Info About Deep Plane Face lifting in New York, NY
Deep Plane Facelift Before and After This patient had a Minimal Access Extended Deep Plane Facelift which is the signature M.A.D.E facelift procedure by Dr. Andrew Jacono. This patient was so thrilled with her results that she sent us her before and after photos that she took on her cell phone. This dramatic transformation has this patient looking 15 years younger. Dr. Jacono is a facial plastic surgeon who has pioneered this technique and regularly lectures around the world from Tokyo, Paris, London, Singapore, to Yale, Harvard, and Stanford University. Dr. Jacono has also published several books and articles on his developments in facelift procedures.
The deep plane facelift avoids the problem of the tight overfilled look of many modern facelifts. The main tenet of the deep plane facelift is that it lifts only under the muscle layer, leaving the skin attached to the muscle layers, so it can never look tight. It also lifts the cheeks by releasing the tethering points of the face in the deep plane so that the addition of fat or filler is unnecessary.
What is a Deep Plane Facelift
The “deep plane” is the term used to describe the anatomic plane that exists between the SMAS-platysma complex (which is muscle and fascia) and the deeper layer of muscles responsible for facial expression. The deep plane facelift focuses on the release and movement of muscle and fat layers instead of skin pull and removal. The extended deep plane facelift that Doctor Jacono has developed incorporates the release of the ligaments tethering the deep plane layer to achieve tension-free movement so that no tightness can be created by the facelift procedure. There are four ligaments that he releases with corresponding natural lifting throughout the face and neck.
The first ligament released is the zygomatic ligaments that tether the cheek so that drooping cheeks can be elevated superiorly. This restores the cheek shape and volume recreating the heart-shaped face of youth avoiding the need to add filler, fat, or cheek implants to the face. It also will improve the nasolabial folds (creases from our nose to the corner of the mouth), and hollowing and shadowing seen under the lower eyelids by restoring volume that is lost by gravitational descent associated with aging. Doctor Jacono has published research in the Aesthetic Surgery Journal that this restores cheek volume equivalent to adding 3 vials of injected filler or fat in the face and that this effect is permanent. He releases the masseteric and mandibular ligaments that tether the jowl so that it can be lifted creating a smooth and crisp jawline appearance.
Doctor Jacono was the first surgeon to describe the release of the cervical retaining ligaments that tether the platysma muscle in the neck and is the basis for his technique that is the extended deep plane facelift. This extension of the deep plane into the neck allows for more significant redraping of the platysma and rejuvenation and refinement in the neck and jawline is more natural and longer-lasting. This part of the technique also improves the definition along the angle of the jaw, which is often blunted by the bunching that is created in SMAS techniques.
Also unique to Doctor Jacono’s technique is the vector or direction the face is lifted after the deep plane facelift release is accomplished. A traditional facelift tightens the face horizontally or towards the ears and making the face appear stretched and the cheeks flattened. This can also cause the corner of the mouth and eyes to look pulled. To avoid these problems a vertical vector or redraping is utilized. By lifting the facial more vertically a smoother more natural appearance is created, the cheeks are restored, and the corners of the mouth that sag with age is elevated. Doctor Jacono performed clinical research that was published to better define the angle of the proper vertical vector or direction of the lift. Dr. Jacono found the ideal vertical facelift “Angle for Maximal Rejuvenation” to be 60 degrees for patients with a mean age of 60 years old. As the age of the patient increases, the angle decreases. Conversely, patients younger than 60 years old will require a greater more vertical facelift angle.
Deep Plane Facelift Patient Before and After 1: This middle-aged woman had a deep plane facelift procedure performed by Dr. Jacono to lift her cheeks, jowls, and neckline. Minimal incision techniques were used to create a natural facial rejuvenation with no visible scarring.
Another innovation in deep plane facelifting Dr. Jacono has introduced to the plastic surgery literature is the ability to perform a deep plane facelift through a smaller incision. Often referred to a short scar or S-lift type incision, Dr Jacono’s hybrid deep plane facelift is called a M.A.D.E. “Minimal Access Deep Plane Extended” facelift. This approach has a deep plane facelift scar that is half the length of a typical facelift scar. It is hidden inside the tragus and behind the ear so it cannot be visualized even when the hair is pulled back or placed in a ponytail.
Depending upon the degree of neck drooping and heaviness that occurs, the deep plane facelift may be combined with a midline platysma tightening called a platysmaplasty. Through a small hidden incision under the chin, vertical cords and bands in the neck can be tightened and chin fat that accumulates with age can be removed. Because Dr. Jacono’s extended deep plane facelift more significantly lifts the platysma than other facelifting techniques, the additional midline surgery, trauma, and recovery can be avoided in a majority of cases.
Since the deeper layer utilized in a deep plane facelift is fibrous and inelastic, unlike the skin which is very elastic, the deep plane facelift procedure has the most long-lasting result of any facelifting technique. Because it works on the structural elements of the face, the deep plane facelift is more durable than SMAS type facelifts often lasting 10 years and beyond.
Over the course of almost two decades, Dr. Andrew Jacono has developed and pioneered the most advanced and comprehensive deep plane facelift that helps create natural results lifting drooping cheeks, jawline and neck without the appearance of the stigmata of tightness that can occur with other facelifting techniques. Doctor Jacono has published multiple hallmark research studies on his extended deep plane facelift technique in the Aesthetic Surgery Journal, the leading peer-reviewed plastic surgery publication of the American Society of Aesthetic Plastic Surgeons.
He has given lectures on deep plane facelift at Harvard Medical School, Yale University, Stanford University, and the University of Pennsylvania, as well as delivered over 100 lectures on his extended deep plane facelift at the most important national and international plastic surgery symposia of the American Academy of Facial Plastic and Reconstructive Surgeons, European Academy of Facial Plastic Surgeons, and the International Society of Aesthetic Plastic Surgeons. He is considered an international expert in deep plane facelifting, and was recently selected as one of the 20 best facelifting surgeons worldwide to contribute to a textbook comparing their expert methods in facelift surgery. He has performed over 1500 deep plane facelifts and continues to teach his techniques performing live demonstration deep plane facelift surgery all over the world. Hundreds of surgeons from 6 continents have traveled to observe Dr. Jacono performed a deep plane facelift.
How This Technique Compares to Other Approaches
Most patients are concerned about “looking like they had a facelift” or looking pulled after surgery because they see so many celebrities, newscasters, and people in their communities looking like they had work done. The reason for this is that the most commonly performed facelift surgery in the United States is a superficial facelift called a SMAS plication lift, not a deep plane facelift. This facelift technique involves simply elevating the skin followed by placing sutures to lift the SMAS-Platysma complex. The SMAS (Superficial Musculo-Aponeurotic System) is the muscle of the lower cheeks and jowl, and the platysma is the muscle that drapes across the neck and lower third of the face. Pulling this SMAS-Platysma layer is better than lifting the skin alone, but separating the skin from the underlying muscles as is performed in a SMAS facelift creates a tight look to the skin. This surgery only treats the lower third of the face and jawline and does not lift drooping cheeks. As a result, many surgeons will perform fat grafting to the cheeks at the same time. Fat grafting is performed by liposuctioning fat from the abdomen or thighs and injecting it into the face, often making the cheeks look overfilled because they are not lifted as they droop simply inflated. Unlike a SMAS facelift where the skin is separated from the deeper muscles and soft tissue, the deep plane technique re-positions under the loosened saggy muscles and fat of the face as a unit leaving the skin intact.
Deep Plane Facelift – Deep Plane Facelift Before and After – Deep Plane Facelift Results
Deep Plane Facelift Before and After Patient 2: This patient was unhappy with the loose, excess skin and wrinkles on her face and neck. She wanted to smooth out her facial wrinkles including under her eyes, neck region and wanted to reduce the appearance of her jowls and nasolabial folds which she felt were making her look older. Dr. Jacono performed a deep plane facelift to reduce the appearance of her sagging jowls and to lift her cheeks naturally. He also performed a neck lift to address the loose hanging neck skin, and he performed a lower eyelid lift procedure. Her after photos show her looking natural and 20 years younger. She does not look like she had any type of cosmetic procedure and her family and friends have all told her that she looks terrific.
Recovery following a deep plane facelift usually involves some bruising and swelling around the re-positioned areas for the first few days. These symptoms will gradually disappear on their own. Because the deep plane technique is accomplished in the layer that naturally exists in our face there is minimal bruising and minimal pain after the procedure. Deep plane surgery also maintains more of the natural blood supply to the skin by not severing blood vessels between the muscle and skin allowing for more rapid healing. SMAS type facelifts lift under the skin disrupting blood vessels. Because of this bruising is greater in non-deep plane facelifts.
Some pain medication may be prescribed to help the patient to feel more comfortable during the healing process. Patients will also be encouraged to apply cold compresses to help alleviate swelling and elevation of the head will be recommended as well. It is important to get plenty of rest during the recovery
Deep plane facelift incisions heal with minimal to no visible scarring. Because the deep plane facelift does not separate the skin and the lift is supported under the muscles, there is no tension or pulling on the incision lines once closed. This tension-free closure allows the incision to heal like imperceptible fine lines. It also prevents pulling of the earlobe after facelift which can create a “pixie ear” deformity where the earlobes elongated and are pulled down after facelift surgery.
There are many advantages to having Dr. Jacono perform your deep plane facelift. As a pioneer and teacher of this surgical procedure, Dr. Jacono has developed improvements that his patients benefit from. To begin with, Dr. Jacono uses local or twilight anesthesia to perform the deep plane facelift and this allows him to keep the surgical time around 1 ½ to 2 hours long. Often patients will have an awake deep plane facelift with just numbing shots in the face using medication like Novocaine you get at the dentist. A standard facelift procedure involves general anesthesia and surgical time that can last up to 5 hours. There is also less trauma caused to the facial tissue so the recovery time is also shorter.
An overview of some benefits includes:
- Shorter surgical time
- More natural results by repositioning the SMAS, platysma
- Restoration of natural volume and elevation of the cheeks
- Excess skin is removed leaving smoother skin
- Nasolabial folds are softened
- Quicker Recovery
- Better Facelift Scars
- Longer Lasting Result
Am I a Candidate for a Deep Plane Facelift?
Good candidates for a deep plane facelift are men and women who are showing signs of aging in their face that includes sagging and drooping skin. Candidates should be in good physical health and have a realistic expectation of the surgical outcome. During your consultation with Dr. Jacono, he will be able to determine if a deep plane facelift is a right procedure for you.
Deep Plane Facelift Patient Before and After 3: Unhappy with her sagging jawline, neck, and eyelids, this patient opted for a deep plane facelift combined with a lower blepharoplasty with Dr. Andrew Jacono. Her before and after photos show her stunning jawline and tight neck area. It is also apparent that her cheeks have been lifted and her lower eyelids no longer look droopy and tired. Her overall facial rejuvenation shaved years off of her age and she looks beautiful and refreshed.
Deep Plane Facelift Before and After Patient 4: This lovely patient had a prior facelift procedure with another surgeon 2 years ago. She was unhappy with the results as her cheeks were overfilled and her jowls were still visible. She felt her facial contour was lumpier, then smooth. To correct this, Dr. Andrew Jacono performed a revision facelift procedure using his deep plane technique which lifts the cheeks and nasolabial folds to their natural position while smoothing the jawline. To complete the transformation, a lateral temporal lift was used to open the upper eyelids and outer brow, so she did not look tired anymore. She loves her new refreshed look and looks natural even without makeup.
Deep Plane Facelift Before and After Patient 5: This wonderful 53-year-old patient was unhappy with how she was aging. She did not like how her cheeks had fallen, the appearance of jowls, and how she always looked tired. Dr. Andrew Jacono performed his signature deep plane facelift procedure combined with a neck lift to address her concerns. He also performed an eyelid lift with a lateral temporal lift to open her eyes and appear less tired. She loves how natural and awake, she looks.
Deep Plane Facelift Before and After Patient 6: This 60-year-old female patient wanted to look more youthful and refreshed. Dr. Jacono performed a deep plane facelift with a platysmaplasty to address her concerns. She looks beautiful and natural with a smooth neck and jawline.
Mini Facelift Before and after with Upper and lower Eyelid Lift Patient 7: This patient underwent a deep plane facelift lifting the drooping muscles of the jowl and neck through a short incision often called a short scar facelift. Dr Jacono uses endoscopes through these smaller incisions to limit scarring. She also had a lip lift at the same time and lip augmentation using SMAS Muscle.Fat transfer was performed to her temples and under her eyes to complete the transformation.
Deep Plane Facelift Before and After Patient 8: This patient is a woman in her late fifties who wanted to restore a more youthful jawline, lift her hanging neck and chin, and smooth vertical platysma bands under her neck. After her surgery, she looks natural and not tight because he performs a deeper procedure that lifts under the muscles and does not stretch the skin
Deep Plane Facelift Patient Before and After 9: This beautiful fifty-four-year-old patient was worried about her fallen cheeks, tired eyes, her dropping jawline, and jowls. To address her concerns, Dr. Jacono performed a series of surgical techniques which started with his deep plane facelift technique to lift her cheeks to a more natural position. He coupled that with a necklift with platysmaplasty which smoothed her neck and jawline. To address her tired puffy eyes, an upper and lower blepharoplasty was performed. During the lower eyelid surgery, the lower eyelid bags are transposed into the hollows under the eye which remove the dark circles and buildup of the upper cheeks. A lateral temporal lift and pstosis repair were also performed. To complete the overall facial rejuvenation process, Dr. Jacono performed a lip lift to shorten the distance between the bottom of the nose and the top of the lip. As we age, the distance between that region continues to grow and we look tired and droopy. The after photo was taken three months post-operative. She feels fantastic and loves how young she looks again!
Deep Plane Facelift Patient Before and After 10: Unhappy with her wrinkles, sagging cheeks, jowls, and turkey neck, this woman in her mid 60’s wanted to look refreshed and younger. Dr. Jacono performed a deep plane facelift combined with an upper blepharoplasty and co2 laser resurfacing. This patients before and after deep plane facelift photos show her looking radiant and 15 years younger.
Deep Plane Facelift Before and After Patient 11: This female patient wanted to reverse the hands of time to look 10 to 15 years younger. Dr. Jacono performed a combination of procedures including a deep plane facelift, a browlift, an eye lift procedure, rhinoplasty, and laser skin resurfacing. You can see in her after photos that she looks much younger and happier. Her results look natural and not plastic or pulled too tight. Her friends and family can’t stop telling her how great she looks.
Deep Plane Facelift & Platysmaplasty Before and After Patient 12. This 53-year-old woman wanted to refresh her appearance while still looking natural. To accomplish this task, Dr. Jacono performed a combination of procedures which included his deep plane facelift technique which addressed her fallen cheeks, nasolabial folds, and jowls. A fat transfer (fat grafting) restored her temples and cheeks. To smooth her neck and reduce the appearance of her neckbands (platysma bands), Dr. Jacono performed a neck lift with platysmaplasty. For the upper portion of her face, he performed a lower blepharoplasty to reduce her eyebags and a lateral temporal lift for her upper eyebrows which caused her to look tired. To complete the overall facial rejuvenation, Dr. Jacono performed a lip lift to reduce the distance between the bottom of her nose and her upper lip. She loves her results and feels that she looks natural and refreshed.
Deep Plane Facelift Before and After Patient 13. This lovely 67-year-old patient was unhappy with the early signs of facial aging. Dr. Jacono performed a combination of procedures to reverse the hands of time and return her natural beauty. To address her fallen cheeks, nasolabial folds, and her jowls, Dr. Jacono performed his deep plane facelift technique. A lower eyelift coupled with a lateral temporal lift was used to reduce the under-eye bags and lift her brows. A platysmaplasty was completed to remove her neck bands leaving her with a smooth neckline. To complete the overall rejuvenation, he also performed a lip lift which raised her long and droopy lips. Her after photo is 5 years post-op and she still looks amazing. Natural results with no visible scarring, even with her short pixie hairstyle.
Deep Plane Facelift & Platysmaplasty Before and After Patient 14. This female patient was looking to reduce the appearance of her sagging cheeks and jowls. She was also unhappy with the loose skin under her chin and neck region. Dr. Jacono performed a deep plane facelift in combination with a platysmaplasty to address this patient’s concerns. Her after photos show the deep plane facelift created a smooth, contoured chin and jawline, as well as lifted her cheeks to a more natural position. The platysmaplasty left her neck smooth and removed the excess handing skin. She looks 10 years younger and looks very natural.
Lateral Temporal Lift & Deep Plane Facelift Before and After Patient 15. This female patient was not happy with her tired eyes, deep facial lines and wrinkles around her mouth, and her sagging cheeks and jowls. Dr. Jacono performed a lateral temporal lift in combination with a deep plane facelift, as well as, a SMAS lip augmentation to complete this amazing facial rejuvenation. The after photos show the patient looking 10 to 15 years younger.
To learn more about this procedure or to schedule your deep plane facelift consultation, contact Dr. Jacono today at 516-773-4646.