Facelift: Q&A

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Deep Plane Midface Lift vs Suture Suspension?

What would you recommend?

1) suture suspension midface lift

2) the deep plane mid face lift?

Is the deep plane mid face lift really better? I have to make a decision soon between the two procedures and don't know which one to chose.

I am a 53, female. I have strong nasal folds and my lip corners now go downwards. I didn't have that when I was younger. My lower face looks fine as I had a good mini lower face lift last year. Please inform me about your experiences and I thank in advance.

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18 Doctor Answers | Asked by GabrielleC. in Kansas City

Doctor Answers (18)
Community Comments (0)

Which Facelift technique is Best?

There is no one facelift technique that is necessarily the best in every circumstance. Each technique as its advantages and disadvantages. Each technique has its proponents and detractors. Each face is unique and a good surgeon will choose the technique or variation to give the best result. It is more than reasonable to ask your surgeon what technique he/she will use for your procedure and why he/she thinks that best for you. Beware: it is safe to bet that you'll... more

Results of any operation depend almost exclusively on the surgeon

I wouldn't hitch my wagon to any one hot or popular technique. A good surgeon will strive for the best result for a given patient through the best approach. A poorly executed "best way of doing it" operation will be disappointing. Go to a good surgeon and he will explain what his going to do, why he is doing it that way, and how you will look when he is through. Oops, your doctor could be a "she".

Deep planes have traditionally been found to last the longest among facelifts

The suture suspension lift most likely refers to a midface lift, and there are many ways to do this. You can do it in a minimally invasive way through incisions in the scalp by the temple area. All is needed are very tiny incision near your nasolabial folds to allow the sutures to pull up the middle part of the face. Data on how long this lasts is not sufficient. Most surgeons believe that effect is not as long lasting as other procedures. A midface lift that is done traditionally can... more

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

It's all about the timing...

It is my theory that the right procedure at the right time will give the best possible outcome with the optimal lasting power. For example. If you are young and have just experienced a drastic weight loss then a treatment to tighten up the jaw line may be reasonable; however, that same technique will not be substantial enough for elder skin that is much less supportive. A SMAS "style" facelift should last between 8-10 years successfully! A neck lift or mini facelift is not... more

You have a good doctor!

Your doctor has taken good care of you based on my reading of your letter to Dr. Gross. Please understand that NO surgical procedure will eradicate the nasolabial folds and that improving your jawline and neck was a safe and effective rejuvenation for you. The problem with midface lifting is that the results are subtle and hard to see in photographs and the procedures are fraught with complications the more aggressively the midface is approached. There isn't an answer to whether suture... more

They may be both appropriate

Unfortunatley it is difficult to give a general answer for all patients for this question. The surgical plan is developed uniquely for each patient and depends on their unique anatomy, skin, volume, underlying bony support, as well as each patients goals and time for recovery. That said i am not a fan of procedures that rely only on "threads" or sutures to do all the "work" of rejuvenation. There are typically just too many things going on to get a good result with only... more

Midface Lift Works Much Better

As the originator of the SOOF lift blepharoplasty I can tell you that in my opinion this is the best procedure for improving the hollow look under the eyes that accompanies the aging process. I've been doing nothing but this procedure since I originally published this approach around 1999 in the Archives of Facial Plastic. As far as improving the nasolabial fold a SOOF lift by itself will help minimally. Most of my patients that have midface laxity have laxity elsewhere and have a deep... more

M. Sean Freeman, MD

9 reviews

Charlotte Facial Plastic Surgeon

www.onlyfaces.com

Deep plane or sutures

I really do not like either of these techniques.The deep plane dissection is much more time consuming and I believe that over the years comparisons of patients do not show a significant difference in long term results. Operating deep in the face puts other deep structures such as the branches of the facial nerve at risk. I believe that the standard subcutaneous facelift with SMAS plication produces excellent results that will stand the test of time and I sleep better at night... more

Robert E. Zaworski, MD

4 reviews

Atlanta Plastic Surgeon

Surgeon over Technique

Choose the surgeon first. The surgeon should have the requisite experience, expertise, training, and understanding of your objectives. Once the decision on the surgeon is made, you will be comfortable to follow his/her recommendations.

Deep plane or suture suspension lift

The procedure itself is not as important as the surgeon performing the procedure. The same procedure or approach may be called something different by different surgeons. For example, I have performed midface lifts for many years and I'm not really sure of what exactly the "Deep plane midface lift" is. If the surgeon you like best is making a distinction between these two procedures, get him/her to explain. make sure you like his/her results. Good luck.

Midface Lift: Sutures vs. Surgery

As with every surgical procedure, there are many different techniques which can be utilized to achieve similar results. Choosing the correct procedure depends on the patient's anatomy and the experience / comfort of the surgeon. Formal surgical approaches to the midface vary in incision (the lower eyelid, the mouth, or the forehead), and the surgical planes vary as well. You will hear a number of opinions regarding which plane gives a better or longer lasting result,... more

Deep Plane versus others

I am not a large proponent of the deep plane lift due to its higher potential risk for nerve injury as well as the lack of any long term study suggesting its superiority over traditional rhytidectomies

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Midface lift or suture suspension face lift

The answer to this is easy. Don't choose by technique, choose by surgeon's results. You are not trained or experienced enough to evaluate techniques, and each surgeon will justify the technique he or she prefers. You shouldn't care about the technique, but should care about risks and results. Look critically at before and after pictures, and decide which "before" patients ended up with the nicest improvement. Beware if the before... more

Mid face or nasolabial fold problem?

If your problem is the nasolabial folds and the downward turning of the mouth, a deep plane facelift or the suture suspension might not give long term correction. Direct excision of the nasolabial folds and a corner lip lift can correct these problems and are minimally invasive . Scars are the drawback to these approaches. These procedures work best on weathered, wrinkled skin as scars are almost invisible under such circumstances.

Best technique for facelift

The answer depends on your anatomy and your surgeons experience. Both techniques can yield excellent results. Some proponents of deep plane facelift argue that the lifting of the midface is improved with the deep plane technique. The risks of nerve injury are significantly higher with the deep plane technique. I recommend consultations with several surgeons to get multiple opionions. Remember to choose a surgeon who is Board Certified... more

Deep plane facelift vs Midface Lift vs Cable Lifts

This topic is difficult to answer in a small blog posting like this but there is a definitive answer for each person. First of all the deep plane facelift is an excellent procedure for giving overall improvement to the midface and lower third of the face and it is best for younger patients because this procedure is not very effective for improvement of the jowls and the marionette lines and the general aging changes that we see around the sides of the mouth in the older population of people... more

Filler Is Best Answer for Sagging Cheeks

Deep plane facelift is quite invasive and after a few years the nasal folds will return. Suture suspension can cause streaking or track marks under the skin or irregularities. Your best bet is to restore the youthful look of your cheeks and hence the nasal folds by plumping up the cheeks with a filler like Sculptra or Radiesse. For the downturned corners of your mouth, a small dose of Botox done by an advanced injector experienced in that particular technique will work best. Regards... more

Deep plane vs suture suspension

The midface lift works best for cheek descent the upper nasolabial fold and depressions of the infraorbital rim. The symptoms you describe can actually be imrpoved by an extended high SMAS facelift which works on the areas of concern that you have.