To simplify and to give a generic and understandable explanation: There are 2 different perspectives, anatomy and surgical technique.
Both facelift terms describe an anatomical layer. The term “Deep plane” defines everything below the so-called SMAS layer. The so-called SMAS is an important anatomical layer in any facelift technique for a variety of reasons. It is always part of the surgery with the exception of the mainly abandoned “skin only” facelifts. Anatomy wise, the deepest deep plane facelift, is the subperiostal facelift. To clarify, one could interpret the term “deep plane” as the headline of a chapter. Whereas the so-called SMAS relates to a specific anatomical layer of the face and neck. A SMAS facelift where the surgical dissection is performed below the SMAS is called a sub-SMAS facelift and is considered a Deep Plane Facelift. If the SMAS is not undermined, but plicated, some would not consider it being a deep plane.
The original “Deep Plane Facelift” Technique, described by Sam Hamra in 1990, is different from what most perform and call it today. 2 key elements of the nowadays popularized technique are the direct access, and the mobilization and lifting of the sagging facial tissue (ie, mobile SMAS) as a composite flap. This means the skin is not widely undermined, which results for most in a faster recovery.
Both types of facelifts and their variations can lead to compelling results, once executed skillfully. Less ideal results are often related to the limited mobilization and therefore a limited lifting effect. Most commonly this affects the mid face. The so-called “Vertical lift” in social media touches on this. In both “types” of facelifts, the complete release of certain ligaments under the preservation of the nearby facial nerve is key. Those maneuvers during surgery are paramount to mobilize and to reposition the tissue, avoiding a pulled and tethered look.
Most patients undergo a
facelift or a
neck lift procedure, when they feel time is right. Patients find themselves often at an intersection choosing between surgical and non-surgical. And some may have already undergone some procedures beforehand. Over the years it has been noted, that patients tend to prefer a more complex lasting surgical procedure, than continuing with smaller interventions longterm.
A deep plane facelift can be performed with several limited, hidden scars, if skin elasticity is still good. Most of these patients are younger or have maintained their youthfulness. But even if the incisions are placed in a “classic” way, around the ear, they can become nearly invisible with the right technique, genes, and aftercare.
Best outcomes are achieved, the less procedures and interventions a patient has undertaken beforehand. This is especially the case, if commercially available volume filling material, or energy based devices have been used. During the consultation Dr Knoll will advise patients about the possible short-comings and potential solutions.
Best candidates for a Deep Plane Facelift are patients:
- who are noting jowls, deep nasolabial folds, maybe already marionette lines, and the visible bony rim of the orbit
- who are willing to undergo a surgical procedure and are accepting of the recovery time
- who are in great physical health, and who are non-smokers
- who are mentally stable and emotionally healthy
Deep plane facelift consultations with Dr Knoll are complex, very informative and educational. Most patients value being in contact with us to prepare for their consultations. It is the goal of Dr Knoll and her team to guide and to provide you with information relevant to your situation. During your consultation with Dr Bianca Knoll, she will honestly advice you about different techniques and approaches available. There are advantages and disadvantages to each. Each patient should be allowed to understand those to make an educated decision. A choice that each patients should feel comfortable about; by understanding immediate and long-term consequences of the procedure.
