The Extended Deep Plane Facelift
For the most advanced facelift technique, the Deep Plane Facelift, performed by only a select number of highly specialized facial surgeons worldwide, you no longer need to travel to the United States. Dr. Callum Faris, Otolaryngology Head and Neck Surgery/Facial Plastic and Reconstructive Surgeon trained at Harvard University, performs this facelift here in the Netherlands. For more information and a personal assessment by our multidisciplinary team, you are warmly welcome at our clinic. For more info, get in touch.
Pre and Post-Facelift: Drs. Callum Faris's Artistry in Facial Rejuvenation. Example 1
Case studies
We have included the follow examples case to demonstrate the power of our approach. We use an extended deep plane facelift and deep neck lifting in combination when indicated with fat grafting, forehead lifting, lip surgery, chemical peels and eyelid surgery to achieve the best results. In the case studies 1-9 below the plans have been chosen by our clients after recommendations made by Dr Faris and Dr Schmidt.
Facial fillers were dissolved to reset the canvas, followed by pan facial fat grafting and an extended deep plane facelift and neck lift. The outcome is a sophisticated, sculpted, and naturally rejuvenated look.
An extended deep plane facelift and deep neck lift showcase a beautifully natural rejuvenation. One of our classic plans for a timeless transformation.
Another panfacial approach with an extended deep plane facelift, deep neck lift, endoscopic brow lift, and targeted face fat grafting by Drs Susan Schmidt, this transformation celebrates balance and restoration.
Dr. Faris and Dr. Schmidt Explaining The Extended Deep Plane Technique.
In this 7-minute video, Dr. Faris and Dr. Schmidt draw the three zones of facial ageing directly on the face — the midface with its nasolabial creases, the jawline with jowling, and the neck with platysmal banding — and explain which operation corrects each: a standard facelift for the jawline, a neck lift for the neck, and the deep plane facelift with ligament release for the midface.
Extended deep plane facelift, deep neck lift, endoscopic brow lift, and full face fat grafting, The result: restored volume and lifted features.
Another beautiful example of our extended deep plane facelift and deep neck lift. A refined, refreshed result from one of our signature plans.
Extended deep plane facelift, deep neck lift with platysmaplasty, fat grafting to three zones, endoscopic forehead lift, and a phenol/TCA mosaic facial peel. The result: a defined jawline and a smooth, tightened neck.
Natural results with the Deep Plane Facelift.
Our most basic plan: Combining an extended deep plane facelift, a traditional neck lift and lip lift.
Our most requested plan: an endoscopic brow lift (result not shown), extended deep plane facelift, deep neck lift, and fat grafting. The result exudes a lifted, refreshed, and effortlessly youthful look.
Our third most common plan: An extended deep plane facelift, neck lift, and fat grafting result in an elegant, rejuvenated appearance with refined contours and volume restoration.
Our second most common plan: Featuring an extended deep plane facelift, deep neck lift, and fat grafting. The outcome is a stunning balance of definition, volume, and graceful rejuvenation.
Our most basic plan: Combining an extended deep plane facelift and a traditional neck lift to reveal beautifully sculpted contours.
Extended deep plane facelift together with a deep neck lift with structural contouring.
The team behind your result
Your result is the work of one team. Dr Faris and Dr Schmidt plan every face together, supported by our nurses and anaesthetic team — whose care shapes both the outcome and your recovery.
Your surgeon
Dr Callum Faris — Otolaryngology Head and Neck Surgery/Facial Plastic and Reconstructive Surgeon
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Deep plane facelift explained
This is where we go deeper. Below we answer the questions we're asked most about the deep plane facelift — but the answers make far more sense once you can see how the face is built. So we'll start with a short tour of the anatomy, then come back to your questions.
Before we answer these questions, we will briefly explain the anatomy of the face and some important anatomical concepts, how a Deep Plane Facelift works, and why it is different from normal facelifts. Important anatomical structures and concepts:
- The face is arranged in layers – each layer has a defined role.
- The facial skin and facial muscles are attached to the bony skeleton through ligaments.
- A ligament is a very strong piece of tissue that attaches bone to other structures. It is designed to stop movement – like the chain and anchor of a boat.
- Between the facial retaining ligaments there are facial spaces. Spaces are loosely attached tissue. Spaces in the body are designed to allow movement of overlying structures. Spaces have nothing inside them – it is purely a gliding plane – thus allowing maximal movement of the overlying skin layers.
Frequently asked questions
Tap a question to jump straight to its answer.
- Who is a good candidate for the deep plane facelift?
- Why is the deep plane facelift more effective than other facelifts?
- How are these results achieved with a deep plane facelift?
- Is the deep plane facelift a more serious surgery than other facelifts?
- Does it take longer to recover from a deep plane facelift? How long will I have to stay off work?
- I need a revision facelift. Will the deep plane facelift work for me?
- Why does the deep plane facelift cost more than other facelifts?
The face is arranged in layers, there are 5 see image:
The 1st layer is the skin and fat provide a tough waterproof cover layer for the deeper structures’ deklaag voor de onderliggende structuren. 2nd layer is the fat layer which is the insulating layer and the layer with the blood vessels to supply the skin with blood. 3rd layer is the SMAS layer, which provides the muscular layer for facial movement allow use to smile and frown and raise our eyebrows 4th layer is the ligament and facial spaces layer. The spaces allow the muscular layer to move over the bone and it has ligaments which attach the SMAS/skin/fat layer to the skeleton. 5th layer is the very tough strong layer covering and supplying the bone with a blood supply. It is totally fixed and cannot be stretched.
More abouth the 4th layer
The facial ligaments are like a tree. They secure the skin/fat/muscle (layer 1-2-3) to the bony skeleton. They do allow a degree of movement of back and forth of the skin, a bit like a tree bending in the wind. However, ligaments do significant amounts of movement of the overlying skin.
In layer 4 the facial spaces lie between the facial ligaments. The spaces have a defined purpose- to act as a gliding plane. They allow the more superficial layers, layers 1-2-3 above to move over the deeper layer (periosteum) layer 5 which is totally fixed to bone. This movement is key for producing facial expression. If it was not for the gliding plane of the spaces in layer 4, we would not be able to produce a wide smile and would have limited facial expression.
The mobility of the skin over the space also has a draw back. The skin is inherently weaker over the spaces than over the ligaments. As we age the skin over the ligaments tends to remain tight to the face, but the skin over the spaces can become loose and saggy. This creates bulges (as above).
Which layer is the facelift performed on?
The face lift can be performed in three layers. Over 95% of facelifts are S lifts, MACS lift, SMAS plication, SMAS flaps all mainly use the dissection in level 2. This means the SMAS layer level 3 is still attached to the bony skeleton by ligaments. This has two very important consequences: 1. The SMAS and skin can only be tightened (or the lift) a moderate amount as the ligaments are still intact. The ligaments stop the movement or lift of the SMAS and the skin tissues. The dissection is in layer two, the fat layer. The fat layer has the most blood vessels. This results in many blood vessels being divided leading to bleeding during the operation and bruising after the operation.
In layer 4 the facial spaces lie between the facial ligaments. The spaces have a defined purpose- to act as a gliding plane. They allow the more superficial layers, layers 1-2-3 above to move over the deeper layer (periosteum) layer 5 which is totally fixed to bone. This movement is key for producing facial expression. If it was not for the gliding plane of the spaces in layer 4, we would not be able to produce a wide smile and would have limited facial expression.
Extended Deep Plane Face Lift is performed in layer 4. All the facial ligaments are divided in this technique. This has significant benefits. 1.As the ligaments are now divided (the anchors of the face have been removed) the SMAS can be tightened/lifted significantly more and with less tension. One anatomical study showed that a Deep Plane Face lift resulted in twice the skin excision and twice the neck and midface improvement as SMAS plication (such a SMAS plication – MACS lift type surgery] 2. The dissection is in the facial space layer 4 that has far fewer blood vessels and this results in less blood vessels being divided, leading to less bleeding and bruising after the operation.
Let’s look at those questions again
Who is a good candidate for the deep plane facelift?
Individuals looking for improvements in their jawline, nasolabial fold or neckline. Almost anyone who is medically fit for elective surgery can have a deep plane facelift. Most patients are between the ages of 40 and 75.
Why is the deep plane facelift more effective than other facelifts?
The deep plane facelift allows a surgeon to address the effects of ageing more comprehensively, lifting the whole skin and SMAS as one unit after dividing the facial ligaments in layer 4. This leads to a much more natural look, very different from the old-style operated appearance. The improvements produced are longer lasting than alternative facelifts that do not divide the facial ligaments. The technique uses the natural deep spaces of the face, so there is reduced tissue damage — in our experience, patients have less bruising, swelling and bleeding. Because the facial tissues are lifted by repositioning the deeper layers, there is no pulled skin and no tell-tale trace of a facelift having occurred. After a deep plane facelift, patients simply look a much younger version of themselves — well rested and rejuvenated — and the results stand the test of time. In our view, all of these factors make the extended deep plane facelift far more effective than any other type of facelift available at present.
How are these results achieved with a deep plane facelift?
The surgeon works in the deepest planes of the face, where there are natural spaces, and releases the retaining ligaments of the face (layer 4). Once released, the entire facial skin of the cheeks, jawline and neck can be repositioned with minimal trauma to the skin surface. This is not achieved with a skin-only facelift or a standard SMAS or MACS facelift.
Is the deep plane facelift a more serious surgery than other facelifts?
Yes and no. Yes, because this surgery is technically more demanding than other types of facelift and requires superior skill and expertise in handling the deeper tissue layers. For this reason, only a select few surgeons in Europe and around the world perform deep plane facelifts. No, from a patient's point of view: recovery times after a deep plane facelift are relatively short compared to alternative facelifts. The surgical work is done on the deeper tissue layers where there are natural spaces, rather than near the surface. As the skin is minimally disrupted, bruising is much less, and the avoidance of tension means scars heal better — without lumpy, red or stretched scars. Is it riskier, or does it have more complications? No. The deep plane procedure is not any riskier than other facelift techniques. In fact, it leads to fewer complications, for the reasons above. Does it hurt more than a regular facelift? No. There is less skin trauma in a deep plane facelift, and in our experience this technique hurts less than many other types. Because the surgery is performed in layer 4 rather than layer 2 — which has a high concentration of nerve endings and blood vessels — less trauma is produced. Patients usually have a recovery that just requires paracetamol, with occasional Tramadol or codeine over the first 3–4 days.
Does it take longer to recover from a deep plane facelift? How long will I have to stay off work?
In our experience it requires similar downtime to other facelifts, but with less bruising, swelling and pain. Most people can get back to work or social activities in two weeks. Usually, by three weeks people will not notice you've had a facelift, but will comment on how well rested and rejuvenated you look. Many patients value this: most do not like to announce their beauty decisions to the world, and they appreciate the natural-looking results and the confidentiality this brings.
I need a revision facelift. Will the deep plane facelift work for me?
Yes, absolutely. The deep plane technique is ideal for revision surgery. As the majority of facelifts are performed in the superficial plane (layer 2), this leaves the deep plane (layer 4) unoperated on. A deep plane facelift is therefore actually the preferred technique for a second facelift.
Why does the deep plane facelift cost more than other facelifts?
As mentioned above, the deep plane technique requires specialised expertise and experience. The operation is performed under general anaesthesia and takes a longer operating time than other types of facelift.
For more information, please get in touch — we're happy to talk you through whether a deep plane facelift is right for you.