Suitable Candidate for Deep Plane Facelift
Suitable candidates for deep plane facelift should meet the following criteria:
- Physical Health: Be in good overall health with no underlying medical conditions that could interfere with the wound healing process.
- Emotional Well-being: Have realistic expectations and a positive mindset regarding the outcomes of mastopexy surgery. As of 1st of July 2023, patients are required to have a psychological evaluation to ensure they are suitable to proceed with surgery.
- Stable Weight: It is recommended to be near your target weight before undergoing the procedure, as weight fluctuations can affect the cosmetic results.
- Non-smoker: Smoking or vaping dramatically interferes with the healing process and increases the risk of complications. Therefore, candidates are required to cease smoking for a minimum 6 weeks before and after the surgery
Understanding the Deep Plane Facelift
The success of a deep plane facelift largely depends on the surgeon’s expertise and in-depth understanding of facial anatomy. As a Specialist Plastic Surgeon, Dr. Turner focuses on facial plastic surgery, particularly deep plane facelifts, ensuring the procedure is performed with precision to achieve optimal results.
What is the SMAS?
The superficial muscular aponeurotic system, or SMAS, is a thin continuous layer of fibromuscular tissue that continues as the platysma into the neck and vital in maintaining the facial structure. Beneath the SMAS layer lies a critical section of the face that includes muscles, nerves, salivary glands, and blood vessels, which are responsible for facial movement and expression. This area also contains specialized retaining ligaments help keep the skin tethered to the deeper fascia and periosteum. As we age, these ligaments loosen, which leads to sagging of the SMAS and platysma and ultimately the skin.
Different types of SMAS Facelifts?
Tightening and repositioning of the SMAS is a critical component of all modern facelift procedures. The SMAS facelift is a versatile technique with several variations, each designed to address specific concerns and achieve different levels of rejuvenation.
SMAS Plication:
This technique involves folding and suturing the SMAS layer to create lift without fully detaching it from the deeper facial structures. It offers moderate improvement for mild sagging but not as effective for patients with more significant facial laxity. It is Dr Turner preferred method in revision facelifts to correct minor issues from previous surgeries or patients with thin facial tissues.
SMASectomy:
SMASectomy involves excising a portion of the SMAS layer, which partially releases some of the deep retaining ligaments for an improved lift over the traditional SMAS plication technique. It is Dr Turners preferred method in patients with heavy facial features that need reduction in volume in the lateral face.
Extended SMAS Facelift:
The extended SMAS facelift goes beyond the standard SMAS technique by extending the lift into the neck below the jawline, offering more comprehensive rejuvenation. It addresses both sagging in both the midface and lower face, including areas like the jowls and neck, so more suitable for those with advanced signs of ageing.
High SMAS Facelift:
In a high SMAS facelift, the dissection of the SMAS occurs higher on the face, above the zygomatic arch, so it can more effectively target the midface and cheek areas. This approach allows for a more vertical lift to restore volume and elevate the midface, providing improvement in facial contours.
How is Deep Plane Facelift Different from SMAS Facelift?
The deep plane facelift and the SMAS facelift share similarities in their approach to facial rejuvenation, but they differ in execution and outcome.
- The SMAS facelift involves tightening the SMAS layer by plication or resection techniques, however as there is no dissection beneath the SMAS layer the retaining ligaments remain intact. This limits the elevation that can be applied to the SMAS and ultimately to the skin of the face.
- The deep plane facelift in contrast involves utilizing dissection below the SMAS into safe, well defined anatomical facial spaces and release of structural retaining ligaments. Allows improved lifting and tightening of the SMAS layer with less tension for improved correction of facial contours and long-lasting outcome.
Choosing between these techniques depends on individual goals and anatomical considerations. Dr. Turner will discuss the differences during your consultation, helping you decide which method aligns best with your aspirations and needs.
How is a Deep Plane Facelift Performed?
Deep plane facelift surgery is always performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. Depending on the complexity of the procedure it may take 3 to 4 hours, and Dr Turner recommends patient rest in hospital overnight before being discharged home the next day.
The procedure begins with careful marking of incision locations along the hairline, ear contours and under the chin. Dr Turner will mark the location of the deep plane entry point, areas of facial volume loss that needs to be corrected with fat transfer and important anatomical landmarks such as the frontal nerve. Next Dr Turner will infiltrate local anaesthetic is the areas to be dissected to minimize bleeding and discomfort after the procedure is completed.
Once the incisions are made, Dr. Turner will elevate the skin and subcutaneous tissue to the marked deep plane entry point. At this point Dr Turner will dissect under the SMAS in defined anatomical facial spaces, elevating the SMAS with the skin and subcutaneous tissue as one composite flap, and carefully releasing the retaining ligaments. The SMAS is then reposition in a vertical direction to correct midface and jowl laxity.
The neck is frequently addressed during a deep plane facelift, providing a harmonious transition between the face and neck. Through the incision for the deep plane facelift, Dr Turner can correct excess fat deposits with liposuction and correct deep neck laxity with a formal platysmaplasty neck lift. In many cases, fat transfer can be used in conjunction with a deep plane facelift to restore lost volume in areas like the cheeks, temples, and under the eyes. Fat transfer enhances the overall results for patients with significant volume loss.
Recovery After Deep Plane Facelift
Recovery from a deep plane facelift is a gradual process, with initial swelling and bruising subsiding within the first few weeks. Most patients can resume regular activities in two to three weeks, though complete healing and final results may take several months.
Dr. Turner offers personalized post-operative care, emphasizing the importance of following instructions to manage discomfort, minimize swelling, and ensure smooth recovery. Patients are advised to avoid strenuous activities and heavy lifting during the early stages. Light walking is encouraged to promote circulation.
Following all post-operative care, including protecting the skin from sun exposure, is vital to prevent complications and achieve lasting results.
Risks and Complications of Deep Plane Facelift
Like any surgical procedure, deep plane facelift carries certain risks and potential complications. It is important for patients to be fully aware of these before deciding to undergo surgery. Dr. Turner will discuss them in detail during your consultation, ensuring you have realistic expectations and a clear understanding of the potential outcomes.
Common risks include infection, bleeding, scarring, and temporary numbness or swelling, which typically subside during recovery. Less common but possible complications involve nerve damage, which could affect facial sensation or movement, and reactions to anaesthesia. Rarely, patients may experience hair loss at incision sites, skin discoloration, or delayed wound healing, leading to more noticeable scarring. Adhering to post-operative care instructions is essential for minimizing complications and ensuring a smooth recovery.
See our detailed guide on risks and complications after facelift surgery