The Deep Plane FaceLift (DPFL) technique is one of the few that not only corrects the neck and jawline, but also significantly improves the midface, thereby improving the hated nasolabial folds and “marionette” wrinkles. At the same time, the cheeks are lifted from their sagging position, which increases the volume on the cheekbones (without the use of fillers and lipofilling), and the “transition” from the lower eyelid to the cheek is smoothed. Thus, the face regains youth and the classic “heart” shape.
How is Deep Plane FaceLift performed?
Deep plane is a deep space in the midface deep under the skin: between the SMAS layer and the facial muscles.
During DPFL, the surgeon’s main work is carried out in the deep spaces of the midface, exactly where age-related changes are most pronounced
This area is mobile and represents a “sliding space” for the soft tissues of the face and is needed for the work of the facial muscles. It is due to this mobility that we can smile, open our mouths, puff out our cheeks, convey emotions, grimace, etc. Since this zone is very active, it is subject to great “wear and tear” during life: it ages and begins to “sag” with age.
The deep plane is practically devoid of blood vessels, so detachment in this area is minimally traumatic, compared to detachment of the skin.
During the Deep Plane FaceLift, I am not “interested” in the plane under the skin, I need to immediately “enter” the deep spaces of the face, therefore, I peel off a very small, limited area of skin in front of and behind the ear. This is the area of excess stretched skin that I will subsequently remove.
Next, through the dissection of the SMAS layer, a surgical “entry” under the SMAS is performed – into the deep spaces of the face. Everything changes at this moment, and not earlier, since these spaces contain the most important anatomical structures. For most surgeons in our country, the “transition” through this critical point goes beyond their anatomical “comfort zone” and qualifications. This is one of the reasons why they prefer to remain in a “safer” “territory” for themselves – on the side of the face (in front of the ear), where all the important structures are very deep and the risk of damaging them is minimal.
So, after “entering” the deep plane, a full detachment under the SMAS is performed and all retaining ligaments of the face are released almost to the nose (to the nasolabial fold).
First of all, the chewing and mandibular ligaments are released. This allows you to form a clear line of the lower jaw (jawline), eliminate “jowls” and smooth out the “marionette” wrinkles.
Next, the zygomatic ligaments and all areas of strong tissue fusion (adhesion) are released. This group of ligaments is responsible for fixing the entire middle zone of the face. Dissection of these ligaments is necessary to lift the cheeks, smooth out the “eyelid-cheek” transition and smooth out the nasolabial folds.
As a result of such a complex extensive dissection, the face becomes very “mobile”: the soft tissues of the face are disconnected from the ligaments and facial muscles, nothing “holds” them anymore. Then the SMAS as a whole, together with the skin lying on it, without the slightest tension, is shifted (not stretched!) almost vertically to its “new” position.
Then the SMAS flap together with the skin and subcutaneous fat is fixed with strong sutures. These surgical sutures act as “new” ligaments and hold the facial tissues in the new position for many years. This is one of the most important advantages of Deep Plane FaceLift – after the operation there is no tension at all on the soft tissues, including the SMAS layer itself. Patients immediately look natural, “fresh” and natural without the effect of an “operated”, “stretched”, “tight” face.