The deep plane facelift (rhytidectomy) is a surgical technique that repositions the deeper layers of facial tissues to address signs of ageing in the midface, lower face, and neck. It also involves repositioning the SMAS (superficial musculoaponeurotic system) and facial fat pads.
When undergoing a facelift (rhytidectomy), there are several types of procedures that may be performed. The traditional facelift, also called SMAS facelift, may be suitable for some patients. However, for some, there are other methods of facelift surgery that are better suited, such as a deep plane facelift.
The deep plane facelift targets deeper structures compared to the traditional facelift (SMAS). It gives your surgeon access to the deep-retaining facial ligaments, facial muscles, and connective tissue.
Understanding Facial Anatomy
To understand how a facelift works and how different types of facelifts compare, you need to know a little anatomy first. The face is made of several layers. From the surface of the skin down, these are as follows:
- Facial skin
- SMAS – The Superficial MusculoAponeurotic System – This is a layer of connective tissue and superficial muscles covering the whole surface area of the face.
- The deeper plane – This is, for our purpose, the deepest layer of the face, containing the facial muscles and ligaments.
Keep in mind that these were oversimplified to be easily understandable for everyone.
What is a Deep Plane Facelift?
A deep plane facelift is a more comprehensive method of facelift than SMAS. It goes an extra layer deeper compared to the traditional SMAS facelift. This allows Dr Turner to target and lift the deeper structures of the face.
The original facelift techniques in plastic surgery aimed to lift the skin alone, and not operate on the deeper muscular structures. This, however, resulted in poor cosmetic results compared to the modern techniques that plastic surgeons utilise now. The skin was lifted, but all the facial structures (muscles and connective tissue) remained lax and stretched.
Then came the SMAS facelift, and it was a revolution. It allowed surgeons to lift both the skin and the lax SMAS layers of the face. The SMAS allows surgeons to lift several layers together. It’s now considered the standard facelift technique by most plastic surgeons.
The deep plane facelift technique came next. Compared to the SMAS facelift, the deep plane lift goes an extra layer further. It goes below the SMAS layer and gives access to the facial ligaments and muscles of facial expression.
The deep plane facelift allows Dr Turner to release the ligaments and reposition them in a higher location. He can tighten the facial muscles and fix them higher up on the face. Moreover, the deep layer access allows Dr Turner to target any herniated fat pads causing jowls on the sides of the face.
How is Deep Plane Facelift Performed?
A deep plane facelift is performed under general anaesthesia (you’ll be asleep). Nevertheless, local anaesthesia is sometimes an option. The duration of a deep plane facelift varies from 2 to 4 hours depending on how much lifting and repair needs to be done.
The steps of a deep plane facelift usually consist of:
- First, Dr Turner starts with the skin incisions. This usually starts high up in front of the ear, goes down to the earlobe, and then around and upward to the hairline behind the ear. This incision is done on both sides of the face.
- Through the incision, Dr Turner will dissect the deeper tissue of the face.
- Dr Turner will create a space under the SMAS layer, exposing the deeper layer of facial tissue.
- Once the deep plane is fully visible, Dr Turner will release the lax ligaments from their attachment. He will then pull them up and fix them with sutures in a higher position in the face. This will be done on different ligaments to lift and tighten all the deep facial muscles.
- Any fat herniation that’s causing jowls will be repaired.
- Once the deep plane is lifted, the SMAS is also lifted and fixed in a higher position.
- This will pull all the facial structures and tighten the face. All that remains is the superficial excess lax skin. This will be cut out, and the remaining skin will be pulled.
- The wounds are finally closed using sutures.
Depending on your health condition and recovery process, you may need to stay overnight at the hospital after a deep plane facelift. Keep in mind that you aren’t allowed to drive after a facelift. Make sure to have arrangements in place for someone to pick you up and look after you during the first days of your recovery.
Recovery after Deep Plane Facelift Surgery
During your recovery period, you will likely experience symptoms like:
- Swelling
- Bruising
- Pain
- Numbness around the wounds
These usually peak during the first week of facelift recovery and then start to gradually decrease. The full recovery after a deep plane facelift usually takes 3-5 weeks. Your surgeon will advise you on when to return to work and most of your daily routines after the surgery.
You can usually resume light work 7-10 days after your procedure. Sports and exercise should be minimal during the recovery period, however, walking is encouraged. You can try to pick up the pace as of the third week of facelift recovery and gradually increase your physical activity over the coming weeks.
After a deep plane facelift, swelling is still present. At around 6 weeks, you may start to notice the results. As the residual swelling completely disappears, you can see the full results of the procedure.
Potential Risks & Complications of Deep Plane Facelift
The potential risks and complications associated with this procedure are the following:
- Wound infection
- Facial nerve injury
- Salivary gland/duct injury
- Seroma (fluid collection in the wound)
- Hematoma (blood collection in the wound)
During your consultation, Dr Turner will conduct a thorough assessment of your overall health and expectations. He will discuss with you your medical history. This allows him to determine if you are a suitable candidate for the procedure. He will also discuss the benefits, risks, and complications of the procedure.
