The Deep Plane Facelift: Game-changer or Fad?
Would you like to improve or correct the outcome of your original facelift procedure?
There are many reasons patients come to our Center for revision facelift procedures. Some patients are simply unhappy with the outcome of a previous surgery, while others are bothered by the occurrence of new signs of aging and would like a secondary procedure.
Revision facelifts can safely and effectively be performed for men and women of all ages. Many patients opt for our TLC Premier Lift™ for total face and neck rejuvenation. However, revision facelifts can easily be customized to help you achieve your desired outcome.
What is a deep plane lower facelift, and is it better than a traditional SMAS lower facelift?
Deep plane facelifts (DPFLs) have existed in the surgical textbooks for over 30 years.
DPFLs are also known as a “composite lifts”, where both the skin and muscle are lifted as one unit versus those two layers being lifted individually as it is in a SMAS (Superficial Musculoaponeurotic System) Lift.
DPFLs have just recently been revisited by the surgical community as a possible better solution to the traditional, SMAS lower face and neck lift. Historically, studies from decades ago that compared the two methods demonstrated that the results were nearly equivalent in most cases, with potentially slightly more improvement in the lower cheeks and nasolabial folds (a.k.a. Smile Lines) with a deep plane facelift approach. It is note worthy that many studies recognized that the patient’s anatomy and the experience of the surgeon was more important than the technique in regards to the overall result.
It is critical to appreciate that DPFLs ONLY applies to the lower face/jawline and portions of the midface (cheeks and nasolabial folds), and NOT to the neck itself nor the tissue under the jawbone. The vast majority of plastic surgeons would agree on fact that there is no such procedure named a “deep plane necklift”.
RealSelf Patient Reviews of Paul Lanfranchi, DO, FAOCO RealSelf Patient Reviews of Paul Lanfranchi, DO, FAOCOWhy the resurgence in Deep Plane Facelifting?
As is commonplace in today’s world of the internet and social media, DPFLs have gained some popularity driven largely by a small group of physicians in major metropolitan markets, such as NYC and Southern California. It is inappropriate to call it a “resurgence” or “revival”, as the technique was never popular nor commonly performed at any point in time since described over 30 years ago in the textbooks.
In my opinion, the primary reason for the current hype is mainly financial. Plastic surgeons will charge at least double, and often triple, the amount they charge for a time-tested SMAS lower facelift with necklift (>$100,000 in some markets!). This simple fact makes it unaffordable for most patients, therefore making it exclusively accessible to the ultra-wealthy. Whether the results of a DPFL are even better is debatable.
What are the risks to the DPFL?
Since DPFLs are more aggressive and invasive in nature, the risk of permanent motor nerve injury is unequivocally higher than in a safer SMAS Lift. This type of nerve injury can present as either temporary, or possibly permanent, malfunction of one’s facial muscles (similar to as one would appear after a cerebral stroke).
Also notable is that since the deeper tissues of the face are disrupted, the recovery from a DPFL can be up to 50% more than a SMAS Lift.
Additionally, since the muscle and skin are moved together in a DPFL, there is less ability to tailor a result for the patient. In contrast, a SMAS Lift provides targeted treatment to both muscle and skin and individually, allowing for better customization.
Finally, the majority (>95%) of DPFLs in the U.S. are performed under general anesthesia since they usually take 4-6 hours to complete. Obviously general anesthesia presents with it’s own set of risks (pulmonary and cardiovascular issues, allergic reactions, and post-operative nausea and vomiting etc.).
Why can Deep Plane Facelifting be seen as “Irresponsible”?
Currently, my personal fear is that the majority of plastic surgeons in our country have never performed a DPFL, or at best have not performed one the last decade or more.
Unfortunately many patients are now going to be potentially exposed to surgeons performing riskier surgeries all for the sake of chasing “what’s hot” on social media, while charging the patient 2-3x the amount of money. I believe that most of my colleagues probably would provide a better result by just improving and mastering their personal current technique.
In my opinion, the higher complication rate, longer recovery, and less accessibility (from an economic standpoint) is a recipe for a procedure that will not gain popularity or become the new standard of facelifting.As a final intriguing point, it is quite ironic that the incision placement on the face and around the ears for a DPFL and SMAS Lift are exactly the same. Thus the patient, nor any surgeon for that matter, cannot tell which technique was exactly performed “under the hood” during surgery.
So will Deep Plane Facelifting stand the test of time?
Classic SMAS Lifts have been the “gold standard” of lower facelifting for multiple decades. They are effective, safe, reasonably affordable, and have a undeniable track record.
I’m quite confident that in just a few years DPFLs will join the long and evergrowing list of “once hot” facial procedures that enjoyed a few moments of fame and hype, but fail the test of time. For reference, a few relevant surgical fads in the past decade include buccal fat removal, thread lifting, surgical “lip lifting”, and under eye filler for hollows to name a few. In the interim, patients will need to decide if they wish to pay 2 to 3 times more for procedure that may yield slightly better results, has a much higher risk profile with longer recovery, and that most patients cannot afford in the first place.
Take the First Step
Ready to learn more about the Revision Facelift? The first step is to come in for an in-person consultation with Dr. Lanfranchi. Please fill out the form on this page to request a consultation or call our office directly at 702-929-3880 during normal business hours (please leave a message if we are unable to answer). The Lanfranchi Center serves the Las Vegas and Henderson, NV areas.
