Supporting structures such as the cheekbones and jawline, or deep fascia in areas without bone, such as the neck.

The deep plane facelift focuses primarily on lifting the SMAS layer by accessing the gliding layer (layer 4). This allows surgeons to reposition the muscles and fat structures of the face, resulting in a smoother, lifted, and more defined appearance.

Step-by-step approach to the Deep Plane Facelift

1. 1. Preparation and anesthesia
      During a consultation, the surgeon evaluates the anatomy of the face, the skin condition and aging issues. On the day of surgery, general anesthesia is administered to ensure the patient's comfort.

      

1. Incision placement
   The incisions are strategically placed along natural facial contours, such as:

   • Along the hairline (in front of or behind the tragus).
   • Around the earlobe and behind the ear, possibly further into the hairline if there is excess skin.
     
     This placement minimizes visible scarring after healing.
     Scars are red and slightly swollen during the first months after the face or neck lift, in front of the ear the scars are almost always good. Usually you can hardly see the scars from the beginning.

2. Dissection of the deep tissues
   The surgeon separates the skin from the underlying SMAS layer and connective tissue, freeing the ligaments in layer 4. This allows the surgeon to manipulate the deeper structures of the face without damaging nerves or blood vessels.

3. Lifting and repositioning the SMAS layer
   The SMAS layer is lifted upwards and outwards, correcting sagging tissues of the cheeks, jawline and neck. This improves both the lower face and the midface, restoring contours and volume.

4. Approach to the neck
   An important difference with minilifts and MACS-lifts is the ability of the deep plane facelift to also address the neck. Where these superficial techniques work in layer 2 (subcutaneous fat), the deep plane facelift works in the deeper layers. In case of severe neck problems, an additional incision under the chin may be necessary to address deeper structures.
   

5. Redraping the skin
   The skin, along with the underlying fat and SMAS layer, is re-draped over the facial lines. Excess skin is removed without tension, resulting in a smooth, natural result.

6. Closing of incisions
   The incisions are carefully closed with fine sutures so that the scars are barely visible after healing.

7. Aftercare
   After surgery, dressings are applied to aid healing and reduce swelling. Patients are given detailed aftercare instructions, such as avoiding strenuous activities and keeping their head elevated while sleeping. Swelling and bruising usually subside within six weeks.

Why choose the Deep Plane Facelift?

The deep plane facelift offers a number of advantages over traditional methods:

1. Natural results: The focus on underlying structures prevents a “pulled” appearance.
2. Long Lasting Effects: Results often remain visible for 8-10 years or longer thanks to the deeper approach.
3. Comprehensive rejuvenation: It treats the entire face, including cheeks, jawline and neck, for a balanced and youthful appearance.
4. Less skin tension and scars: By working with natural tissues, less tension is created on the skin and scars are minimally visible.

The deep plane facelift is an excellent choice for those seeking a lasting and natural facial rejuvenation. As with any cosmetic procedure, a consultation with an experienced and qualified surgeon is essential to determine if this technique is suitable for your desires and needs.

The skin is then detached from the underlying tissue. This is done up to a few centimeters beyond the cutting lines and deeper at the cheekbone. At the jawline, a special instrument with light is used to be able to work precisely around the platysma, a muscle in the neck. Local anesthesia is used to prevent bleeding as much as possible.

The SMAS (a deep layer of connective tissue and muscles) is tightened and carefully loosened further. During this process, care is taken to ensure that the important nerves in the face remain well protected. The fat pad in the cheek can be moved upwards and fixed, especially if the eyelids are also corrected. This is done via a small incision under the muscle around the eye.

The excess SMAS tissue is removed, and the remaining portion is fixed in place to strong structures such as connective tissue bands at the parotid gland. Finally, the excess skin is removed and the skin is carefully sutured.

Who is a good candidate for a deep vertical lift?

Any healthy person over the age of fifty who wants to get rid of sagging cheeks and tighten the neck.

What can you expect and what should you do during the recovery period after a Deep Plane Facelift?

The healing process after a Deep Plane Facelift is fast (maximum one week) due to the deep plane of the dissection. If bruising occurs, it occurs under the muscle so that only a small amount of bruising will be visible. In contrast, bruising caused by an eyelid correction (if performed) can remain visible for two weeks.

• The day of the procedure: The face may be swollen and bruised, especially around the eyes. Pain is not really a problem and can be effectively controlled with the painkillers we provide for you. It is important to take it easy and avoid activities that can increase blood pressure. We therefore strongly advise our patients to stay overnight in the clinic after a deep vertical facelift.
• The first week: The bruising and swelling of the neck and jawline will disappear after four to six days, leaving only some bruising around the eyes.
• The weeks after: The patient can resume social activities after two weeks, if necessary with some makeup around the eyes to mask any remaining bruising.
• Full recovery: After two to three weeks.

What are the risks of a Deep Plane Facelift?

There may be a temporary weakening of some facial muscles. This is caused by the dissection in the plane under the muscle. You will fully recover from this in the next 3 to 4 months. If the dissection is performed carefully, there should never be any permanent damage to the facial nerve.

How long can I expect the results of the face/neck lift to last?

In effect, you are turning back the clock by about ten to fifteen years. However, the aging process continues, so in ten to fifteen years you will look about the same as before the procedure.

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