A deep plane facelift addresses the lower two-thirds of the face — the midface, the jawline and the neck — by working beneath the SMAS, the fibromuscular layer that lies between skin and deeper structures.
The distinction from a conventional facelift matters. In the older technique, skin is lifted separately from the SMAS and much of the tension is carried by the skin itself. That produces the tight, swept-back appearance that patients recognise as “having had a facelift”, and because skin stretches over time, it also relapses sooner.
The principle of the deep plane
The face is anchored by retaining ligaments — fibrous attachments running from bone to skin. As the face ages, tissue descends around these fixed points, producing the fold beside the nose and mouth and the jowl along the jawline.
Pulling on skin without releasing those ligaments simply stretches the skin between them. The deep plane approach releases the ligaments directly, so the tissue can move as a unit. The SMAS and overlying skin are repositioned together, vertically, and secured by the deep layer. The skin is then redraped and closed without tension.
Because tension sits in tissue designed to hold it, the result does not depend on skin tightness. This is why it looks natural in motion and why it holds its position for years rather than months.
What it corrects
The technique is directed at established, structural change:
- Midface descent — flattening over the cheekbone and deepening of the fold between nose and mouth
- Jowling — loss of a clean jawline as tissue crosses the mandibular border
- Neck laxity — banding and loss of the angle beneath the chin, addressed by extending the dissection into the neck
- Marionette lines — the creases running down from the corners of the mouth
It is not the right operation for someone whose principal concern is a heavy brow or tired eyes with a jawline still intact. That pattern is better addressed by an endoscopic face lift.
The operation
Surgery is performed under general anaesthesia and typically takes four to six hours.
Incisions are placed in the natural creases in front of the ear, around the earlobe and into the hairline behind. Dissection proceeds into the sub-SMAS plane, where the branches of the facial nerve are identified and protected — this anatomical knowledge is what makes the technique safe in trained hands.
The retaining ligaments are released, the composite flap repositioned along a vertical vector, and the SMAS secured in its new position. Where the neck requires it, the platysma is addressed through a small incision beneath the chin. Excess skin is then trimmed conservatively and closed without tension.
Recovery
A light dressing is worn overnight and most patients stay one night under observation. Swelling and bruising are expected through the first two weeks; sleeping with the head elevated helps considerably.
Sutures are removed in stages across the first two weeks. Numbness in front of the ears and along the cheek is normal and resolves over several months as sensory nerves recover. A firm, slightly tight sensation in the neck during the first weeks is part of normal healing.
Most patients feel presentable at two to three weeks. Refinement of the jawline and neck contour continues for six months and beyond as the deeper tissues settle.
Strenuous exercise is avoided for four weeks. Sun protection and stable weight matter for the longevity of the result.
For patients travelling to Antalya
Plan around fourteen days in Antalya so that sutures can be removed and the early result reviewed before travelling home. Structured remote follow-up continues through the first year.
