Many people concerned about sagging in the face and neck mistakenly believe that “all facelifts are the same—as long as the face looks tighter.” As a surgeon, however, I can tell you that tightness alone does not always create a youthful appearance. When the tissues are pulled incorrectly, the result can be a stiff, overly stretched face—what I call an “artificial look” that appears unnatural.
Today, I will explain modern facelift techniques designed to restore a fresher, more youthful appearance while addressing concerns about facial distortion and visible scarring.
Facelift surgery has developed considerably, moving beyond lifting only the skin (Subcutaneous Facelift) to working with deeper structures, including the SMAS (Superficial Musculoaponeurotic System). In particular, Deep Plane Facelift and High SMAS techniques aim to achieve natural-looking, lasting results. An important element of these approaches is releasing the facial retaining ligaments so that the deeper tissues can be repositioned more effectively. Treatment may also include individualized procedures such as buccal fat management, fat grafting, and neck rejuvenation to create a balanced overall appearance. Safety and results depend on the technique, the surgeon’s expertise, and the patient’s individual circumstances.
Incorrect pulling can produce a stiff appearance, widened scars, or the unnatural “wind-tunnel look.” This article explores modern deep plane facelift techniques that aim to restore a refreshed appearance while reducing excessive skin tension.
Key takeaway: A Deep Plane Facelift addresses the SMAS and facial retaining ligaments to lift the deeper facial structures. It aims to achieve natural-looking results that may last around 10–15 years, although individual outcomes vary and aging continues. It may be suitable for people concerned about sagging, nasolabial folds, loose neck skin, and a poorly defined jawline.
Deep Plane Facelift vs. Conventional Facelift: Why Tightness Alone Is Not Enough
Many people believe that “all facelifts are the same—as long as the face looks tighter.” As an aesthetic surgeon, Dr. Gorn explains that this belief can lead to inappropriate expectations. When tissues are pulled incorrectly, possible consequences include:
- A stiff, unnatural appearance, sometimes called the “wind-tunnel look.”
- Wide, noticeable scars caused by excessive tension on the skin.
- Shorter-lasting results, with sagging potentially returning within 2–3 years in some cases.
One approach to achieving natural-looking, lasting rejuvenation is the Deep Plane Facelift.
The Evolution of Deep Plane Facelifts: Moving Beyond Skin-Only Lifting
Looking back at the history of facelift surgery,
deep plane facelift techniques have evolved continuously. Many patients may not realize how substantially the available approaches differ:
- Subcutaneous Facelift (Early Approach): Lifts the skin and superficial fat. It is relatively straightforward, but potential limitations include shorter-lasting results and wide, noticeable scars.
- SMAS Plication and Imbrication (Subsequent Developments): Address the SMAS through folding, suturing, or overlapping the tissue. The longevity of results depends on the specific technique and the patient’s anatomy.
- Deep Plane Facelift (A Modern Approach): Addresses the SMAS and facial retaining ligaments to reposition deeper tissues, with the aim of achieving natural-looking, lasting results.
The Key to a Deep Plane Facelift: What Does “Removing the Facial Anchors” Mean?
An important element of a deep plane facelift is releasing the facial retaining ligaments—a process I describe as “removing the facial anchors.”
Facial retaining ligaments are structures that anchor the facial soft tissues to underlying bone or deeper fascia. They act like anchors holding tissues in position. Age-related changes in these structures and the surrounding tissues contribute to facial sagging.
If These Ligaments Are Not Adequately Released:
- There may be greater resistance when lifting the SMAS.
- Excessive pulling may create a stiff, unnatural appearance.
- Higher tension at the incision may contribute to noticeable scars.
After the Ligaments Are Released:
The surgeon can reposition the facial tissues more freely, helping create softer, natural-looking contours while reducing tension on the skin closure. This is an important feature of the deep plane facelift. Healing time varies between patients.
Personalizing a Deep Plane Facelift: What Makes Modern Treatment Different?
A modern deep plane facelift involves more than lifting. It also includes designing and balancing the facial contours for each individual:
- Fat Repositioning — In selected patients with sagging cheek fat, the surgeon may reposition and suspend the fat rather than remove it, restoring fullness beneath the cheekbones and improving facial contours.
- Platysma Management — Tightening the neck muscle and carefully addressing fat beneath it may help improve loose neck skin and create a more defined neck contour.
- Submandibular Gland Management — Prominent glands beneath the jaw can contribute to an uneven neck contour after lifting. In selected cases, repositioning or other gland procedures may improve definition, following careful assessment of the benefits and risks.
- Autologous Fat Grafting — Adds volume to areas that remain hollow or look tired, helping create a refreshed, natural appearance.
Frequently Asked Questions About Deep Plane Facelifts
Q: What Is a Deep Plane Facelift?
A: It is a facelift technique that addresses the SMAS (Superficial Musculoaponeurotic System) and facial retaining ligaments rather than lifting only the skin. Repositioning the deeper structures aims to create natural-looking rejuvenation. Results may last around 10–15 years, but this varies between patients and does not stop the aging process.
Q: How Does a Deep Plane Facelift Differ from a Conventional Facelift?
A: A skin-only or subcutaneous facelift primarily lifts the skin and superficial tissues. A Deep Plane Facelift addresses deeper tissues and releases selected retaining ligaments, allowing more extensive repositioning with less reliance on skin tension. The most suitable technique depends on the patient’s anatomy and goals.
Q: Who May Be Suitable for a Deep Plane Facelift?
A: It may be suitable for people with sagging cheeks, deep nasolabial folds, loose neck skin, or a poorly defined jawline, including those dissatisfied with the results of laser or filler treatments. Patients are often aged 40 or older, but suitability also depends on individual anatomy and overall health.
Q: How Much Does a Deep Plane Facelift Cost at Dr.Gorn Aesthetique?
A: The clinic’s described Full Face treatment plan may cover the brows, forehead, temples, hairline and temple incisions, midface, lower face, back of the neck, and the area beneath the chin. The listed regular price is THB 350,000–450,000, with a promotional price of THB 299,900–399,900. Pricing depends on the individualized treatment scope. Please consult Dr. Gorn directly for an assessment and confirmation of current pricing and inclusions.
Q: How Long Is Recovery After a Deep Plane Facelift?
A: Recovery generally takes approximately 2–3 weeks before returning to usual activities. Swelling and bruising often improve substantially within 10–14 days, while results become more settled over approximately 3–6 months. Individual recovery times vary.
Conclusion: The Key to Lasting Rejuvenation with a Deep Plane Facelift
The key is how well the surgeon understands the deeper facial structures and restores balanced contours, rather than how tightly the skin is pulled.
A Deep Plane Facelift combines surgical science and artistry, requiring precise technique and an understanding of individual anatomy. Your face is unique—choose a surgeon who pays attention to these details.
