58 y/o female considering a lower facelift for jowls and neck skin laxity. I have questions about the difference between SMAS and Deep Plane, the time it takes, the healing and the longevity. Does one cause more nerve issues following surgery? Additionally, is it most beneficial under general anesthesia or can it be done under twilight? Can it be done in conjunction with a endoscopic brow lift? Pros and cons, please. Thank you.
Answer: Deep Plane versus SMAS Hello, hope you are well. I will start by saying that there are as many facelift variations as there are plastic surgeons. Find someone you trust who has demonstrated good results (it is less the technique that is important, and more the surgeon's capabilities). The key differentiator of a 'deep-plane rhytidectomy' is release of a midfacial ligament called the zygomatic cutaneous ligament which allows for further mobilization and repositioning of the midface and malar fat pad. The deep-plane facelift was first described and the term coined by Hamra, a surgeon in Texas, in 1990. Since then, facelifts have evolved even further into 'extended deep-plane' techniques, and beyond. If this sounds technical, it's because it is! Amazing results can be achieved with either a SMAS, a deep plane lift, or their modifications, especially in the lower face, jowls and neck. SMAS lifts are more limited in the midface. I offer my patients whatever suits their particular anatomy and stated goals. Like any surgeon, a deep plane lift takes me longer to perform than a SMAS lift because of the additional dissection. Healing and longevity of results are comparable. In skilled hands, there is no greater risk to nerve injury with one technique versus the other. Facelifts of any variety can be performed under GA or with sedation monitored by an anesthesiologist. Endoscopic brow lifts are routinely performed concurrently.
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Answer: Deep Plane versus SMAS Hello, hope you are well. I will start by saying that there are as many facelift variations as there are plastic surgeons. Find someone you trust who has demonstrated good results (it is less the technique that is important, and more the surgeon's capabilities). The key differentiator of a 'deep-plane rhytidectomy' is release of a midfacial ligament called the zygomatic cutaneous ligament which allows for further mobilization and repositioning of the midface and malar fat pad. The deep-plane facelift was first described and the term coined by Hamra, a surgeon in Texas, in 1990. Since then, facelifts have evolved even further into 'extended deep-plane' techniques, and beyond. If this sounds technical, it's because it is! Amazing results can be achieved with either a SMAS, a deep plane lift, or their modifications, especially in the lower face, jowls and neck. SMAS lifts are more limited in the midface. I offer my patients whatever suits their particular anatomy and stated goals. Like any surgeon, a deep plane lift takes me longer to perform than a SMAS lift because of the additional dissection. Healing and longevity of results are comparable. In skilled hands, there is no greater risk to nerve injury with one technique versus the other. Facelifts of any variety can be performed under GA or with sedation monitored by an anesthesiologist. Endoscopic brow lifts are routinely performed concurrently.
Helpful 1 person found this helpful
Answer: Deep plane facelift versus SMAS facelift Thank you for your question.
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Answer: Deep plane facelift versus SMAS facelift Thank you for your question.
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May 12, 2023
Answer: Need to come in to consult For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.
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May 12, 2023
Answer: Need to come in to consult For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.
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May 11, 2023
Answer: Deep Plane or SMAS? Deep Plane in My Hands The first thing to consider in your consultation process is the Surgeon and his/her results. After 22 years in practice, I have seen excellent results from both techniques, and results are more individual Surgeon specific than technique specific. That having been said, I prefer the deep plane technique, which allows for a composite lift of skin and SMAS, release of ligamentous structures, and harmonious repositioning of the cheek, jawline and neck. Bear in mind that all modern facelift techniques are SMAS based, but extended SMAS usually means a bilaminar approach: fist elevation of skin, followed by separate elevation of SMAS. In skilled hands, both techniques should take about the same time, about 3 hours in an uncomplicated deep plane facelift in my hands. The exception is a pure plication technique which is quick, doesn't involve lifting SMAS, but doesn't last very long. A deep plane facelift can easily be performed alongside an endoscopic forehead lift, which takes about 30 minutes. You can separate procedures but this means two down-times and two recoveries. I prefer level III sedation, which means that you won't remember anything, nor feel any pain during the procedure.
Helpful 1 person found this helpful
May 11, 2023
Answer: Deep Plane or SMAS? Deep Plane in My Hands The first thing to consider in your consultation process is the Surgeon and his/her results. After 22 years in practice, I have seen excellent results from both techniques, and results are more individual Surgeon specific than technique specific. That having been said, I prefer the deep plane technique, which allows for a composite lift of skin and SMAS, release of ligamentous structures, and harmonious repositioning of the cheek, jawline and neck. Bear in mind that all modern facelift techniques are SMAS based, but extended SMAS usually means a bilaminar approach: fist elevation of skin, followed by separate elevation of SMAS. In skilled hands, both techniques should take about the same time, about 3 hours in an uncomplicated deep plane facelift in my hands. The exception is a pure plication technique which is quick, doesn't involve lifting SMAS, but doesn't last very long. A deep plane facelift can easily be performed alongside an endoscopic forehead lift, which takes about 30 minutes. You can separate procedures but this means two down-times and two recoveries. I prefer level III sedation, which means that you won't remember anything, nor feel any pain during the procedure.
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May 9, 2023
Answer: What's the difference between deep plane and SMAS lower facelifts A deep plane facelift involves dissection in the cheek area in Direct proximity of the facial nerve branches, and has a higher incidence damaging those nerves. A SMAS facelift involves tightening the Facial muscles/fascia safely without seeing the facial nerve branches. Study your prospective surgeon's before and after facelift photo Gallery, which should be extensive with natural results that you like.
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May 9, 2023
Answer: What's the difference between deep plane and SMAS lower facelifts A deep plane facelift involves dissection in the cheek area in Direct proximity of the facial nerve branches, and has a higher incidence damaging those nerves. A SMAS facelift involves tightening the Facial muscles/fascia safely without seeing the facial nerve branches. Study your prospective surgeon's before and after facelift photo Gallery, which should be extensive with natural results that you like.
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