DEEP PLANE Facelift

A facelift refers to all surgical procedures that aim for lasting rejuvenation of the face and neck. However, only a Deep Plane Facelift or a facelift using the High-SMAS method will achieve a harmonious, naturally appearing outcome.

To restore youthful facial contours, both the skin and underlying tissue are tightened, volume loss is corrected, and the face, cheek, and jawline are reshaped.

Every Deep Plane Facelift is preceded by a detailed examination and thorough photographic documentation. The exact course of the surgery is individually planned to ensure optimal results.

The procedure is inpatient and performed under general anesthesia. If desired, fat grafting for volume restoration is done at the start. The facelift begins with skin preparation.

Incisions follow the hairline or within the hair, running in front of the ear in the ear’s natural crease, around the tragus and earlobe, and then extending backward into the neck’s hairline.

This discreet placement elegantly minimizes future scar visibility. Next, the SMAS is separated and lifted. Finally, excess skin is removed.

A Deep Plane Facelift is often combined with a brow lift, lower eyelid lift, or upper eyelid lift. Depending on the extent of corrections, the procedure lasts between four and six hours.

Deep Plane and High SMAS facelifts are similar in incision placement, but differ because only in High SMAS facelifts is the skin separated from the underlying muscle layer.

By preparing the skin and underlying muscles separately, the High SMAS method allows tightening them in different directions. A Deep Plane Facelift lifts skin and facial muscles as one unit.

How does a Deep Plane Facelift differ from other methods?
Since the 19th century, traditional facelifts have changed little: skin is prepared, tightened, and the excess is removed.

Yet facial aging involves more than sagging skin, including fat loss and loosening connective tissue beneath the surface.

A modern, sustainable facelift should also reconstruct volume, such as through additional fat grafting, and should always include tightening of subcutaneous connective tissue.

This explains the superiority of Deep Plane Facelifts: tension is transferred from the skin to the deeper connective tissue layers. The skin is therefore tightened without excessive tension.

Unlike conventional facelifts, this technique achieves much longer-lasting, natural-looking results and far finer scars that are virtually invisible.

A midface lift is a method of tightening the midface, the triangular area from the tip of the chin to the lower rim of the eye sockets, including the front cheek areas.

With age, the fat pads beneath the midface diminish. The gentle transition from the lower eyelid to the cheek disappears, and the face appears tired and hollow.

Attributing this solely to sagging skin and calling it ‘drooping’ misses the real cause: changes in fat and tissue volume. A midface lift can lift sagging areas but does not address volume loss.

The only suitable technique for rejuvenating the midface and cheeks is a fat injection—which can be combined with a Deep Plane Facelift if desired.

A mini-lift is a tightening of the facial skin to lift sagging cheeks. Like a midface lift, it does not fully address facial aging.

The tightened skin alone cannot hold tension over time, so a mini lift does not produce lasting results. As the skin retracts further, noticeable scars may also develop.

Results of a facelift performed with experience, expertise, and modern technique can last 10 to 15 years. Genetics, nutrition, and personal habits, especially sun and nicotine exposure, play too great a role to make general predictions.

The first sutures are removed after five days, the last after seven to ten days.

Normally, wound drains are removed with the first sutures, about five days after the facelift.

As with any surgery, bleeding, bruising, wound healing problems, and infection can occur. To avoid injury to facial nerves, facelifts should only be performed by experienced, board-certified specialists in Plastic & Aesthetic Surgery familiar with facial anatomy.

After a facelift, you will be observed as an inpatient for one to two days. Afterwards, avoid sun, sauna, and sports for at least six weeks. Physical exertion should be avoided for about 14 days. It is important to use strong sunscreen and cool your face intermittently in the days after surgery.

In the temples and forehead, facelift scars run within or along the hairline. Around the ears, they follow the natural curves, go around the earlobe, and continue behind the ear into the neck’s hairline.

You will be socially presentable about three weeks after a facelift. Bruising will have faded and swelling will be gone. Numbness and slight redness of the scars can last up to three months, and facial firmness up to six months.

A facelift is always performed as an inpatient procedure. The stay lasts one to two days.

Deep Plane Facelifts are technically far more demanding than conventional facelifts. Only a few board certified Plastic & Aesthetic Surgeons have the necessary training and experience to perform them.

A facial rejuvenation facelift should include the neck to avoid a noticeable difference between face and neck.

The results of liposuction alone are usually not satisfactory. With age, superficial neck fat decreases, while fat under the neck muscles often increases.

As only the superficial fat can be removed, liposuction alone does not achieve the desired neck rejuvenation.

Every neck lift is preceded by a detailed exam and thorough photo documentation. It must be determined if there’s just skin laxity, or if the muscle bands are especially pronounced or saliva glands enlarged.

The procedure is inpatient, under twilight sedation or general anesthesia. Depending on findings, neck lifting includes reducing submuscular fat and enlarged salivary glands. The neck muscles in the midline and side skin behind the ear are finally tightened.

A neck lift is ideally done only together with a facelift. Exceptions are very full necks at a young age. When rejuvenating the face, both face and neck should always be seen as a unit.

Because facial aging varies individually, a facelift can be considered even before age 40.

If previous surgeries have been performed carefully, a facelift can be repeated two to three times.

No other method achieves the results of a good facelift. As a non-surgical alternative, facial volume can be restored—using hyaluronic acid or, especially in younger adults, autologous fat injections.

The costs of a facelift can only be determined after a careful examination of your face and neck. A non-binding consultation including photo analysis lasts about 60 minutes.