Who Does a Deep Plane Facelift?

I have had 2 disastrous facelifts,in that the results were nil. The results lasted only a matter of months,and i am sure that only the skin was lifted.? Certainly i traveled out of the country for these precedures,mainly because of costs,but on reflection i should have paid more,and concentrated on a doctor who specialises in faces. So just wondering what doctors really do a 'Deep Plane' lift,as to be honest ,how are we to know exactly what has been done?

Doctor Answers 8

Composite facelift gives a better natural and longer lasting result than subcutaneous facelift.

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I have been doing a composite facelift for over 20 years.  The skin is not detached from the deeper "plane" which preserves nearly normal blood supply to the remaining skin.  The deeper tissue supports the lift so the skin is sutured under little tension. 

You need the "right facelift" and perhaps not a deep plane face lift.

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Foreign facelifts can be problematic..

I practice in South Florida and consequently have seen and re-operated on many "off-shore" facelifts.

A common feature is that they tend to be underdone compared to the local well trained plastic surgeon.  An offshore plastic surgeon, no matter what his background is, has to plan and operation which allows the patient to return home with limited or no long term followup.

This means they typically do not use our more advanced approaches that require a much longer followup as well as the chance of complications that might extend the patients stay

in a foreign country. 

It seems that you need to be seen by an American plastic surgeon who does multiple styles of surgery and who can redo your surgery.  The style needed may not be a deep plane at all.

Unfortunately the cost will be that of a good surgeon doing hopefully a much better operation well suited to your needs.

Dr. Mayl

Fort Lauderdale.

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

It Is Not The Plane, It's The Surgeon!

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The internet and the abundance of information, tends to cause people to focus on the wrong things.  Getting a deep plane facelift is not the answer to your issues.  I can tell you that and I have not even seen your photos.  Deep plane, composite facelift, SMAS flap, SMAS plication--what is the best method for you?  I can virtually guarantee you that the right surgeon can make any of these methods work for you.  It is the surgeon and not the method that gets the job done.  Look at the list of top contributors for facelift questions on this website.  Virtually any of these surgeons will be able to help you with you  situation.  Focus on the surgeon and not on the method.  Good luck and please be careful.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Seeking the Truth in Facelifts

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Deep plane facelifts are one of the more technically demanding procedures in facelift surgery.  The knowledge of facial anatomy is important as to not disrupt vital structures such as nerves while releasing facial ligaments to mobilize the face and neck.  Several studies have shown further release and more skin excised after deep plane lifts than SMAS lifts.  In addition, there are many acronyms and trademarked facelifts which can make patients seem like they are getting a unique lift but may be getting a variation of a standard facelift.


So how does a patient find out what a surgeon's lift is all about?  

  • -Ask the surgeon- He/she may tell you their technique in detail.  Beware that many surgeons claim to perform a "deep" plane but are in fact doing a SMAS lift
  • -Research any scientific writings by the surgeon-  If the surgeon has written in a medical journal about deep plane technique and can demonstrate it in a scientific article, it is fair to assume that he/she actually performs deep plane lifts
  • -Seek out results from other patients- Many facelift patients are word of mouth.  Usually, other patients, hair dressers, people in the beauty industry know whose lifts are the best.  


Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 177 reviews

Who does a true deep plane facelift? Are there differences? Who is the best?

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The term "deep plane facelift" no longer describes a single type of lift.  Instead it is a large range of lifts including lifts similar to smas lifts all the way to MADE or extended deep plane lifts.  There are only a handful of surgeons in each state who perform the more extended lifts and even less than that nationwide who do the most significant lifts and do them safely with durability as well as a natural aesthetic. The best results I have seen nationwide are Andrew Jacono in New York, Sam Hamra in Texas, Ben Stong in Atlanta, Sachin Parikh and Evan Ranson in Northern CA, and only a few others.  these surgeons achieve the most significant results without the need for fat grafts in the cheeks.  They change the face better than others I've seen and get long lasting and reproducible results.  Of course there are others around but I haven't seen their work and can't attest for them. Those I mentioned are just the ones I'm familiar with.

The only way to know however is to look at before and after photos and see which you like the best.  Look for actual changes in the cheek, face and nasolabial folds which look natural.  Make sure the lighting is the same in the before and afters and that there is no hair covering the incision lines.  

For revision lifts, my belief is that a true deep plane is the way to go.  I know this because in my training we became convinced of this after doing hundreds of revisions and now I use the same techniques still.  This does not mean that other surgeons with other techniques can't also get good results, but since the deep plane is performed in a plane that most surgeons don't operate in, the revision is much easier and pulls in a vector which is also different than the prior failed surgeries. 

Hope this helps. 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Deep Plane Facelift

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   Deep plane facelift was receiving a great deal of press several years ago, but most plastic surgeons use either SMAS plication or SMASectomy techniques to treat the underlying tissue.  A SMAS plication facelift has an almost nil chance of facial nerve damage, whereas the deep plane facelift can be several percent chance (or more).  The results of a SMAS plication in the right hands can produce the result you want.  Find the plastic surgeon with ELITE credentials who has performed hundreds or thousands of facelifts.  Kenneth Hughes, MD Los Angeles, CA

Don't Pick the Facelift type, Pick the Best Surgeon !

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Your experience regarding your travel medicine results unfortunately are all too common choosing cost as the most important feature rather than the best surgeon.

Please don't make a second similar mistake by choosing the technique rather than the best surgeon available and then following their advice.

The below link is how I would select the best possible surgeon to do a facelift.


Very Few Plastic Surgeons Do True Deep Plane Facelifts.

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As the other doctors say, you just need a good facelift.  Trust the right surgeon and let him or her use their preferred technique.  It is true that the deeper tissues need to be lifted, but a "deep plane" facelift is a very specific procedure with considerable risk.



George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.