Not all facelifts are created equal — the Deep Plane Facelift is the Gold Standard
Although the Deep Plane facelift has been used for at least 40 years, it has more recently come into the public spotlight. It is renowned for its natural appearance, avoidance of the “pulled” face lift look, nigh-imperceptible incisions, and enduring results. The Deep Plane facelift requires intimate knowledge and familiarity with neurovascular anatomy of the face in addition to understanding of the aging process in the face. It is the foundation of Dr. Gerth’s facial rejuvenation and key to satisfying and long lasting results.
What is the Deep Plane Facelift?
The Deep Plane Facelift is actually a neck and facelift. The Platysma muscle and SMAS (superficial musculoaponeurotic system) are released from their deep attachments in the neck and face and then repositioned in a more vertical vector than traditional facelift techniques. This creates more movement of tissues which rejuvenates the neck, jawline, and even cheek and nasolabial fold while avoiding the “done” or “pulled” look. The patient never looks like someone else; rather they look like a refreshed and well rested younger version of themselves.
History of the Deep Plane Facelift
The first facelifts described a century ago involved raising and pulling large flaps of skin. The results were not durable; usually within a year or two the effect was lost. Additionally, the scars were unsightly. Patients tended to lose a lot of hair becacause of the way the incisions were placed.
Eventually surgeons developed techniques that prolonged their results and improved the appearance of the incisions. SMAS plication and SMASectomy allowed surgeons to move the deeper tissues while taking tension off the skin. These techniques still involved pulling SMAS instead of repositioning it. Additionally, large skin flaps needed to be raised which increased the risk of complications and prolonged healing.
Dr. Tord Skoog then developed the subplatysmal facelift in the early 1970s– the first “deep plane” facelift technique. He was the first to describe releasing the deep attachments of the platysma muscle in the neck and face to improve movement and durability of results.
Dr. Mark Lemmon, a student of Dr. Skoog, further developed the plastyma lift by extending the plane vertically to include the SMAS layer over the buccal fat pad and zygomaticus muscle in the cheek. When extended to the nasolabial fold, the resulting deep plane flap could easily be moved in a vertical angle without pulling or stretching tissues. His partner, Dr. Sam Hamra added the composite face lift which included the orbicularis (eye) muscle as part of the flap.
Subsequent surgeons have developed other modifications to the Deep Plane facelift, including crevasse technique, sailboat modification, laryngeal setback, and Preservation Deep Plane Facelift. Dr. Gerth has mastered these techniques as well and has included his own modifications which allow him to achieve even more facial and neck rejuvenation for his patients.
Are You a candidate for Deep Plane Facelift?
The ideal facelift patient is in good health, a non-smoker, and has moderate or advanced age related changes in the
- nasolabial folds
- jowls
- neck
Those who have had previous facelifts but are not happy with the results may also benefit from this procedure.
It is also crucial for patients to manage their expectations. Discussing outcomes and expectations is an essential part of any pre-procedure consultation.
If you think you may be a candidate for a deep plane facelift, contact Dr. Gerth in Miami, Florida, by calling (305) 204-6183.
Why choose Dr. Gerth for your Deep Plane Facelift?
Dr. Gerth has been performing Deep Plane facelifts for over 13 years. His deep and detailed knowledge of head and neck anatomy as a Board Certified Otolaryngology-Head and Neck surgeon combined with his experience in microsurgery as a Board Certified Plastic Surgeon allows him to perform a “true” Deep Plane facelift — he is able to perform wide undermining in the Deep Plane, all the way to the nasolabial folds while protecting the delicate nerves and blood supply of the face. This allows him to fully release and reposition tissues to achieve maximal and durable results.
Dr. Gerth takes a very hands on, tailored approach to each and every patient. Dr. Gerth is personally involved and present in each step of your journey, from consultation to your 1 year postoperative visit (or longer). He wants to get to know each patient, their goals, and concerns to he can formulate the best possible treatment plan. Dr. Gerth operates in a fully accredited OR on site in the same facility as his office, giving him maximal availability to his patients.
Planning and consultation for your Deep Plane Facelift
Although Dr. Gerth performs virtual consulations, in-person consultations are always appreciated and encouraged. In your consultation, we will review:
- past medical history and medications
- previous surgeries
- previous non-surgical and surgical facial treatments
- smoking history
Then Dr. Gerth will discuss his findings related to
- skin/textural changes from age, sun, or tobacco
- volume loss
- loose skin
in the forehead, brow, eyes, cheek, lips, jawline, and neckline. Preoperative photos will assist in the assessment. Then a fully customized operative plan will be devised. Preoperative preparations, the day of surgery, and recovery will be discussed. Please prepare a list of questions so that Dr. Gerth can address them during your visit.
Personalizing your Deep Plane Facelift
Dr. Gerth knows that your face is unique and your goals are unique too. During your consultation, Dr. Gerth will discuss your goals and recommend additional procedures if he thinks adding them to your facelift will provide the most balanced results. Rest assured Dr. Gerth will design your deep plane facelift and facial rejuvenation plan, bespoke and customized specifically for you.
Combining Deep Plane facelift with other procedures
The Deep Plane Facelift specifically addresses aging in the neck, jawline and cheek region. Because Dr. Gerth’s Deep Plane facelift technique creates significant vertical movement, it may be necessary to include a temporal brow lift in cases of more advanced aging. Other procedures to address the eyes, lips, and skin, such as blepharoplasty, lip lift, and skin resurfacing, can be performed simultaneously as needed. Fat transfer to address volume-related aging is commonly included as well. In very specific cases, even rhinoplasty can be performed concurrently.
Dr. Gerth’s approach and technique to the Deep Plane Facelift
Your Deep Plane facelift journey on the day of surgery starts with Dr. Gerth reviewing the operative plan and performing the markings for incisions and important anatomic landmarks. Then you will proceed to the operative suite, where the surgery will be performed under either IV sedation or general anesthesia (depending on your unique operative plan).
Afterwards, local anesthesia will be used to futher comfort you during the procedure. If needed, a small incision is made under the chin and the platysma muscle is tightened underneath. Next, carefully placed incisions around the ear are made so that, once healed, they will be nearly imperceptible. The skin around the ear is lifted up, gaining access to the SMAS of the cheek and the platysma in the neck and lower face. The deep plane is then entered under the SMAS and Platysma. Careful dissection is performed, freeing the SMAS and platysma from their deep attachments. This is performed from the deepest neck crease all the way to the cheekbone, and from the side of the face to the nasolabial fold. The platysma muscle is also partially divided at the level of the deepest neck crease. Facial nerves and muscles are seen underneath and are preserved during this portion of the surgery. Then the Deep Plane-skin flap is advanced up and back, in the vector of greatest movement from the neck up to the cheek. Sutures are placed to hold the flap in place. In Dr. Gerth’s experience, lifting the neck first increases the amount of lifting that can be done in the face and cheek. Finally, excess skin is removed and the incisions around the ear are closed in a tension-free manner.
You will be able to go home the same day, after recovering in the postop area.
Recovery after Deep Plane Facelift
Deep plane facelift recovery involves bruising and swelling for a week or two, but discomfort is often less than with a traditional facelift. Pain medication may be prescribed, and applying cold compresses and elevating your head can also help. You will need lots of rest during your recovery to support healing.
Most patients can expect most of their swelling, bruising, and discomfort to begin subsiding by week two of their recovery, with only residual swelling left by week four. Dr. Ackerman provides detailed postoperative instructions to help you successfully manage your recovery and ensure the best possible results.
Dr. Gerth personally attends to each patient during their recovery process. He will see you at regular intervals until you are fully healed. Incisions reach their final result at about 1 year.
Deep Plane Facelift Results
A deep plane facelift provides significant and long-lasting results. Most patients will see a dramatic reduction or elimination of sagging, deep folds, and wrinkles, with more youthful cheek and jawline contours.
A deep plane facelift is the ultimate solution for anyone who wants to restore a youthful facial appearance. The Deep Plane Facelift provides a more natural, longer-lasting result than traditional facelifts by addressing deeper facial structures.
Under the care of Dr. Gerth, facelift patients in Miami, Florida can expect personal attention and exceptional results tailored to their individual goals.
Your Miami Deep Plane Facelift Expert
Dr. Gerth’s extensive training and experience in the anatomy of the face and the Deep Plane facelift technique allows him to perform each surgery met to the demands of each case. His meticulous attention to detail allows him to design customized surgical plans unique to each patient. The end result is an experience focused on superior surgical outcomes, long lasting results, and maximum patient satisfaction. Call (305) 204-6183 today to schedule your consultation.