Published: January 23, 2024
Category: Latest News

Despite the upsurge in nonsurgical alternatives like Botox, fillers and RF microneedling, the tried and true facelift remains a staple in facial rejuvenation. No other treatment is nearly as effective in successfully removing 10+ years from the face, especially in patients with advanced facial aging. The results from a facelift last for many years without the need for regular follow-up treatments.

If you are a candidate for a facelift, you have many options to choose from. One of these options is the extended deep plane facelift. This advanced technique has many advantages over more traditional facelifts, but it may not be for everyone. If you’ve heard about this procedure and would like to learn more, keep reading.

An Overview of Facial Aging

As we grow older, fine lines and wrinkles appear, skin begins to sag and facial volume starts to shift. These changes happen for many reasons, including reduced collagen production in the skin, facial fat shifting and atrophy, bone resorption and loosening of facial ligaments. While your genetics and lifestyle determine how soon these changes take place, they affect us all sooner or later.

Facial aging typically starts in one’s 20s but becomes noticeable in your 30s or 40s. At this age, plastic surgeons can often reverse or soften signs of facial aging with minimally invasive and nonsurgical approaches. These treatments are becoming increasingly popular because they work, create natural-looking results and require no downtime.

But for patients in their 50s and 60s with more advanced signs of aging, nonsurgical techniques have limited effectiveness. A facelift is the most powerful way to “turn back the clock” and restore a youthful neck and jawline. A facelift may also be the preferred route for those seeking a longer-lasting solution that doesn’t require regular maintenance.

Common Types of Facelifts

The first facelifts, performed in the early 20th century, involved simple excision of ellipses of skin around the ear. Later on, surgeons began to remove and re-drape larger amounts of excess skin. The problem with these early facelifts was that they created a “wind tunnel” effect, making the face look overly pulled or tight and creating an unnatural appearance.

As facelifts became more popular sometime in the 1970s, more effort was put into advancing surgical techniques to make the results look natural. These efforts have resulted in a number of different facelift techniques emerging:

Standard facelift

Also known as the traditional facelift, this is the most commonly utilized facelift technique today. It treats moderate to advanced aging in the mid-face and neck by repositioning the superficial musculoaponeurotic system (SMAS). The SMAS is located between the superficial fat layer and the deep layer containing nerves and muscles. It extends from the cheekbone to the jawbone. This fibrous network of tissue becomes weaker with age, providing less support to facial fat, muscle and skin.

During the standard facelift, an incision is made around the ears and into the hairline to access the SMAS. The SMAS and overlaying skin are then tightened, any excess skin excised and the incision closed with stitches.

Mini facelift

The mini facelift is a variation of the SMAS technique designed for patients with mild jowling and sagging in the lower third of the face. It is a less invasive technique in which surgeons create shorter incisions along the hairline or around each ear. The SMAS layer is then repositioned and tightened along with the overlying skin. Minimal surgery is performed on the neck itself.

Because it is less invasive, a mini facelift can be performed under local anesthesia and leads to quicker recovery. It can help postpone more extensive facelifts for many years in patients who are just beginning to show signs of aging.

Deep Plane Facelift

The deep plane facelift is the most advanced technique practiced today. It is a great option for patients with significant jowling and lower face sagging and creates very natural-looking and long-lasting results. What’s particularly noteworthy about this technique is that it also volumizes the midface, thus reducing the need for fat grafts and fillers.

The deep plane encompasses an area below the SMAS of the midface. Accessing this area allows surgeons to release facial ligaments and to reposition muscles and other soft tissues without tension on the skin. The surgeon places tension only at the level of the fascia — the connective tissue that holds all these other facial structures in place. This creates an essentially tension-free lift that yields natural results. Surgeons also reduce or reposition the herniated fat that contributes to jowling with this technique.

What About the Extended Deep Plane Facelift?

At Ridenour Plastic Surgery in St. Louis, Dr. Ridenour also performs what is known as the extended deep plane facelift. This technique takes things a bit further by lifting and tightening the neck area — essentially a combined deep face and deep neck lift.

Many patients who are candidates for a deep plane facelift — meaning those with significant sagging in the lower face — also have visible sagging and skin laxity in the neck area. The extended deep plane facelift can address both issues for more harmonious-looking results.

The extended deep plane facelift involves the same steps as the deep plane facelift but with the addition of releasing additional retaining ligaments in the lower jaw and neck. Once released, Dr. Ridenour repositions the deep plane flap and lifts the platysma muscle found in the jaw and neck. The muscle is tightened underneath the bone to create an envious and youthful jawline.

Besides improving the appearance of both the lower face and neck area, the extended deep plane facelift also adds strong definition and support to the jawline. Lifting and anchoring the platysma muscle also supports aged and ptotic submandibular glands.

Benefits of the Extended Deep Plane Facelift

Being the latest and greatest in the world of facelifting, the extended deep plane facelift comes with many benefits. Here’s why we often recommend this treatment to patients seeking comprehensive facial rejuvenation:

  • Rejuvenates both the lower face and neck in a single procedure
  • Creates natural-looking results
  • Creates natural volume in the midface by also repositioning fat
  • Defines the jawline and neck better than any other facelift procedure
  • Lifting of the platysma muscle also supports sagging submandibular glands.
  • Removes the need for additional procedures, e.g. Botox and filler injections
  • Results last up to 15 years, if not longer with no need for follow-up treatment

Downsides of the Extended Deep Plane Facelift

Of course, there are downsides to every type of treatment, the extended deep plane facelift being no exception:

  • A slightly elevated risk of temporary nerve damage (about 1.5%)
  • Longer recovery time of one to two months vs. a couple of weeks with less invasive techniques
  • A higher risk of complications, such as bleeding and bruising
  • Not every surgeon can offer this treatment since it requires a more extensive understanding of anatomy and experience

The Extended Deep Plane Facelift at Ridenour Plastic Surgery

At Ridenour Plastic Surgery, board-certified facial plastic surgeon Dr. Brock D. Ridenour is trained and experienced in some of the most advanced facial plastic surgery techniques in the world. Our patients can feel confident they are in the hands of an expert who can perform an extended deep plane facelift with beautiful results and minimal risks. To schedule your consultation with Dr. Ridenour, contact us today or call 314-878-8600.

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