A Facelift is the most popular and definitive way to rejuvenate an aging face. It helps restore droopiness and jowling in your face, as well as the sagging neck appearance. Although there is no proven study to establish the superiority of one technique over another, the Deep Plane Facelift has become extremely popular and is gaining prominence as the gold standard for facial rejuvenation.
Deep Plane Facelift: Is it the best technique for facial rejuvenation?
My Personal Opinion on Facelift Surgery
This blog reflects my personal opinion based on my experience with facelift surgery. A facelift is not just skin surgery; the lift must come from deeper layers of the face, specifically the SMAS layer in the face and the platysma in the neck. Any facelift performed by merely pulling the skin will likely last only a few weeks. The simplest way to do a facelift is through SMAS plication, which involves suturing the SMAS layer without undermining it. However, I believe that some undermining below the SMAS layer is essential to release tethering and achieve a better lift.
This technique is commonly known as SMAS facelift. Depending on the extent of undermining, it can be a high SMAS lift (above the zygomatic arch) or a low SMAS lift (below the zygomatic arch). This was my go-to technique when I started performing facelifts. While the results were decent, I felt something was missing. “Close, but no cigar” describes my experience with the traditional SMAS facelift. Then I encountered the ‘Deep Plane Facelift’ technique.
What is a Deep Plane facelift
A good analogy for the Deep Plane Lift is “trying to lift a rug that’s stuck to the floor.” In this analogy, the rug represents the SMAS (in your face) and platysma (in your neck), while the floor symbolizes the deeper layers of the face to which it is tethered. In a traditional facelift using the SMAS technique, you cut the edges of the rug and partially unglue it, then tie the edges together. While this approach is helpful, the underlying problem remains that the rug is still stuck to the floor beneath it.
With the deep plane facelift technique, you completely unglue the rug from the floor. This method allows for greater freedom of movement in the direction it has fallen. As a result, the outcomes are more natural and arguably longer-lasting. Additionally, since all the lift comes from deeper layers, there is no tension on the skin during closure, allowing the surgical scar to become imperceptible within a few months.
An important modification I've incorporated with the Deep Plane Facelift is an Extended Neck Lift, which lifts the deeper layers of the neck (the platysma) laterally, in addition to contouring the neck from a midline incision. This combination works synergistically with the Deep Plane Facelift for the lower and mid-face.
In my experience, my outcomes and overall results have significantly improved since incorporating deep plane facelifts and extended neck lifts into my practice, making it my preferred technique for facelifts.
