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Newsletter: Deep Plane Facelift

Deep Plane Facelift Technique: Deep Plane vs. Minilift and MACS-lift

For several years, I have been deeply involved in a new facelift technique known as the DEEP PLANE FACELIFT.

I have attended various training sessions and conferences to refine my expertise, including those led by Mike Nayak and Dominic Bray. Additionally, I participated in five cadaver courses. Over time, the technique has been further refined through extensive experience-sharing within a Telegram group I am a member of, which includes over 3,000 facial plastic surgeons. This group engages in daily discussions on advantages and disadvantages, special and unique cases, anatomical variations, technique refinements, and more.

The Deep Plane Facelift is an advanced facial rejuvenation technique that delivers natural and long-lasting results. Unlike traditional (mini) facelift procedures, which primarily focus on the skin, the Deep Plane Facelift targets the deeper layers of the face.

What Is a Deep Plane Facelift?

A Deep Plane Facelift is a surgical procedure that lifts and repositions the deeper layers of the face (such as muscles, connective tissue, and fat) to restore a more youthful appearance, targeting layer 4. Most other facelift techniques are more superficial, focusing on layer 2.

The face consists of five layers:

  1. Skin
  2. Subcutaneous fat
  3. SMAS (Superficial Musculo-Aponeurotic System) – platysma
  4. Sliding layer (loose areolar plane)
  5. Periosteum / deep fascia

Each layer varies in composition across different parts of the face:

  • Layer 1: The skin is thickest around the cheeks and nose and thinnest on the eyelids and temples.
  • Layer 2: Fat is prominent in the cheeks and nearly absent in the eyelids (under-eye fat bags originate from a deeper layer).
  • Layer 3: The SMAS is a muscle layer responsible for facial animations like talking, laughing, and blinking.
  • Layer 4: Contains ligaments, facial nerves, and blood vessels. This layer supports the top three layers.
  • Layer 5: Bones (or deep fascia in the cheeks and neck) provide structural support to the face.

The procedure focuses on lifting the SMAS layer by accessing layer 4. This results in a tighter, lifted, and more defined appearance.

Step-by-Step Process of the Deep Plane Facelift

  1. Preoperative Planning and Anesthesia
    The patient undergoes a consultation during which the surgeon evaluates facial anatomy, skin condition, and aging concerns. The procedure is performed under general anesthesia or IV sedation.
  2. Incision Placement
    Incisions are discreetly placed along natural facial folds:

    • Along the hairline (in front of or behind the tragus).
    • Around the earlobe and behind the ear (extended into the hairline if necessary).
  3. Dissection of Deep Tissues
    The skin is separated from the underlying SMAS layer. Ligaments anchoring the SMAS are carefully released to protect important nerves and blood vessels.
  4. Lifting and Repositioning the SMAS Layer
    The SMAS is lifted and repositioned, creating a tighter appearance for the cheeks, jawline, and neck. This enhances both the lower and midface.
  5. Addressing the Neck Area
    A significant distinction from a Minilift or MACS-lift is the treatment of neck laxity by securing the platysma to the mastoid bone. For a deep neck reduction, an incision under the chin allows further contouring of the neck and tightening of the jawline by removing deep fat, submandibular glands, and more.
  6. Closing the Incisions
    The skin is meticulously sutured without tension using fine stitches to minimize visible scarring.

Swelling and bruising typically subside within six weeks. Most patients are presentable after 2–4 weeks.

Benefits of a Deep Plane Facelift

  • Natural Results
    By working with the underlying structures, this technique delivers natural results without the “pulled” appearance.

  • Long-Lasting Effects
    Results often remain visible for 8-10 years or longer.

  • Comprehensive Rejuvenation
    The procedure targets all facial areas, including the cheeks, jawline, and neck.

  • Minimized Scarring
    With little to no tension on the skin, scars are discreet and less noticeable.

  • Facial Nerve Safety
    An experienced surgeon minimizes the risk of nerve damage. Proper training and expertise are essential.

  • Improved Neck Contour
    For heavier necks, a deep neck reduction is performed.

  • Ideal for Advanced Aging
    By addressing the central third of the face, the Deep Plane Facelift delivers superior results compared to superficial techniques like the Minilift or MACS-lift.

 

Why Choose a Deep Plane Facelift?

By targeting the underlying structure of the face, this technique provides transformative rejuvenation that surpasses traditional methods such as the Minilift or MACS-lift.

Always consult an experienced surgeon to determine if this procedure aligns with your goals.

The patients shown below can be found on the Instagram page—follow the page for updates by clicking on these photos and then following.

 

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