The Deep-Plane Lift
Understanding the limitations of skin-only and SMAS facelifts, research in facial anatomy showed that procedures accomplished one layer deeper, below the SMAS sheet instead of above it, created better, more natural results and longevity not capable in the past.
As a modification and advancement of the standard facelift, the deep-plane facelift involves repositioning all the drooping facial soft tissues that are involved in facial aging. Since only the deeper SMAS layer is utilized to reposition all the drooping facial tissue, no tension or tightness is ever needed or placed on the skin. If the skin is never pulled in doing the facelift the result will never produce a pulled, tight or plastic appearance.
This facelift is the most effective in restoring the midface and nasolabial folds (creases from our nose to our mouth) because the fat pads in the cheeks are lifted and repositioned removing facial hollows and restoring our cheekbone shape. In addition, since the SMAS layer is connected to the loose muscles of our neck, a deep-plane facelift is also the most effective in recreating our smooth neckline.
Unlike the SMAS procedure where the skin is separated from the deeper tissues, the deep-plane technique repositions the entire loose saggy soft tissue of face as a unit causing less tissue trauma and faster healing. Since the deep-plane technique is accomplished in the plane or layer that naturally exists in our face (instead of an unnatural plane or level that is produced in other facelifts), there is minimal bruising and minimal pain after this procedure.
Areas such as loose buccal cheek fat (the part of the face that produces jowls) can be assessed and treated during the procedure addressing aging changes that were not accessible before.
Since the deeper layer that is utilized is fibrous and inelastic, unlike the skin which is very elastic, the procedure produces the most long lasting results of any facelift technique.
The deep-plane technique can be modified to include only the midface, from under the eyes to the jawbone, accomplishing a significant result in a limited region. Replacing old fashioned minilifts, this can be an option if you are younger and do not have signs of aging in your neck.
Since most facelifts previously performed have been SMAS procedures, the deep-plane facelift is the preferred technique in revision or secondary facelifts in order to prevent an unnatural tightening of the surface or skin layer that can occur with repeated SMAS procedures.
Most important, because this technique focuses on the deeper facial structure, there is never any unnatural tightening or pulling of the facial skin that typifies older and obsolete facelift techniques. The Deep-Plane Facelift is the most sophisticated procedure available today and studies have shown that it is the most effective procedure available for repositioning sagging soft tissue. This is why it has won the devotion of patients and acclaim from the plastic surgery community.
TAKING THE DEEP-PLANE FACELIFT TO ITS HIGHEST LEVEL
Clearly the Deep –Plane facelift is a superior procedure, but amongst the elite surgeons that can perform the deep-plane facelift, Dr. Gordon stands out.
Dr. Gordon was one of the early pioneers’ in the technique and the first fellowship trained, facial plastic and reconstructive surgeon to specialize in the deep-plane facelift in New York City. Throughout his career Dr. Gordon has been recognized as an international expert in deep-plane facelifting as evidenced by his academic appointment as Director, Head and Neck Aesthetic Surgery in the Section of Otolaryngology at Yale School of Medicine, as well as recognition through invitations to give prestigious academic lectures, contributions to the medical literature and the training of international surgeons.
Beginning in 1996, Dr. Gordon, has been annually invited to lecture at both national and international academic conferences on deep-plane facelifting. Specifically, lectures have focused on adaptations, modifications and nuances of the technique in applying the procedure to different face types for specific goals, and in the techniques’ preferred use in revision or redo-facelifts.
As a recognized international expert on the nuances of deep-plane facelifting, Dr. Gordon was invited to be a contributing author in multiple academic books and published the modifications of the deep-plane technique for the treatment of the neck in the publication Clinics of Facial Plastic Surgery, modifications for treatment of the mid-face in Clinics of Plastic Surgery, and wrote the content for deep-plane technique in a special monograph edition on Facelifting published by the European Academy for Facial Plastic and Reconstructive Surgery.
Most recently, Dr. Gordon was invited to author the contrarian chapter in a book on Volume Loss and was recognized for his work titled, “The Illusion of Volume Loss” , where he definitively shows how the majority of facial aging is not due to volume loss and how deep-plane facelifting reverses facial aging changes in an anatomically correct manner, creating natural appearing and long lasting results.
In addition to his role as Coordinator of Residency Education in Facial Plastic and Reconstructive Surgery in the training of surgical residents at Yale School of Medicine (Dr. Gordon always performs all procedures), surgeons from 5 continents have traveled to observed Dr. Gordon perform deep-plane facelifts and he is credited with the expansion of the technique in the United States, Europe and Australia.
Are You a Candidate for a Deep-Plane Facelift?
In general, any candidate for a standard facelift is also a candidate for a deep-plane facelift. Many scientists believe that a deep-plane facelift is a better choice for smokers than a standard facelift, since the deep-plane region has a more ample blood supply and is more resistant to smoking complications. This is the preferred technique for secondary or revision facelifts. Since a greater level of facial plastic surgical training is often associated with doctors who perform deep-plane facelifts, make sure your surgeon has in-depth experience in this technique to ensure the proper outcome.
Besides the actual procedure, the consult is probably the most important part of the process. Since Dr. Gordon can perform uncommon procedures that require specialized training, the main goal of the consult is to educate the consumer on the aging process, how to evaluate their aging changes and what options they can consider to meet their goals.
This will be the opportunity for you to communicate what your thoughts, desires and concerns are about your face and approaching the facial rejuvenation process.
Understanding how facial regions relate and influence one another is an important part of the consult process. Often these concepts are not intuitive but will easily be communicated during the consult visit. Dr. Gordon will usually manipulate your facial features in front of the mirror to illustrate how to reverse your specific aging changes, how different regions influence one another and allow you to view your “after” result on your own face. The process for all potential procedures will also be discussed.
Overall, a detailed understanding of how to view your face over time and will make you feel comfortable with Dr. Gordon as a physician and a person. You should not feel rushed during this process.
Before and after photos:
It is extremely important to view before and after photos of the outcomes from any surgeon you are considering. Often patterns will emerge, such as all the faces appear operated upon, incisions are prominent or the opposite, different faces have different cosmetic results and all the results appear natural regardless of the initial age or appearance. A surgeon who does facial rejuvenation regularly should be able to show you many different outcomes that are similar to your cosmetic issues; as well as outcomes that may not be your situation, but illustrate their ability to accomplish natural, detailed outcomes on all face types and ages. This will form a basis of communication between you and your surgeon and provide valuable information.
Our practice does not publish before and after photographs on the internet for a number of reasons. The main reason is privacy. Photographs on the internet can be used by people for other non-authorized purposes and no one can control this behavior. We cater to the high-end consumer and appreciate that many allow us to use their photographs, so in respect for that privilege, we will not publish photographers when we cannot control who has access to them and their ultimate use. In addition, sophisticated facial rejuvenation is individually designed and before and after results shown on most web sites are not necessarily reflective of your specific type of aging changes or the outcome you could expect. The consult environment is best to view other patients’ results in direct relation to your specific anatomy, goals and desires.
We chose not to use computer imaging because it is not real. It does not predict how your face will behave or that you will receive the image as a real outcome. We always want to focus on what actually occurs and viewing your surgeon’s cosmetic outcomes is the most predictive of what result you can expect.