Deep Plane Face Lift

A Deep Plane Facelift is an advanced facial rejuvenation procedure that lifts and repositions the deeper tissues of the face rather than relying primarily on tightening the skin. By releasing specific facial ligaments and repositioning the deeper facial tissues as a unit, the procedure can improve sagging of the cheeks, jawline, and neck while maintaining a natural appearance.

The goal is not simply to make the face tighter, but to restore facial contours and create a refreshed result that remains harmonious with the patient's natural features.

A Deep Plane Facelift may be appropriate for patients with moderate to advanced facial aging who want to improve sagging of the cheeks, jawline, and neck while maintaining a natural appearance.

During consultation, I assess the degree and pattern of facial tissue descent, skin laxity, facial volume, jawline definition, and neck changes to determine whether a Deep Plane Facelift is appropriate.  Not every patient with facial aging requires a Deep Plane Facelift, and the surgical approach should be individualized to the patient's anatomy and goals.

You may be a candidate if you have:

• Sagging cheeks or midface, including descent of the malar tissues
• Jowls or loss of jawline definition
• Loose or aging skin of the lower face and neck
• Deepening nasolabial folds associated with facial tissue descent
• Loss of youthful facial contours
• A desire for natural facial rejuvenation rather than a tight or pulled appearance

My approach to Deep Plane Facelift begins with understanding how the face has changed with age rather than simply tightening loose skin. During consultation, I assess the position of the cheeks and midface, degree of jowling, jawline and neck definition, skin quality, facial volume, and overall facial proportions to determine whether a Deep Plane Facelift is the appropriate procedure.

A Deep Plane Facelift is not the right operation for every patient. Some patients may benefit from a different facelift technique, while others may achieve a more balanced result with additional procedures such as a neck lift, eyebrow lift, forehead lift, or eyelid surgery. My goal is to select the approach that addresses the patient's underlying anatomy while preserving natural facial movement and expression.

Rather than relying primarily on tension in the skin, the Deep Plane technique allows the deeper facial tissues to be repositioned as a unit after releasing the appropriate retaining ligaments. This can improve the midface, jawline, and neck while reducing the appearance of a tight or pulled result.

I also consider the relationship between the facelift and the rest of the face. The eyes, eyebrows, forehead, cheeks, jawline, and neck are interconnected, and treating one area without considering the others may result in an unbalanced appearance. When appropriate, I may recommend combining a Deep Plane Facelift with eyelid surgery, eyebrow or forehead lift, or neck lift to achieve more harmonious facial rejuvenation.

My goal is not to make a patient look different, but to restore facial contours in a way that remains natural and appropriate for their individual anatomy.

Before surgery:  

Before surgery, I perform a detailed assessment of the face, including the cheeks, midface, jawline, neck, skin quality, facial volume, and degree of tissue descent. Medical history, medications, and any factors that may affect healing or bleeding are also reviewed. Preoperative laboratory tests and medical clearance are arranged when appropriate based on the patient's health and planned anesthesia.

Careful preoperative photographs and markings are performed to help plan the incision placement and areas of tissue repositioning.

Anesthesia: 

A Deep Plane Facelift is generally performed in a hospital setting under IV sedation or general anesthesia, depending on the patient's health, surgical plan, and anesthesiologist's assessment.

The appropriate anesthesia plan is discussed during consultation to prioritize patient safety, comfort, and the requirements of the procedure.

Procedure: 

The procedure begins with carefully placed incisions around the ears extending into the hairline. The skin is gently elevated to expose the deeper facial tissues.  Rather than relying primarily on pulling the skin, the Deep Plane technique involves releasing selected facial retaining ligaments and mobilizing the deeper facial tissues as a unit. These tissues can then be repositioned to improve the midface, cheeks, jawline, and neck.

Once the deeper tissues have been repositioned, the skin is redraped without excessive tension and any appropriate excess skin is conservatively trimmed. The incisions are then carefully closed with attention to natural contours and scar placement.

The exact extent of dissection and tissue repositioning is individualized according to each patient's anatomy and degree of facial aging.

A Deep Plane Facelift is not performed in exactly the same way for every patient. The surgical plan may be modified depending on the patient's facial structure, degree of midface descent, jowling, neck laxity, skin quality, and previous facial procedures.

When appropriate, a Deep Plane Facelift may be combined with procedures such as neck lift, eyebrow lift, forehead lift, or blepharoplasty to address other areas of facial aging and create a more harmonious result.

• Post-operative Medications: I usually prescribe appropriate pain medication and other postoperative medications based on each patient's needs. Instructions for wound care and medications will be reviewed before discharge.

• Suture Removal: Sutures are generally removed approximately 7–10 days after surgery, depending on the location and healing of the incisions.  Regular follow-up appointments are important so that I can monitor healing, assess the surgical result, and address any concerns during recovery.
   
• Downtime:  Swelling and bruising are expected after Deep Plane Facelift, particularly during the first 1–2 weeks. Keeping the head elevated and using cold compresses during the early recovery period, as instructed, can help reduce swelling. Swelling gradually improves over the following weeks, although subtle swelling and tissue firmness may persist for several months as the deeper tissues heal.  Most patients need approximately 2–3 weeks before they feel comfortable appearing in public, although the amount of downtime varies depending on the extent of surgery, individual healing, and whether additional procedures are performed.  Many patients can begin returning to less strenuous work after about 1–2 weeks, depending on their occupation and the amount of residual swelling or bruising.

• Scarring:  The incisions are placed around the ears and, when necessary, within or near the hairline. Scars may initially appear pink, firm, or more noticeable but generally soften and fade gradually over time.  Scar maturation can continue for 6–12 months or longer.
   
• Results: The initial improvement is visible once the early swelling begins to subside, but the face continues to change as swelling resolves and the repositioned tissues settle.  The result gradually becomes more refined over the following months.  Final healing and tissue maturation may take several months.

The cost of Deep Plane Facelift in Manila varies depending on the surgical setting, anesthesia, complexity of the procedure, and whether additional procedures are performed.

Cost of Deep Plane Facelift for uncomplicated cases

Estimated Deep Plane Facelift: ₱350,000–₱400,000*

This estimate does not include preoperative laboratory tests, medical clearance, or postoperative medications. Hospital, anesthesia, and other facility fees may vary depending on the surgical setting.  The final cost depends on whether the procedure is performed as an outpatient surgery or with hospital admission and may vary according to the individual surgical plan.

Additional Procedures

Additional fees apply when Deep Plane Facelift is combined with procedures such as:

• Forehead Lift
• Eyebrow Lift
• Upper Blepharoplasty
• Lower Blepharoplasty
• Neck Lift

A final quotation is provided after consultation and treatment planning.

Deep Plane Facelift is a major facial surgery and, like any surgical procedure, carries potential risks and complications. During consultation, I discuss these risks carefully so that each patient can make an informed decision about surgery.

Possible complications include:

• Hematoma or bleeding 
• Seroma 
• Temporary facial weakness or numbness 
• Infection 
• Delayed wound healing or skin injury 
• Scarring or hair loss near the incision 
• Asymmetry or contour irregularity 
• Changes in the position of the earlobe or hairline 

Serious complications are uncommon, but they can occur.  Careful patient selection, detailed surgical planning, meticulous technique, and appropriate postoperative monitoring are important in reducing risk.  During your consultation, I will discuss the potential benefits, limitations, and risks of Deep Plane Facelift based on your individual anatomy and medical history.

Deep Plane Facelift requires a detailed understanding of facial anatomy, including the skin, soft tissues, retaining ligaments, muscles, nerves, and underlying structures.  A Plastic and Reconstructive Surgeon is trained to work with these structures while considering both function and aesthetics.

My training in Plastic and Reconstructive Surgery has given me extensive experience in facial anatomy and reconstructive surgery. This foundation allows me to approach facial rejuvenation with careful attention to tissue position, facial proportions, and natural movement—not simply the removal or tightening of skin.

During consultation, I assess each patient's anatomy and goals to determine whether a Deep Plane Facelift is appropriate and whether additional procedures, such as a neck lift, eyebrow lift, forehead lift, or blepharoplasty, would provide a more balanced result.