Deep Plane Facelift
What is a Deep Plane Facelift?
The Deep Plane Facelift works by releasing the SMAS and Platysma layers from underlying structures, including the masseter muscle and facial nerve branches. This allows for a more comprehensive and tension-free lift, providing longer-lasting, natural results. The tension of the lift is held in the deeper structural layers of the face, meaning the skin is simply re-draped after – meaning no windswept unnatural results and providing the best environment for the scars to heal beautifully without any tension or risk of stretching. The deep plane approach also repositions the midface fat compartments, which conventional facelifts cannot address. This restores the volume to the cheek area and recreates the “V” shaped youthful face. A deep plane facelift is technically much more complex than traditional facelift procedures as the surgeon must dissect around important nerves of the face. Mr Orfaniotis’ dedicated his training to head and neck reconstructive surgeon for over a decade and is adept at handling this complexity. Read more about his experience here.
What are the other types of facelift procedures?
Facelift techniques vary based on the extent of the surgery and the depth of dissection of the S.M.A.S. The choice of procedure is less about severity of laxity, but rather skillset of surgeon, and patient preference on recovery. There are three main types:
1.Superficial SMAS Procedures: These involve minor adjustments to the S.M.A.S. layer, such as plication or imbrication, and are less invasive.
2.Sub-SMAS Procedures: A more advanced technique, where a flap of S.M.A.S. is lifted for repositioning. These may include lateral SMAS approaches or a deeper dissection.
3.Deep Plane Facelift: The most advanced technique, where the SMAS and Platysma are completely released from underlying tissues, enabling a more effective, natural re-suspension. This technique requires extensive anatomical knowledge in order to achieve successful results.
Do I also need a Deep Plane Necklift?
In almost all cases where a facelift is indicated, a deep structural neck lift is also needed. It is rare from Mr Orfaniotis to perform a facelift procedure without also performing a necklift procedure at the same time. By freeing the Platysma muscle which is the muscle found in the neck during a deep plane necklift, Mr Orfaniotis can improve neck contours and reveal a sharper jawline, which would not be possible with a facelift alone owing to the vectors of aging. During a deep neck lift there is also the option of reduction of the deep structures located underneath the platysma including fat and submandibular glands. Read more about the necklift procedure here.
What happens to the face as we age? The Ageing Process
As we age, the youthful “V-shape” of the face transitions into a squarer shape, with the cheeks flattening and the lower face widening. The key to achieving a natural, youthful result lies in restoring volume and repositioning tissues and the deeper structures to reverse these changes.
Ageing affects all layers of the face: the skin, fat, facial muscles, and bone structure. The skin loses vital collagen and elastin, leading to thinning and reduced elasticity. Fat volume decreases in certain areas (atrophy) while increasing in others (hypertrophy). Ligaments that anchor the facial tissues begin to weaken, causing a downward descent of the fat compartments.
One of the most important structures however in facial ageing is the S.M.A.S. (Superficial Musculo-Aponeurotic System). It is located between the skin and deeper facial muscles, with the facial nerves traversing just below them. The S.M.A.S. provides key anchors in the face that keep the fat and muscle in position during our youth. As we age the S.M.A.S. becomes lax. This laxity is the reason for the majority of facial ageing, and not an anatomical structure that can be addressed with non-surgical techniques, or more traditional facelifts. During a deep plane facelift and necklift the S.M.A.S. and the Platysma muscle (in the neck), respectively, are the key targets.
What Does a Facelift and Necklift Address?
In almost all cases where a facelift is indicated, a deep structural neck lift is also needed. It is rare from Mr Orfaniotis to perform a facelift procedure without also performing a necklift procedure at the same time. By freeing the Platysma muscle which is the muscle found in the neck during a deep plane necklift, Mr Orfaniotis can improve neck contours and reveal a sharper jawline, which would not be possible with a facelift alone owing to the vectors of aging. During a deep neck lift there is also the option of reduction of the deep structures located underneath the platysma including fat and submandibular glands. Read more about the necklift procedure here.
Common Areas Addressed in a Facelift:
Midface
- Flattening of the upper cheeks (malar fat atrophy)
- Hollowing at the eyelid-cheek junction (tear troughs)
- Deep nasolabial folds
- Ptosis of the buccal fat pad
Lower Face
- Jowls and excess fat falling over the jawline
- Loss of jawline definition
- Deep nasolabial folds
- Marionette lines (melo-mental and melo-labial folds)
Neck
- Thinning, lax skin contributing to wrinkles
- Vertical bands due to Platysma laxity
- Fat accumulation and digastric muscle bulging
- Ptosis of the submandibular glands
Lip & Perioral Area
- Loss of upper lip volume
- Thinning of the vermillion border
- Vertical lip lengthening and perioral wrinkles
Periorbital Area
- Laxity of the lower eyelids, fat herniation, tear trough deformity
- Upper eyelid and temple rejuvenation
- Brow and forehead rejuvenation
Who is a Good Candidate for a Deep Plane Facelift?
Ideal candidates for a facelift are those experiencing sagging, volume loss, or a downward descent of tissue. Both men and women of varying ages can benefit. Just as no two faces are the same, no two surgeries are the same. Each patients is assessed in person on a case-by-case basis to develop a bespoke plan that can addresses your own personal concerns and expectations.
To undergo surgery with Mr Orfaniotis, patients should be non-smokers with well-controlled blood pressure and a BMI under 30.
Recovery After a Deep Plane Facelift
Most patients choose an overnight hospital stay but some can return home a few hours after the procedure with the assistance of a companion. You will be given pain relief, antibiotics, and anti-nausea medication as needed. A compression garment will need to be worn for the first week, and patients are advised to rest for 48 hours post-surgery. The recovery process typically involves:
- Initial bruising: Bruising may last 10-14 days, depending on the extent of surgery.
- Pain and discomfort: Most patients experience mild discomfort for 2-5 days, which is managed effectively by the recovery team.
- Swelling: Swelling is common, and while it can take 2-4 weeks to subside, the final result should be expected at 6 months after surgery
- Return to work: Most patients return to work within 2 weeks, although strenuous activities should be avoided for 4-6 weeks.
- Exercise: You can begin gentle movement, like brisk walking immediately after surgery. Using a stationary bike, from around 10 days post-surgery. Light stretching or yoga is usually fine after 2 weeks. We advise waiting 4 weeks before resuming more vigorous activity, and 6 weeks before return to full strenuous training.
Mr. Orfaniotis’ dedicated recovery team ensures a smooth healing process, providing continuous support throughout your recovery. Read more about the recovery team here.
What About Scarring?
Facelift scars are typically discreet, healing in natural skin folds around the ear and hairline. In most cases, these scars are barely noticeable after 4 months. Scar healing varies, but patients can expect redness in the early weeks, which gradually fades. Surgical technique impacts on scar outcomes, and this is why Mr Orfaniotis dedicates 90 minutes at the end of each operation purely on stitching the skin neatly together.
How Long Does a Facelift Last?
A facelift is a permanent solution to the effects of ageing, but it cannot stop the natural ageing process. With proper care, the results can last for many years. Mr. Orfaniotis and his team will provide guidance on how to maintain your result.
Additional Procedures
It is common for additional procedures to be performed alongside a deep plane facelift. These include the following;
- Deep Neck Lift: Performed alongside most cases of deep plane facelift. Performed via a submental incision (hidden beneath the chin), this treatment targets neck heaviness and excess skin.
- Brow Lift: Performed alongside most cases of deep plane facelift. Addresses forehead and temple laxity and restores the youthful vector of the upper face.
- Fat Grafting: Can restore volume to the cheeks, tear troughs, and lips using fat harvested from your own body.
- Lip Lift: A procedure to reduce the distance between the base of the nose and upper lip. This distance elongates as we age, and contributes to the aging lower face.
- Blepharoplasty: Upper and lower eyelid surgery to rejuvenate the eye area.
Conclusion
A Deep Plane Facelift is the gold standard for those seeking long-lasting, natural rejuvenation of the face. If you are considering a facelift, Mr Georgios Orfaniotis offers personalised consultations to help you achieve your aesthetic goals with advanced techniques and exceptional care.
Contact us today to schedule a consultation and explore the possibilities of a rejuvenated, youthful appearance.
Pricing: The cost of a face and necklift starts from £42,000. For more detailed pricing and a full breakdown of services, click here to view our price list.
Read more on facelift procedure facts below.
Deep Plane Facelift Procedure Facts
Anaesthesia
General anaesthesia (TIVA)
Length of Stay
Overnight hospital stay or day case.
Surgery Duration
6–8 hours, depending on additional procedures.
Drains
Drains may be used, particularly for deep lifts involving submandibular gland reduction. A “Hemostatic Net” quilting technique is used to reduce bleeding. Drains and the hemostatic net are removed at your first post-op appointment, 48 hours after surgery.
Aftercare
We offer a comprehensive recovery support package designed to ensure a smooth recovery. Read more about our first class recovery support package here.
Post-Op Appointments to plan for.
- 48 hours: Dressings removed and wounds inspected.
- 7-9 days: Wounds cleaned and sutures removed.
Deep Plane facelift Procedure Facts
What are the risks of a Facelift?
Although face and neck lifts are generally safe, as with any surgery, there are potential risks. These include:
- Bleeding: Uncommon, but may require surgical drainage if a haematoma forms.
- Seroma: Fluid accumulation beneath the skin, sometimes needing drainage. Rarely leads to fibrosis.
- Infection: As with any surgery, infections are possible but manageable.
- Scarring: Scars are inevitable but typically improve with time. Hypertrophic or keloid scars can occasionally occur, requiring additional treatments.
- Delayed Healing: Healing times may vary, with some areas taking longer. Smokers or those with previous skin treatments may experience delayed healing.
- Skin Discolouration/Swelling: Bruising and swelling are common, with skin sometimes discolouring temporarily.
- Sensory Changes: Numbness, tingling, or pain in the face and neck can occur due to nerve recovery. These sensations usually subside after 12–18 months, but occasionally can persist.
- Suture Extrusion: Rarely, sutures may protrude from the skin after healing. Simple dressings can help.
- Skin and Fat Necrosis: Insufficient blood supply to the skin can cause tissue death. In extreme cases, further surgery may be necessary.
- Skin Contour Irregularities: Wrinkling or puckering may develop and require additional treatments.
- Restricted Movement: Some patients experience temporary tightness and restricted movement (e.g. difficulty opening the mouth fully).
- Facial Nerve Injury: Very rarely, facial nerve injury may affect facial muscle movement, but this is typically temporary.
- Salivary Gland Leakage: Salivary glands may leak, requiring drainage and additional appointments until the leak seals.
- Hair Loss/Changes: Temporary or permanent hair loss can occur near incisions, especially in male patients around the beard area.
- Asymmetry: Pre-existing asymmetries in the face and neck may affect surgical results, though adjustments are made to minimise noticeable differences.
