Turning Back Time: A Deep-Plane Facelift Journey at 40

The quest for lasting youthfulness is a timeless pursuit, and as we navigate through our 40s, the reflection staring back might not always mirror how we feel inside. For some, this is when the idea of a facelift starts to surface. With advancements in cosmetic surgery, procedures like the deep-plane facelift offer a promising solution. This is the story of one woman’s experience, exploring the motivations, the procedure itself, and the transformative results of undergoing a deep-plane facelift at 40.

Understanding Facial Aging in Your 40s

Before diving into the specifics of the deep-plane facelift, it’s important to understand what’s happening with our skin and facial structure as we enter our 40s. Several factors contribute to the visible signs of aging:

• Collagen and Elastin Loss: After 40, the body produces less collagen and elastin, essential proteins that keep skin firm and supple.
• Slower Skin Cell Turnover: Skin cell turnover slows down, leading to a duller complexion, increased fine lines, and loss of moisture.
• Hormonal Changes: Hormonal changes can affect skin thickness and elasticity, particularly in premenopausal women as estrogen levels decline.
• Loss of Facial Volume: Bone resorption occurs, leading to a loss of volume, especially in the middle of the face. Fat loss can also occur in the cheekbones.
• Muscle Changes: Muscle pull remains even when the muscles relax, contributing to more defined lines and wrinkles.
• Gravity: The effects of gravity become more apparent, leading to sagging skin, jowls, and a less defined facial oval.
• Sun Damage: Years of sun exposure can cause significant damage, leading to wrinkles, age spots, and a leathery texture.

These changes can manifest as:

• Fine lines and wrinkles
• Sagging skin around the face and neck
• Jowls
• Deep nasolabial folds (lines from the nose to the mouth)
• Loss of cheek volume
• Drooping eyelids
• Sunken cheeks

Why a Deep-Plane Facelift at 40?

Traditionally, facelifts were more common among older individuals. However, with advancements in techniques, more people in their 40s are considering this procedure. Here’s why:

• Early Intervention: Addressing signs of aging early can lead to more satisfactory and lasting outcomes.
• Better Skin Elasticity: In your 40s, the skin’s elasticity is still relatively good, allowing for better response to surgical adjustments.
• Bypassing the “Filler Phase”: A deep-plane facelift can help patients avoid relying heavily on fillers to restore volume and address sagging.
• Longer-Lasting Results: Facelifts at this age typically have longer-lasting effects because younger facial tissues are more robust and resilient.
• Natural-Looking Results: Modern facelift techniques, especially deep-plane facelifts, aim for a natural look, avoiding the “pulled” appearance.

What is a Deep-Plane Facelift?

A deep-plane facelift is a surgical procedure designed to address signs of aging by repositioning the deeper layers of the face, including muscles and fat, along with the skin. Unlike traditional facelifts that primarily tighten the skin, the deep-plane technique goes further by releasing and repositioning the deeper muscular and fat layers. This allows for a more significant improvement in the appearance of deep-set wrinkles, sagging skin, and loss of facial volume, providing a more rejuvenated and natural look.

How it Works

The “deep plane” refers to the anatomical plane between the Superficial Muscular Aponeurotic System (SMAS) – a layer of muscle and fascia – and the deeper facial muscles responsible for expression. The procedure involves:

1. Incisions: Incisions are similar to those in a regular facelift, typically made around the ears and hairline.
2. SMAS Release: The surgeon carefully releases the SMAS layer from the underlying tissues.
3. Repositioning: The SMAS and fat are repositioned to restore youthful contours and volume.
4. Skin Redraping: The skin is then redraped, and excess skin is removed.
5. Closure: Incisions are closed meticulously to minimize scarring.

This technique allows the surgeon to lift the face without excessive tension on the skin, reducing the risk of a “pulled” or unnatural appearance. It also provides access to the fat pads in the cheeks, which can be adjusted for a more comprehensive mid-face lift.

Deep Plane vs. SMAS Facelift

• SMAS Facelift: This technique involves tightening the SMAS layer by pulling and stretching it with stitches. It can lift the face near the jawline and lower face.
• Deep Plane Facelift: This procedure elevates the SMAS from the muscles underneath and releases the ligaments that anchor the SMAS down near the folds around the mouth. This allows the SMAS to be “lifted” without tension.

The deep plane facelift generally provides a more significant benefit to the jowls and folds around the mouth compared to a SMAS facelift.

Vertical Deep Plane Facelift

A vertical lift facelift, also known as a vertical facelift or “deep plane vertical facelift,” is a surgical procedure designed to address signs of aging in the lower face and neck. Unlike traditional facelifts, which focus on horizontal repositioning of tissues, the vertical lift technique involves lifting and repositioning facial tissues vertically, providing a more natural and longer-lasting result.

Benefits of a Deep-Plane Facelift

The deep-plane facelift offers several potential advantages:

• Natural-Looking Results: By repositioning deeper facial structures, this technique enhances facial contours and restores youthful definition without the “pulled” look.
• Longer-Lasting Results: Targeting deeper tissues can provide longer-lasting results compared to traditional facelifts. Results can often last up to 10 years or more, depending on individual factors.
• Comprehensive Rejuvenation: This procedure addresses multiple layers of facial tissue, resulting in a more thorough facial rejuvenation.
• Improved Facial Contours and Definition: The deep plane facelift can enhance facial contours and restore youthful definition.
• Reduced Risk of a Pulled Appearance: By lifting deeper facial layers, the risk of a “pulled” or overly tight appearance is reduced, resulting in a natural result.
• Targets the Midface and Lower Face: Deep plane facelifts target sagging in the midface and jowls.
• Potential Improvement of Nasolabial Folds: The deep plane technique repositions tissues vertically and horizontally which results in an improvement of the nasolabial folds or nose-to-mouth lines.
• Restores Volume: The deep plane facelift restores volume to the cheeks.
• Enhanced Confidence: A refreshed appearance can significantly boost self-esteem and confidence.

The Procedure: What to Expect

1. Consultation: The first step is a thorough consultation with a board-certified plastic surgeon. During this consultation, the surgeon will evaluate your facial anatomy, discuss your goals, and determine if a deep-plane facelift is the right option for you.
2. Pre-Operative Preparation: You’ll receive detailed instructions on how to prepare for surgery, which may include:
   • Medical evaluations and lab tests
   • Adjustments to medications
   • Smoking cessation
   • Avoiding certain supplements and medications that can increase bleeding
3. Anesthesia: A deep-plane facelift is typically performed under general anesthesia or intravenous sedation.
4. The Surgery: The procedure can take several hours, depending on the extent of the surgery and whether other procedures are being performed at the same time.
5. Post-Operative Care: After the surgery, you’ll need to follow specific instructions to ensure proper healing. This may include:
   • Wearing a compression garment to minimize swelling
   • Taking pain medication
   • Keeping the head elevated
   • Avoiding strenuous activity

Recovery: A Year-Long Journey

Deep Plane Facelift recovery is best described as a year-long journey with significant milestones along the way. Complete recovery following a deep plane facelift can take quite a bit of time as this cosmetic surgery is more invasive than a typical facelift. You can expect at least 3 weeks of bruising, discomfort, and swelling —- if not longer.

• The First Few Days: The first four days typically have the most significant amount of swelling and bruising. The most dramatic signs of surgery are visible in the first week after surgery.
• 1-2 Weeks: During the first one to two weeks following surgery, you must wear a compression garment, neck support, and drain to help with swelling and allow excess fluids to drain appropriately. You should refrain from returning to work for at least two weeks.
• 2-3 Weeks: You can expect bruising of some areas of the facial and neck skin for at least two to three weeks after a deep plane facelift. You might feel almost completely back to normal two weeks after your deep plane facelift. Most patients can return to work after 2-3 weeks although you may wish to avoid social events till after 3 weeks when much of the fine swelling has settled. At three weeks, patients can begin returning to light exercise activities.
• 1-3 Months: From one month to three months, there will be very slow but steady overall changes in the recovery. The appearance, swelling, and tightness will slowly improve daily. The most swollen areas of the face are the lower cheeks, jawline, and neck. Patients feel like their face looks puffy or “pillowy” because of the residual swelling. Movement of the face and neck feels more and more natural and soft over these weeks.
• 6-12 Months: Finally, there will be some gradual changes between six and twelve months after surgery. These changes will be less dramatic but slow, steady refinement as the soft tissues of the face settle and the results continue to look more natural. By twelve months, the visible and microscopic signs of recovery are essentially complete. The incision color, thickness, and raised appearance should fade gradually, but be aware that this can take six months to a year.

Most patients feel little to no discomfort related to their facial rejuvenation surgery around the one-week mark. You may also see your incisions are beginning to fade. It is normal to still have some feelings of numbness or tightness at this point, but it should be minor compared to how it felt the day of your surgery. While you may feel fabulous and want to jump back into your gym routine quickly after your deep plane facelift, you should put your fitness goals on hold for 3-4 weeks.

Tips for a Smooth Recovery

• Follow your surgeon’s instructions carefully.
• Get plenty of rest.
• Keep your head elevated.
• Apply cold compresses to reduce swelling.
• Take pain medication as prescribed.
• Avoid strenuous activity.
• Protect your incisions from the sun.
• Stay hydrated.
• Eat a healthy diet.

Risks and Complications

Like any surgical procedure, a deep-plane facelift carries some risks, including:

• Hematoma: A hematoma is the formation and pooling of blood beneath the skin.
• Nerve Injury: A deep plane facelift involves dissection below the facial nerves, increasing the risk of nerve injury. Many nerve injuries resolve themselves within 3 to 6 months although there is the potential of permanent injury.
• Infection
• Bleeding
• Scarring
• Asymmetry
• Swelling and Bruising: Following a successful deep plane facelift, swelling and bruising are expected in the weeks and early months following.
• Numbness: The cheeks and ears will feel numb which is normal. Soft feelings of sensation return by 2-3 months, but it may take 12-18 months for normal sensation to return.

These risks can be minimized by choosing a board-certified plastic surgeon with extensive experience in facelift surgery and following all pre and post-operative instructions carefully.

Cost of a Deep-Plane Facelift

A deep plane facelift cost depends on many factors, such as:

• Location
• Board-certified surgeon
• Length and involvement of the procedure
• Anesthesia costs
• Preparation tests

The cost can range from $15,000 to $38,000, depending on the practice.

Is a Deep-Plane Facelift Right for You?

The decision to undergo a deep-plane facelift is a personal one. Ideal candidates typically:

• Are 40 years and older with moderate to severe facial sagging.
• Have some natural resilience in their skin.
• Have significant jowls, deep nasolabial folds, and sagging in the midface or neck.
• Are in good general health, non-smokers, and without conditions that impair healing.
• Have realistic expectations about the potential and limitations of the procedure.
• Are willing to undergo a surgical procedure and commit to the necessary recovery time.

It’s essential to have a thorough consultation with a qualified plastic surgeon to determine if this procedure is appropriate for your specific needs and goals.

Alternatives to a Deep-Plane Facelift

If you’re not ready for a surgical facelift, several non-surgical options can address early signs of aging:

• Botox and Dermal Fillers: Effective for fine lines, wrinkles, and volume loss.
• Radiofrequency Treatments: Can help with mild skin laxity.
• Ultrasound Therapy: A non-invasive treatment that lifts and firms the skin.
• Chemical Peels: Rejuvenate skin with marked wrinkling, sun damage and discoloration.
• Laser Resurfacing: Eliminate wrinkles and treat other facial blemishes.
• Good Skincare Routine: A consistent skincare routine is crucial to maintaining firmness and preventing premature aging.
  • Use a Gentle Cleanser
  • Apply Antioxidants
  • Incorporate Retinoids
  • Hydrate and Lock in Moisture
  • Always Use Sunscreen

The Takeaway

Undergoing a deep-plane facelift at 40 is a significant decision with the potential for transformative results. By understanding the procedure, recovery process, and associated risks, you can make an informed choice that aligns with your aesthetic goals and overall well-being. Consulting with a board-certified plastic surgeon is crucial to determine if a deep-plane facelift is the right option for you and to ensure a safe and successful outcome.