Deep Plane Facelift Procedure

Deep Plane Facelift

"The Deep Plane Facelift is the first technique that I perfected years ago and the technique I built my reputations on. I love this technique for those people who require very subtle change." -Dr. Diamond

The deep plane facelift is extremely safe with the lowest risk of problems when done correctly and allows for the most natural results. This technique is ideal for the younger patient as well as the patient whose main goal is to tighten the neck and jawline. The deep plane facelift is not ideal for those people with heavy jowls or severely sagging faces, because the results are too subtle to help those people. They require a vertical facelift, which is much more aggressive. The deep plane facelift is the most sophisticated facelift technique that gives the most natural results, with the best healing and lowest rate of complications when performed correctly.

When performing a deep plane facelift, the surgeon must create an incision around the ear. I prefer to make those incisions inside the ear cartilage known as the tragus which is called a post-tragal incision. In doing so, the skin can be separated from the underlying muscle layer known as the subcutaneous musculo- aponeurotic system, or SMAS layer. The original and older-style Facelifts only pulled and tightened the skin and did not tighten the SMAS layer. This type of procedure is very problematic for several reasons detailed below.

The skin-only facelifts can create a pulled or surgically altered appearance as well as a common deformity known as the lateral sweep deformity, which is where the skin has strange wavy appearance. The skin-only facelifts also leave tension on the healing incisions and therefore, the incisions can heal very poorly with wide and visible scars. The excess tension also creates a long and deformed appearance to the earlobe called the pixie ear deformity. The skin-only facelifts result in short lived improvements that tend to sag as early as 6 months after the surgery. The results of these types of facelifts are very limited and often unimpressive.

As our knowledge of the facial anatomy improved we learned that all of the above mentioned problems can be eliminated by tightening the SMAS layer at the time of facelift. By tightening up the SMAS layer, all of the tension is placed on the deeper muscular layer and the tension on the skin layer is minimized, allowing for a more natural appearance that is longer lasting and scarring that is invisible.

The standard SMAS facelift done today includes a minimal amount of SMAS elevation but just enough to see an improvement over a skin-only facelift. Advanced facelift surgeons have learned that by performing more extensive SMAS elevations, results will be greatly improved. We learned that after the incision is made, the skin and SMAS layer can be kept attached to each other and the dissection can be performed under the SMAS. As a result, the SMAS is tightened and the skin is passively tightened as well. This is known as a composite facelift flap and allows for the fastest healing with the most natural and best possible results with the least scarring from the incisions.

Furthermore, the cheek or malar fat pad can be elevated with appropriate SMAS dissection to create a natural rejuvenation to the mid-face, which is not possible with the skin-only or standard SMAS facelifts. This advanced type of facelift is known as the Deep Plane Facelift. This facelift requires an extensive knowledge of the facial anatomy, because the facial nerves are in the region of the extended SMAS dissection which can be damaged if the technique is not performed correctly. This is the first facelift technique that I perfected and I built my reputation based on this technique.

|| Back to Top ||