Question 1

What is a Deep Plane Facelift?

Accepted Answer

To understand the deep plane facelift, it’s helpful first to know how traditional and SMAS facelifts are performed.

The traditional “skin-only” facelift technique tightens the face by pulling and removing only sagging skin. This often leads to the stretched “windblown” look, pixie ears, and bad scarring. Since it only pulls skin, the results don’t usually last very long.

Nowadays, many surgeons perform SMAS facelifts, which tighten and reposition not only the skin but also the superficial musculoaponeurotic system (SMAS) underneath. The SMAS is usually referred to as the “facial muscles” when describing facelift surgery. During the procedure, the surgeon tightens the SMAS layers across the plane of the face and then removes excess skin. Addressing some of the deeper tissues improves the appearance and longevity of the results compared to the skin-only traditional method. However, the attachments underneath the SMAS are not addressed and continue to anchor the skin and muscles.

A more advanced deep plane facelift, on the other hand, releases the ligaments underneath the SMAS that are tethering the muscles. The skin and muscles can now be gently repositioned together as one unit. This allows for less tension and resistance which can improve the longevity of the results compared to other facelift techniques. The reason why more surgeons don’t perform this technique is because it requires a higher level of skill and experience.

Question 2

How is a Deep Plane Facelift Performed?

Accepted Answer

With his advanced surgical technique, Dr. Karolak will carefully release the ligaments underneath the SMAS that are causing resistance. Releasing the deeper layers gives Dr. Karolak more control over where the muscles can be repositioned to address different degrees of aging. His procedure is so highly customized and versatile that it can be used to treat early as well as more significant signs of aging, such as severe sagging and jowling.

During the procedure, the skin and muscles are gently repositioned as one unit in a vertical direction, and then multi-directionally for a more youthful and balanced face. This is different from vertical facelifts and other types of deep plane facelifts because of the multidirectional components of tightening. Our faces don’t age in one direction. The movement is downward and forward. By lifting only vertically, there is a higher risk of moving lines from the neck into the face, as well as altering the natural position of facial lines resulting in an unnatural appearance. The multidirectional component that Dr. Karolak uses after lifting vertically allows him to make adjustments based on each individual’s facial structure for a more customized, natural result.

Question 3

Am I a Good Candidate For a Deep Plane Facelift?

Accepted Answer

A deep plane facelift by Dr. Karolak is an excellent option for women and men with mild to severe signs of aging in the lower face, jawline, and neck. If you’ve developed jowls, sagging skin, deep lines, wrinkles, and facial muscle looseness, you might be a good candidate for a deep plane facelift.

Medical conditions that may make someone ineligible for treatment include:

Bleeding Disorders
Liver Disease
History of radiation to the neck or face
History of parotid surgery

Ideal candidates are in good health and have reasonable expectations for what surgery can do for them. During a consultation with Dr. Karolak, he will recommend whether a deep plane facelift is the best option for you.

Question 4

What are the Benefits of a Deep Plane Facelift?

Accepted Answer

A deep plane facelift can help rebalance the face by improving the jawline, softening (not eliminating) the nasal folds and marionette lines, repositioning the existing facial volume, and slightly elevating the cheeks for a more youthful natural-looking result. This procedure is often combined with a neck lift (platysmaplasty) to create a more youthful neckline as well. Together, these two procedures help restore the “foundation” of the areas of the face that are contributing to the visible aging process. Restoring the “foundation” often helps highlight the naturally beautiful features of the face such as the eyes, nose, and lips.

Question 5

Are all Deep Plane Facelifts the Same?

Accepted Answer

As most patients quickly realize when they start researching facelift surgeons and deep plane facelifts, every surgeon’s results are different, even if they are doing the same type of procedure. This has to do with the nuances of each surgeon’s technique and goal. That’s the beauty of the deep plane facelift. Once the muscles are released, the majority of the medical/technical portion is finished. Now it’s up to the surgeon’s aesthetic judgement to determine how the patient is going to look. Just because it’s called a “deep plane facelift” does not mean the results or after-care will be the same from surgeon to surgeon.

Whether performing a primary, secondary, or revision facelift, Dr. Karolak’s rule is always the same… ”There’s a fine line between too much and not enough. The goal is to look better, not different.”

The results should look elegant and highlight your natural beauty. It shouldn’t look like a pulled, stretched, or wind-swept facelift. Your result should be your result…unique, natural-looking, and complimentary to your features.

Question 6

What are the Risks Associated with a Deep Plane Facelift?

Accepted Answer

The types of risks associated with a deep plane facelift are similar to other types of facelifts (ie SMAS facelift). These risks include bruising, swelling, infections, bleeding, hematoma, pain, delayed healing, scarring, numbness, and nerve injury. Choosing a skilled, experienced, board-certified facial plastic surgeon and following their instructions precisely can help limit the risks.

Question 7

What is the Right Age to Have a Deep Plane Facelift?

Accepted Answer

The right time to consider a facelift is when there is nothing nonsurgical or “lifestyle-change” related that will help. When Dr. Karolak started performing facelifts in 2005, the average age for several years in his practice was 55-70. Now it’s 45-60…with some patients in their 30’s, and others in their 70’s. The average age has dropped by a decade. Too often there is a belief that age should dictate when it’s appropriate to have a facelift. Nowadays, we are living longer, healthier, and more active lives. Still, everybody ages differently. Some people visibly age more quickly than others. It’s not so much a question of “What is the perfect age to have a facelift?”, but rather “What is the best treatment to achieve the results you want at your age?”.

Question 8

How Long Will a Deep Plane Facelift Last?

Accepted Answer

A deep plane facelift is considered to be one of the most advanced facelifts that exists today. Instead of just tightening the muscles and removing excess skin, the muscles are freed up from their attachments and then gently repositioned. This allows the muscles and existing facial volume to heal in a more youthful position permanently.

After a deep plane facelift, aging will continue from this new set point. Each person will age differently. This has to do with genetics, lifestyle, health and skin quality. On average, there will come a point 8-15 years later (sometimes longer) when surgery will be helpful again, but often times less needs to be done. Even then, you should still always look better than if you never had surgery.

Question 9

What is Recovery Like After a Deep Plane Facelift?

Accepted Answer

After a deep plane facelift with Dr. Karolak, you can expect bruising, swelling, and some discomfort. Most patients only require Tylenol. Discomfort typically improves significantly within the first few days.

When it comes to recovery, healing times will vary from patient to patient. Some heal quicker, while others take longer. During week one, patients should expect bruising and swelling. On average, peak bruising and swelling will occur on day four. At seven days, visible healing usually begins.

By 14 days, 20-30% of the visible healing is done. This is the amount of time that most patients plan before going back to work or in public. There are still signs of surgery, which can usually, but not always, be hidden with concealer and hair styled over the areas of healing.

If you have a big event coming up. Dr. Karolak recommends eight weeks as the bare minimum to be “event-ready” (i.e. red carpet events, filming, interviews, weddings, photo shoots, black-tie affairs, etc.). At this point, usually 70-80% of the visible healing is done. There is still more healing to go, but this would be the bare minimum. Ideally, you should wait three months before a big event, since that should be representative of long-term results.

Cardio exercise can usually resume at two weeks after surgery while weight-lifting and activities that require chest and neck straining have to wait eight weeks.

Each procedure is unique, so follow your surgeon’s instructions. Dr. Karolak gives all patients his cell phone number so he can be involved directly during their recovery to answer any questions and monitor their progress.

Question 10

How Much Does a Deep Plane Facelift Cost?

Accepted Answer

The cost for a deep plane facelift, as with any elective cosmetic procedure, will vary from surgeon to surgeon. Every surgeon’s results, aesthetic judgment, skill, aftercare, and experience are different. Prices will also vary from patient to patient depending on what needs to be done.

With so much information available these days, it’s important to do your research and feel comfortable with the surgeon you choose, not just the procedure. Our patients find our fees reasonable for all of these reasons. Please call our office at (732) 412-9079. Our team would love to speak with you! They’ll provide you with current average pricing and can answer some of your questions.