Deep Plane Facelift

What is a deep plane facelift? 
The SMAS layer of the face is a deeper layer under the skin of the face which supports the facial fat compartments and the underlying muscles. There are also deeper ligaments which attach this SMAS layer to the facial skeleton to provide additional support. This SMAS layer is the main layer which is lifted during a facelift in order to provide the rejuvenating and lifting effect. The main area of tension and lifting occurs with the SMAS and not the skin. Although some excess skin is removed during a facelift the tension on the skin closure should be minimal otherwise adverse scars can result. The SMAS lift therefore provides reduced tension on the skin closure. A deep plane facelift is simply a variant of a SMAS technique which involves dissecting widely under the SMAS layer and releasing the supporting ligaments to enhance the lifting effect. This also allows a more effective mobilisation of the sagging tissues along the jawline, neck as well as the cheek so that they can be freely lifted and restored to a more youthful position. This often provides a more effective and longer lasting result in many patients. 
How is the deep plane facelift performed, ?
The incisions made around the ear are the same as a standard face lift . The skin is elevated in order to gain access to and dissect under the SMAS layer. The SMAS layer is usually elevated together with the skin and the platysma muscle in the neck. During this dissection some of the ligaments attaching the SMAS layer to the facial bones are released in order to more effectively mobilise the tissues. This can help to accurately position the tissues and help provide volume in areas such as the mid cheek and the cheekbone area at the same time.
There are multiple deeper stitches which are used to position and lift the SMAS layer. The exact vector of lift can be varied in the cheek compared to the neck in order to specifically enhance the rejuvenating effect in different parts of the face.
After the deep layer surgery has been completed the skin is redraped and the excess skin which has been drawn upwards with the SMAS lifting is then trimmed and carefully stitched in a manner that hides the incision in the natural curves in front of and behind the ear.
How long does the procedure take to perform ?
Since the surgery involves more dissection the procedure takes longer than a standard SMAS facelift and is usually perfomed under general anaesthesia. This may take approximately 2 and a half hours. It should be remembered that this surgery is not rushed and that all the necessary time that is required is taken to ensure a meticulous technique is employed to obtain the best results with the time taken varying from person to person. Many patients are usually undergoing additional procedures which may involve chin liposuction , platysmaplasty (neck lift) or eyelid surgery  which add extra time to the overall length of the procedure. 
What is the recovery from a deep plane facelift ?
There is very little discomfort after the procedure and usually only mild painkillers are required. There may be some mild bruising along with swelling which tends to subside by about two weeks.
During the first few days it is important to be gentle with movements, avoid heavy lifting and sleep upright. These measure help to reduce the swelling.
In the first week there will be stitches to be removed from around the ear. 
After two weeks the swelling and bruising should have subsided to the extent that it would not be too noticeable in public.  
It is advisable to refrain from exercise for about 6 weeks.

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