Deep Plane Facelift Surgery

The following information discusses the deep plane facelift procedure with New York’s Top Facial Plastic Surgeon, Dr. Andrew Jacono.

The deep plane face lift avoids the problem of the tight, overfilled look of many modern facelifts. The main tenet of the procedure is that it lifts only under the muscle layer, leaving the skin attached to the muscle layers, so it can never look too 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. This procedure focuses on the release and movement of muscle and fat layers instead of skin pull and removal.

The deep plane facelift technique that Dr. 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. He releases four ligaments with corresponding natural lifting throughout the face and neck.

The first ligaments released are the zygomatic ligaments that tether the cheek so that drooping cheeks can be elevated. 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 (the creases from the nose to the corner of the mouth), and any hollowing and shadowing seen under the lower eyelids by restoring volume that is lost by gravitational descent associated with aging.

Dr. Jacono has published research in the Aesthetic Surgery Journal that this restores cheek volume equivalent to adding three 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 they can be lifted, creating a smooth and crisp jawline appearance.

How Does a Deep Plane Facelift Work?

Dr. Jacono was the first surgeon to describe the release of the cervical retaining ligaments that tether the platysma muscle in the neck – and this is the basis for his technique, the extended deep plane facelift.

This extension of the deep plane into the neck allows for more significant redraping of the platysma. Plus, rejuvenation and refinement in the neck and jawline are 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 Dr. Jacono’s technique is the vector or direction in the face is lifted after the release is accomplished. A traditional facelift tightens the face horizontally or toward the ears and makes 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 face more vertically a smoother, more natural appearance is created, the cheeks are restored, and the corners of the mouth that sag with age are elevated.

Dr. Jacono’s Facelifting Expertise

Dr. Jacono performed clinical research that was published to better define the angle of the proper vertical vector or direction of the lift. He found the ideal vertical facelift – the “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.

His Facelift Innovations

Another innovation in deep plane facelifting Dr. Jacono has introduced to the plastic surgery literature is the ability to perform this technique through a smaller incision. Often referred to as a short scar or S-lift type incision, Dr. Jacono’s hybrid technique is called a M.A.D.E.  or “Minimal Access Deep Plane Extended” facelift.

This approach leaves a 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.

Combined with Necklifting

Depending upon the degree of neck drooping and heaviness that occurs, the surgery 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 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 procedure has the most long-lasting result of any facelifting technique. Because it works on the structural elements of the face, it is more durable than SMAS-type facelifts, often lasting 10 years and beyond.

What is a Deep Plane Face and Neck Lift? And How Is It Different From a Deep Plane Facelift?

When considering facial rejuvenation, many patients get confused between what is a deep plane facelift and what is a deep plane neck lift. These questions are essential in understanding the options available for achieving a more youthful appearance.

A deep plane facelift is a sophisticated surgical technique that focuses on repositioning the deeper layers of facial muscles and tissues. This method provides a more natural and long-lasting result, reducing the appearance of sagging skin and deep wrinkles. The deep plane facelift procedure can offer a transformative effect on the mid and lower face.

On the other hand, a deep plane face and necklift is a comprehensive approach that combines the techniques of a deep plane facelift with specialized procedures for the neck area. It targets not only the face but also the underlying muscles of the neck, creating a smoother and more defined jawline.

So how is it different from a deep plane facelift? While a deep plane facelift primarily focuses on the face, the combined deep plane neck and facelift extend the rejuvenation to the neck area as well. This combined approach ensures harmony and balance between the face and neck, providing an overall more youthful appearance.

Complications and Expertise in Deep Plane Facelift Procedures

A deep plane facelift is an advanced surgical procedure focusing on lifting the deeper layers of muscles and connective tissue of the face and neck. It can rejuvenate drooping cheeks, jawline, and neck without a tight or unnatural appearance. This method differs from other facelift techniques by targeting deeper tissues, offering more natural and lasting results.

Deep Plane Facelift Complications

While deep plane facelift complications are rare, potential risks should be understood:

• Nerve Damage: Among the most common complications, nerve damage occurs in fewer than 1% of patients when performed by a well-trained plastic surgeon.
• Other Complications: As with any surgical procedure, there may be other risks such as swelling, bruising, or infection, though they are less common in deep plane facelift procedures.

Dr. Andrew Jacono: An Elite Plastic Surgeon

Dr. Andrew Jacono’s expertise in deep plane face-lift techniques places him among the most elite plastic surgeons in the nation.

• Two Decades of Experience: His comprehensive technique helps create natural results by lifting drooping cheeks, jawline, and neck, often extending to a deep plane neck lift as well.
• Published Research: He has multiple hallmark studies on his extended deep-plane technique in top publications like the Aesthetic Surgery Journal.
• Educator and Speaker: Dr. Jacono has lectured at prestigious institutions like Harvard Medical School, Yale University, Stanford University, and the University of Pennsylvania. Furthermore, he’s delivered over 100 lectures at national and international plastic surgery symposia.

Choosing a skilled plastic surgeon like Dr. Jacono ensures that the deep plane face lift is performed with the highest level of precision, minimizing potential complications. His vast experience, coupled with innovative techniques, enables patients to achieve natural-looking results without the stigmas of tightness that may accompany other facelift methods.

Should you consider undergoing deep plane facelift procedures, understanding what a deep plane facelift is and consulting with a surgeon of Dr. Jacono’s caliber ensures that you are in expert hands. This offers peace of mind for those looking to rejuvenate their appearance and reverse the signs of aging with a deep plane facelift.

Natural Results with Consistency

Considered an international expert in deep plane facelifting, he was recently selected as one of the 20 best facelifting surgeons worldwide to contribute to a textbook comparing their expert methods in facelift surgery called Face the Facts.

He has performed over 1,500 procedures and continues to teach his techniques by performing live demonstration surgeries all over the world. Hundreds of surgeons from six continents have traveled to observe Dr. Jacono perform his signature technique.

DEEP PLANE FACELIFT VS. SMAS FACELIFT

Most patients are concerned about “looking like they had a facelift” or looking pulled after surgery because they’ve seen 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 Superficial Musculo-Aponeurotic System

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 and are 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.

What Is Dr. Jacono’s Deep Plane Facelift Cost?

How much is a deep plane facelift?   The cost of a deep plane facelift is not an easy question to answer as every person is going to need specialized treatment and care. There is no single procedure with a set cost when it comes to deep plane facelifts.

You’ll note from the before and after pictures below, and the descriptions of the surgeries, that every deep plane facelift is different and there will be different needs special to each patient.

It’s important to remember that the money that you are investing into the deep plane facelift is literally going to be affecting the first thing people see when they meet you. Every time you greet someone and get a smile from them, you’ll know that the facelift from Dr. Jacono is doing its job. In other words, it’s an investment in yourself.

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How Long Does it Take to Recover from a Deep Plane Facelift?

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 your face, there is minimal bruising and minimal pain after the procedure, in the days after surgery. 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 and disrupt blood vessels. Because of this, bruising is greater in non-deep plane facelifts.

Some pain medication may be prescribed to help a patient to feel more comfortable during the healing process. Patients will also be encouraged to apply cold compresses to help alleviate swelling, and elevating the head will be recommended as well. It is important to get plenty of rest during the recovery.

How Long Before I Can Return to Work After a Deep Plane Facelift?

Returning to work after undergoing a deep plane facelift is a common concern for many patients. The deep plane facelift recovery period may vary from person to person and largely depends on individual healing rates and the nature of your work.

• Consulting with Your Plastic Surgeon: Dr. Jacono will have a detailed understanding of your particular situation and will provide personalized guidelines. It is essential to follow his advice to ensure optimal deep plane facelift results.
• Typical Recovery Time: Generally, most patients can expect to return to work about 10 to 14 days after surgery. This time frame allows for initial healing and reduction of any noticeable swelling or bruising.
• Taking Care of Yourself: The deep plane facelift recovery process is crucial to achieving the best results. Adhering to post-operative care instructions and giving yourself time to heal will facilitate a quicker and more comfortable return to work.

Remember, every patient’s healing process is unique, and the exact number of days after surgery before you can return to work may vary. Consulting with Dr. Jacono and following his guidance is the best way to ensure a safe and successful recovery after your deep plane facelift.

Where are the Scars Located?

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 are elongated and are pulled down after traditional facelift surgery.

IS A DEEP PLANE FACELIFT BETTER?

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, which 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 that may be used at the dentist. There is also less trauma caused to the facial tissue, so the recovery time is also shorter.

A standard facelift procedure involves general anesthesia and surgical time that can last up to 5 hours.

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
• Less noticeable facelift scars
• Longer lasting result

Who is a Good Candidate?

Good candidates for a deep plane facelift are men and women who are showing signs of aging in their faces, including sagging and drooping skin. Candidates should be in good physical health and have realistic expectations of the surgical outcome. During your consultation with Dr. Jacono, he will be able to determine if a deep plane facelift is the right procedure for you.

Looking for a deep plane facelift near me? A deep plane facelift in New York City? Or have more questions about the deep plane facelift? To learn more about the deep plane facelift or to schedule a  consultation, contact Dr. Jacono today at 212-570-2500.

Deep Plane Facelift Before and After Photos

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The photographs above are before and after photos of Dr. Jacono’s Deep Plane Facelift patients. These are actual results and have not been altered for presentation here.