Deep plane facelift - advanced lifting of the face and neck

Author and medical review:

Igor Višnjar, MD, FEBOPRAS, Specialist in General, Plastic, Reconstructive and Aesthetic Surgery

A deep plane facelift is an advanced facial rejuvenation technique in which we release and lift the deeper soft tissues of the face, rather than relying mainly on skin tightening. This allows us to restore a higher cheek position, redefine the jawline and improve the transition between the face and neck.

In a properly selected patient, we can achieve significant rejuvenation, often bringing the appearance of the face closer to how it looked approximately 10 - 15 years earlier. Our goal is not to create a different face, but to restore more youthful proportions, a higher cheek position, a cleaner jawline and a fresher overall appearance.

At Klinika Višnjar, we perform deep plane facelift in patients whose deeper facial tissues have already descended to the point where non-surgical treatments can no longer provide the desired correction.

Book a consultation and we will assess together whether a deep plane facelift is the right technique for your face.

What is a deep plane facelift?

Facial ageing affects much more than the skin. Over time, the cheeks, fat compartments and other soft tissues descend, supporting ligaments loosen, the SMAS layer changes and the jawline gradually loses its youthful definition.

If the main problem lies in the deeper tissues, simply removing or tightening excess skin cannot provide the best possible result.

With a deep plane facelift, we work beneath the SMAS, the fibromuscular support layer of the face. We release selected retaining ligaments and mobilise the deeper facial tissues so they can be repositioned into a more youthful anatomical position.

The cheeks, SMAS and deeper soft tissues are treated as a connected unit. Once these structures have been repositioned correctly, we gently redrape the skin and remove any excess.

This is what allows us to create a significant change without producing an overly tight appearance.

What do we want to achieve with a deep plane facelift?

The biggest difference is usually seen in the areas where facial ageing becomes most visible: the midface and lower face.

With a deep plane facelift, we can:

• lift descended cheeks,
• reduce jowling along the jawline,
• restore clearer jawline definition,
• soften deeper nasolabial folds,
• improve the transition between the face and neck,
• give the face a lighter and more youthful appearance.

If ageing changes are also pronounced in the neck, we often combine the procedure with a neck lift, because we want the face and neck to remain harmonious.

A natural result does not mean a small result. In a properly selected patient, rejuvenation can be very noticeable. Natural means that the face remains balanced and recognisable.

Who is a deep plane facelift suitable for?

We most often recommend it to patients who show a combination of several ageing changes:

• descended cheeks,
• deeper nasolabial folds,
• pronounced jowls,
• loss of a defined jawline,
• laxity of the lower face,
• ageing changes in the neck.

It is particularly useful when a patient feels that fillers, biostimulators or other non-surgical treatments can no longer provide the result they are looking for. Age itself is not the main criterion. A 48-year-old may have significantly more tissue descent than a 60-year-old. What matters more than age is facial anatomy.

Who is not an ideal candidate?

If ageing changes are still mild, such an extensive operation may not be necessary. In those cases, we may recommend a smaller surgical procedure or non-surgical treatment. A facelift is also not the right treatment if the main concerns are:

• pigmentation,
• fine surface lines,
• skin texture,
• enlarged pores,
• loss of skin radiance.

For these concerns, procedures such as CO₂ laser, skin biostimulation or PRP are more appropriate.

When are fillers no longer enough?

This is something we discuss with patients very often. Fillers are excellent when we want to restore lost volume or improve individual facial contours. The difficulty arises when we try to compensate for tissue descent simply by adding more volume.

If the cheek has moved downward, additional filler cannot truly return all of the deeper tissues to their original position. With excessive volume replacement, the face may become fuller and heavier without necessarily looking younger. At that point, we often recommend a different approach. Instead of adding more, a facelift allows us to reposition what is already there into a more youthful position.

What happens during the consultation?

Consultation is especially important with facelift surgery because a good result starts with good planning. We first discuss what bothers you and what kind of result you would like to achieve. We then assess the face and neck as a whole: the cheek position, jawline, excess skin, volume distribution and tissue quality.

We also like to look at photographs from ten or fifteen years ago. Not because we can literally turn back time, but because older photographs show us how your face was naturally structured before the tissues began to descend. Based on this assessment, we decide whether a deep plane facelift, SMAS facelift, smaller procedure or another approach is most suitable.

How is the operation performed?

We perform deep plane facelift under general anaesthesia. The incisions are carefully planned along the hairline and around the natural contours of the ear so that they can become as discreet as possible after healing. We then access the deeper layers of the face, release selected retaining ligaments and mobilise the soft tissues. These are repositioned into a more youthful location and securely fixed there.

Only after the deeper structures have been corrected do we redrape the skin and remove any excess, which means that the result does not depend on pulling the skin tightly. The procedure takes several hours. The exact duration depends on the anatomy, extent of the facelift and any additional procedures. When combined with a neck lift or eyelid surgery, the operation may take approximately 4 - 6 hours.

Facelift and neck lift

In patients with visible ageing changes in the neck, we generally do not want to treat the face in isolation. If we rejuvenate the face but leave a significantly lax neck untreated, the overall result may look unbalanced. For this reason, deep plane facelift is often combined with a neck lift, where we improve the area beneath the chin, the jawline and the contour of the neck. The goal is for the transition face → jawline → neck to once again appear harmonious.

Combination with blepharoplasty

Ageing is often not limited to the lower face. If the upper eyelids feel heavy, or there are lower eyelid bags and excess skin, we can combine a facelift with upper or lower blepharoplasty. During planning, we always aim for balance. The goal is not to perform as many procedures as possible, but to choose the procedures that will genuinely improve the overall result.

Recovery after a deep plane facelift

If you are considering a facelift, it is sensible to allow approximately 2–3 weeks for the initial recovery period, even though healing continues for much longer.

The first few days

Swelling, bruising and a feeling of tightness are expected. Temporary changes in skin sensation can also occur. This is a normal part of the recovery process.

The first week

Swelling gradually begins to decrease, but the face still does not look the way it will once healing is complete. At this stage, we are more focused on smooth healing than on the final appearance.

Weeks two and three

Most patients already feel significantly better and gradually return to work and social activities. Some swelling may still remain.

Months one to three

The facial contours become more defined, the tissues soften and the result starts to look increasingly natural.

Around six months

The face has mostly settled, scars continue to mature and we can assess the result much more realistically. Every patient heals at a slightly different pace.

Scars after a deep plane facelift

A facelift cannot be performed without scars, but we can plan them very carefully. The incisions usually run along the hairline and within the natural lines around and behind the ear. At first, scars are more visible. Over the following months they typically soften and fade. Their final appearance also depends on individual healing. Because the deep plane technique transfers the main tension to the deeper structures, we aim to avoid unnecessary tension on the skin when closing the incisions.

What are the risks?

A deep plane facelift is a major surgical procedure and we treat it as such. Possible complications include haematoma, infection, seroma, scar-related problems, temporary changes in sensation, asymmetry, skin healing problems and temporary or, more rarely, permanent injury to branches of the facial nerve. During the consultation, we discuss these risks openly, because aesthetic surgery should never be presented only in terms of the final result.

How long do the results last?

A facelift cannot stop the ageing process. What it can do is return the face to a significantly younger starting point. In a properly selected patient, the goal may be to achieve an appearance approximately 10 - 15 years younger, although this is not a number that can be guaranteed for every individual. After surgery, ageing continues. Ten years later the face will of course look different than it did a few months after surgery, but it will generally still look younger than it would have without the facelift.

The longevity of the result is influenced by genetics, skin quality, sun exposure, smoking, major changes in body weight and lifestyle.

Why choose deep plane facelift at Klinika Višnjar?

Deep plane facelift is a technically demanding procedure in which detailed knowledge of facial anatomy is essential. At Klinika Višnjar, the procedure is performed by Igor Višnjar, MD, FEBOPRAS, Specialist in General, Plastic, Reconstructive and Aesthetic Surgery. We do not use one universal plan for every patient, because no two faces are identical.

During the consultation, we want to understand how you looked before, what has changed over the years and what you would like to achieve now. If deep plane facelift is the most appropriate option, we recommend it. If another technique can provide a better result, we tell you that as well. For us, the technique is a tool. The goal is a face that looks visibly younger while still looking like you.

Deep plane facelift price

The price depends on the extent of surgery and on whether the procedure is combined with a neck lift, blepharoplasty or another operation. Deep plane facelift of the face and neck: from €12,900. After the personal consultation, we prepare an individual surgical plan and a detailed quotation.

A deep plane facelift is not a procedure you should choose simply because you have read a lot about it or because it is currently one of the best-known facial rejuvenation techniques. During the consultation, we first want to understand you and your face.

We assess what has changed over time, what bothers you and how far you would like to go with rejuvenation. We then explain what can realistically be achieved and which technique is most appropriate for your anatomy. If the goal is significant but harmonious rejuvenation of the face and neck, a deep plane facelift may be an excellent option.

Book a personal consultation with Dr Igor Višnjar at Klinika Višnjar in Ljubljana.