Aging is one of the main concerns of mankind, as the passage of time unavoidably leaves its mark on our face. Look how you feel and feel how you look, sometimes a little touchup can help reverse the aging process and here is where a deep plane lift offers one of the most effective methods that have been developed to holistically address the changes that occur in our face and neck over the years.
To appreciate the benefits of a deep plane lift, we first need to better understand what happens when a person ages. The changes of aging concern the skin, fat, muscles, ligaments of the face and to some extent bones. The skin is the “cover” of the face and over the years, it atrophies, loses its elasticity and is subject to changes from solar radiation. However, what mainly leads to the biggest changes is the fat present under the skin, which also atrophies, but mostly shifts downwards, disrupting the harmonious lines of the face. Ligaments and muscles are the more stable elements of the face, which keep fat and skin in place, however these also lose their firmness over the years. Finally, the skeleton shows some smaller changes, but we must also take these into account when examining the effects of time on our face.
One is certain: the deeper we peel in the face, the more robust and stable the tissues and structures we will encounter. This means that a facial lift operation that is superficial is less effective and of shorter duration, while the deeper we are, the more stable the result becomes over time. The deep plane lift has been developed exactly with this in mind, namely how to achieve an effective and stable facial lift and achieves exactly that. The terminology deep plane might be relatively young, however the deep lifting techniques have been performed and perfected for the past 30 years.
For this reasons, the deep plane lifting technique has become the “Holy Grail” of facial surgeries worldwide and most patients are now looking for this exact operation to treat facial laxity.
Deep plane lift indicators
Deep plane lift surgery mainly concerns people over 40 years old, men or women who have less or more sagging of the face and neck. The age limit is not strict, as each person ages differently and it all comes down totissue elasticity, soft tissue weight, genetic predisposition and anatomy. A typical example is with people who have experienced great weight loss, where relaxation can occur prematurely at very early age.
The areas we aim to correct with the deep facial lift are the neck, the oval of the face and the middle face. However, this procedure can be combined with other anti-aging procedures, such as blepharoplasty, brow lift, lip lift as well as anti-aging skin treatments such as laser, peelings , fractional RF etc. In the evaluation of the face and in order to achieve an overall natural and fresh image, a holistic approach is needed, as the deep plane reverses a very large and important part of aging but sometimes it is preferable to be accompanied by some of the above interventions.
Deep plane lift technique
The operation of deep plane lift can be performed either under general anesthesia or with local anesthesia and sedation and lasts about 3 hours without necessarily requiring a stay in the clinic. The way of tissue lift differs radically from other types of facelift procedures, mainly due to the depth of tissue mobilization, but also due to the lifting axis, which is at 60-70 degrees. This means that tissue lifting is done almost on a vertical axis, exactly opposite to gravity, which is much more effective and gives a much more natural result.
Another great advantage of deep plane is the depth of the lift. The undermining of the skin is very limited, usually 2-3 cm, which leaves little dead space for bruising and significantly limits the complications of healing. For the deep plane lift to have any effect, the dissection and release of the 5 main ligaments (the connective tissue that tethers the skin and soft tissues to the underlying stractures and the bone)of the face is absolutely necessary. After the ligaments are released, the ptotic tissues are dramatically lifted and reattached to strong tissues, such as the temporal, parotidal fascia and mastoid.
The scar around the ear is placed in such a way that it is not visible after a period of a few months, and also does not disrupt the hairline at all. Also, the incision is such that it does not change the shape of the ear and the suturing of the skin is done without any tension, so that there is no risk of spreading the scar or causing any deformity in the ear area.
The preparation of tissues in deep shot starts from about the corner of the eye and continues seamlessly up to the neck, under the movable part of the SMAS, ie the superficial muscles of the face. This means that face and neck are lifted as a single entity, which is much more powerful and effective.
As far as the neck is concerned, in addition to the deep lateral lift, sometimes it is necessary to access the central aspect of the neck in order to fix the submental area with a “hammock” suspension, extended myotomy for the platysma bands or hyoid suspension.
New innovations in the field of facelifts have allowed us to significantly reduce bruising and swelling. The combination of the use of new drugs and the special hemostatic net makes the use of drains usually unnecessary and significantly reduces swelling, bruising and thus the return to everyday life.
Recovery after deep plane lift
All operations need a certain amount of time until the aesthetic result matures, the same happens with the deep plane lift. The first week is the so-called week of healing. From the 10th day begins the period of decongestion, where the fluids that have accumulated on the face gradually begin to recede. From 3-6 months is the period of regeneration, when tissues begin to return to their normal function. The final period from the 6th to 12th month is the maturity period, where only subtle changes take place and a much-appreciated natural look is accomplished.
Most patients can return to work and obligations 10-15 days after surgery, without any particular deformity.
Scars on after 3-4 months disappear almost completely. However, both the progress of recovery and the image of scars differ from person to person and are not always predictable.
There is usually no pain throughout recovery, however there is a feeling of pressure in the throat, which can last 2-3 weeks. The numbness of the face gradually subsides after 3-6 months and muscle movement can also be affected for some short time, without this having any consequence or clinical significance long term. From the experience of with various face and neck lift techniques, such as high SMAS, low SMAS, SMAS plication, vertical lift and mini lift, deep plane lift seems to have in comparison a generally a faster and better recovery. This is mostly due to the fact that it is less traumatic and that the main lifting process is done deeply, that does not leave so many traces on the surface of the skin.
Results deep plane lift
In summary, deep plane lift is a revolutionary method of face lift while on the same time being the evolution of face lifting techniqes. In the right hand this technique offers excellent and natural results which will last longer. The term deep plane itself has become viral and worldwide we encounter both patients and surgeons who are ecstatic with the results. It is however a challenging operation that requires a very specific training and for this reason worldwide it is performed in less than 5% of plastic surgeons.
From my experience with the deep plane lift in the recent years, it seems that it clearly excels both in the naturalness of the results and in the duration of the result. This, combined with faster recovery and more effectiveness regardless of age and relaxation, makes a the deep plane technique my now golden standard of face lifting.
Deep plane facelift cost?
The cost of a deep plane facelift is personalized and depends on all the procedures estimated to be needed in order to effectively and completely reverse facial aging. For example, sometimes the deep plane face and neck lift can be combined with upper or lower blepharoplasty, forehead lift, lip lift, laser for skin freshening, fat transfer or other minor operations. Thus, the cost can only be determined after an assessment of each person.
Frequently asked questions
How many years does the result of a deep plane lift last?
The duration of the effect depends on many different factors, such as age, tissue quality, heaviness of the face, smoking, athletic activities and genetic predisposition. The deep plane lift is considered one of the most powerful neck and face lifts and the duration of the effect is roughly estimated at 10-15 years.
How many years younger will my face look after a deep plane facelift?
The changes in the face are proportional to the age you choose to have the operation. This means that if the operation is done at the age of 45-50, the face may look 30-35, while if the operation is done at the age of 60-65, it will look 40-45. So the age difference we expect after a deep plane facelift is 15-25 years.
Why is the percentage of plastic surgeons worldwide performing deep plane lifts so small?
Unlike other techniques, deep plane has a longer learning curve and requires surgeon experience and excellent knowledge of facial anatomy. Global statistics show that only 5% of plastic surgeons perform a deep plane lift, however we must take this with a grain of salt, since some of those perform a variant or a hybrid method and not an actual deep plane and also another percentage may claim to carry out this procedure for marketing purposes. As a result, the actual percentage of doctors who actually perform a true deep plane must be even lower.
At what age is it better to do a deep plane lift?
Age is not the determining factor, as much as the relaxation of the face and neck. In the author's opinion, it is preferable for the deep plane facelift to be performed at the age of 45-55, firstly so that the difference before and after is not so pronounced and secondly so that there is not so much dependence of the face on non-invasive anti-aging techniques, such as fillers, threads, energy based devices and others, which ultimately can under no circumstances offer an aesthetic result comparable to a deep plane lift and additionally create a dependency that can lead to excesses and deformation.
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