Deep Plane Facelift

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) practising in Sydney with over a decade of experience specialising in facial aesthetic surgery. At his Sydney clinics, Dr Turner offers advanced deep plane facelift techniques for patients seeking comprehensive facial enhancement.

The ageing face undergoes complex structural changes that extend beyond the skin’s surface. While traditional facelift methods address superficial tissue layers, the deep plane technique targets fundamental anatomical structures beneath the SMAS (superficial musculoaponeurotic system), releasing restrictive ligaments that limit conventional approaches. This sophisticated methodology achieves more substantial, enduring improvements across the midface, jawline, and neck regions.

Every deep plane facelift performed by Dr Turner is tailored to the individual’s facial architecture and aesthetic aspirations, creating results that enhance natural features rather than creating an artificial appearance.

Understanding Deep Plane Facelift Surgery

The deep plane facelift represents a significant advancement in facial plastic surgery, addressing the root causes of facial ageing rather than simply treating surface-level concerns. To fully appreciate how this technique differs from conventional methods, understanding facial anatomy and the evolution of facelift surgery proves essential.

Facial Anatomy: The Foundation of Facial Ageing

The SMAS constitutes a continuous fibromuscular tissue layer that extends across the face and continues into the neck as the platysma muscle. This critical structure provides support for the overlying skin whilst housing deeper anatomical components, including:

• Facial expression musculature
• Sensory and motor nerves
• Parotid gland tissue
• Blood vessel 
• Specialised retaining ligaments connecting the SMAS to the underlying bone and fascia

Throughout the natural ageing process, the SMAS and retaining ligaments progressively weaken and elongate, allowing the SMAS and platysma to descend under the influence of gravity. This structural descent manifests as the characteristic features of facial ageing: sagging midface tissues, pronounced jowling, deep nasolabial folds, and loss of jawline definition.

Evolution of Facelift Techniques

Modern facelift surgery encompasses several distinct approaches to SMAS management, each offering different levels of correction:

SMAS Plication Method: This conservative technique involves folding and securing the SMAS layer without completely separating it from the underlying structures. Whilst suitable for patients with minor tissue laxity or revision procedures, the limited mobilisation restricts the degree of correction achievable.

SMASectomy Technique: By excising a portion of the SMAS layer, this approach partially releases specific deep retaining ligaments. The technique offers enhanced lifting compared to simple plication and proves particularly effective for patients with fuller facial contours who require lateral volume reduction.

High SMAS Technique: Elevating the SMAS above the zygomatic arch specifically targets the midface and cheek regions. The higher dissection plane facilitates more vertical tissue repositioning, effectively restoring midface volume and recreating defined facial contours.

Deep Plane Methodology: A Fundamental Difference

The deep plane facelift distinguishes itself through its unique surgical approach rather than simply representing another SMAS technique variation. This method:

• Proceeds beneath the SMAS into well-defined anatomical spaces
• Systematically releases structural retaining ligaments
• Enables comprehensive SMAS elevation with reduced tension on overlying tissues
• Provides more enduring results through structural repositioning rather than superficial tightening

The selection between these various techniques depends upon individual facial anatomy, degree of age-related changes, skin quality, and aesthetic objectives. During consultation at Dr Turner’s Sydney practice, these differences receive a thorough explanation, helping patients understand which approach best addresses their specific needs.

Am I a Suitable Candidate for Deep Plane Facelift Surgery?

Deep plane facelift surgery is suitable for individuals who meet specific criteria and present particular facial ageing patterns. This advanced technique requires careful patient selection to achieve optimal outcomes whilst minimising risk.

Physical Health Requirements

Suitable candidates demonstrate:

• Good overall health without medical conditions compromising healing capacity
• Realistic comprehension of surgical outcomes and recovery requirements
• Psychological readiness for surgical intervention (mandatory psychological evaluation required as of July 1, 2023, under Australian regulations)
• Stable body weight maintained for at least six months
• Non-smoking status or willingness to completely cease all nicotine products for a minimum of six weeks before and after surgery

Facial Characteristics Benefiting from the Deep Plane Technique

The deep plane approach proves particularly effective for patients experiencing:

• Moderate to substantial midface descent with volume depletion in cheek regions
• Significant jowl formation along the jawline
• Deep nasolabial folds requiring structural correction rather than superficial tightening
• Thicker skin quality benefiting from robust structural support
• Heavy facial tissues, commonly seen in male facial anatomy

Age Considerations

Whilst chronological age alone doesn’t determine candidacy, most deep plane facelift patients fall within the 45-70 age range. Younger patients with substantial age-related changes may benefit, whilst older patients in excellent health can be suitable candidates. Individual assessment remains crucial, as physiological age proves more relevant than chronological age.

Who May Not Be Suitable

Deep plane facelift may be inappropriate for patients who:

• Present with only mild facial laxity, better addressed through less extensive techniques
• Cannot commit to the required recovery period
• Have uncontrolled medical conditions affecting surgical safety
• Maintain unrealistic expectations about surgical outcomes
• Are unable to cease smoking completely
• Possesses insufficient tissue quality for optimal results

During your consultation at Dr Turner’s Sydney practice, a comprehensive facial assessment determines whether deep plane facelift surgery appropriately addresses your concerns, or whether alternative procedures would better serve your objectives.

How is Deep Plane Facelift Surgery Performed?

Deep plane facelift surgery is exclusively performed under general anaesthesia in a fully accredited private hospital facility in Sydney, with continuous monitoring provided by a qualified anaesthetist throughout the procedure. Surgery duration typically ranges from 3.5 to 5 hours, varying with procedure complexity and whether additional procedures are performed concurrently. Dr Turner recommends overnight hospital observation for patient comfort and safety monitoring before discharge the following day.

Pre-Operative Planning and Marking

Surgery commences with meticulous surgical planning and marking whilst you remain awake and upright. Dr Turner identifies:

• Precise incision locations following the hairline and natural ear contours
• Deep plane entry point based on individual facial anatomy
• Areas requiring volume restoration through fat transfer
• Critical anatomical landmarks, including nerves and vascular structures
• Tissue vectors for optimal lifting direction

Incision Creation and Initial Dissection

Incisions extend from the temporal hairline, following the natural curves anterior to the ear, around the earlobe, and into the posterior hairline. Through these access points, Dr Turner carefully elevates the skin and subcutaneous tissue to the predetermined deep plane entry point, maintaining meticulous tissue handling to preserve integrity.

Deep Plane Dissection: The Defining Component

The critical distinguishing feature of this technique involves dissection beneath the SMAS layer within well-defined anatomical spaces. Dr Turner elevates the SMAS, along with the overlying skin and subcutaneous tissue, as a unified composite flap, systematically releasing the retaining ligaments—including the zygomatic and masseteric ligaments—that restrict conventional facelift techniques.

This deeper dissection plane allows for:

• More substantial tissue mobilisation
• Reduced tension on the overlying skin
• Superior correction of midface descent
• More enduring results through structural repositioning

SMAS Repositioning and Fixation

Following the comprehensive release of restrictive ligaments, the SMAS layer is repositioned in a primarily vertical vector, directly counteracting gravitational tissue descent. This vertical repositioning provides superior correction of midface sagging, deep nasolabial folds, and jowl formation compared to the lateral vectors employed in conventional techniques.

The repositioned SMAS is secured to stable anatomical structures using permanent sutures, creating a stable foundation for overlying tissues.

Neck Lift

The neck region frequently requires attention during deep plane facelift surgery to ensure harmonious transition between facial and cervical contours. Through the facelift incisions and a small submental (under chin) incision when needed, Dr Turner addresses:

• Excess superficial fat accumulation through liposuction
• Deep neck fat removal when indicated
• Platysma muscle banding through formal platysmaplasty
• Excess neck skin removal

In select cases requiring more dramatic neck definition, deeper structures, such as the submandibular glands or parotid tail, may be reduced.

Volume Restoration Through Fat Grafting

Deep plane facelift frequently incorporates facial fat transfer to restore volume depleted through the ageing process. Fat is gently harvested from a donor site (typically abdomen, flanks, or inner thighs), processed to isolate viable adipocytes, and strategically placed in areas requiring volumetric enhancement:

• Temporal hollows
• Lateral brow regions
• Infraorbital tear troughs
• Midface and cheeks
• Nasolabial folds
• Any other areas requiring volume correction

This combined lifting and volume restoration approach enhances overall facial appearance, particularly benefiting patients with substantial age-related volume loss.

Skin Redraping and Meticulous Closure

With deeper structures repositioned and volume restored, facial and neck skin is carefully redraped without excessive tension—a hallmark of deep plane technique that minimises visible scarring and creates natural-appearing results. Excess skin is conservatively excised, and incisions are meticulously closed in multiple layers using fine sutures.

Surgical drains may be temporarily placed to prevent fluid accumulation. Compressive dressings and a supportive facial garment are applied to minimise swelling and support healing tissues.

Recovery and Aftercare After Deep Plane Facelift Surgery

Your deep plane facelift recovery begins with an overnight hospital stay for optimal monitoring and comfort management, followed by a return home the following day. The initial two weeks represent the most intensive healing period, with swelling and bruising reaching their peak within the first 72 hours before gradually subsiding. During these early days, maintaining continuous head elevation, limiting facial movements, and adhering to a soft diet prove essential for undisturbed tissue healing. Sutures are removed progressively throughout the first two weeks. While discomfort is typically manageable with prescribed medications, patients should anticipate visible post-surgical changes, including tightness, numbness, and temporary facial asymmetry, as tissues begin to settle into their new positions.

The healing journey extends well beyond the initial fortnight, with most patients resuming light duties by week three, though visible signs of recent surgery persist. Strenuous activities and vigorous exercise must be avoided for six to eight weeks to prevent complications and optimise wound healing. Between three and six months post-operatively, the true results of your deep plane facelift become fully apparent as residual swelling completely resolves, sensation returns, and incision lines mature. Diligent adherence to post-operative instructions, including wound care protocols, activity restrictions, and sun protection measures, remains crucial throughout your recovery timeline.

For detailed information about each recovery milestone, including specific care instructions and strategies to optimise your healing experience, please visit our comprehensive resource:

Recovery After Facelift Surgery

Risks and Complications of Deep Plane Facelift Surgery

All surgical procedures involve inherent risks that must be thoroughly understood before proceeding with treatment. While deep plane facelift surgery, performed by an experienced Specialist Plastic Surgeon, typically achieves excellent outcomes, patients must be aware of both common temporary effects and potential complications. Dr Turner maintains a commitment to transparent communication, ensuring every patient receives comprehensive information about possible adverse outcomes, realistic expectations, and the measures employed to maximise safety throughout the surgical process.

Most individuals experience the expected post-operative effects, including swelling, bruising, temporary numbness, and mild to moderate discomfort, which typically resolve naturally during the healing phase. Potential complications requiring intervention may include haematoma formation, infection, unfavourable scarring, prolonged altered sensation, asymmetry, or hair loss along incision sites. More serious but uncommon risks encompass nerve injury affecting facial movement or sensation, skin necrosis, significant asymmetry necessitating revision surgery, and adverse anaesthetic reactions. Through meticulous surgical technique, comprehensive pre-operative medical assessment, surgery exclusively in accredited facilities, and detailed post-operative care protocols, Dr Turner minimises these risks whilst optimising patient safety and surgical outcomes.

For comprehensive information about specific risks, preventive measures, and what to expect during recovery, please visit our detailed guide on:

Risks and Complications After Facelift Surgery