In Defense of the Deep Plane Facelift

For an entire facial refresh, there’s nothing that compares to the energy of a facelift. While there are a handful of differing kinds of facelifts—mini, mid, decrease and full, to call a couple of—there was some current chatter questioning the security of a deep airplane facelift, which entails lifting and repositioning the pores and skin and muscle collectively as a single unit. As such, there’s a chance for nerve injury, however as Nashville, TN plastic surgeon Daniel A. Hatef, MD contends, nerve injury is a widely known danger of any facelift.

“Those questioning the safety of the procedure aren’t plastic surgeons,” notes Dr. Hatef. “What they’re saying is not scientific, it’s just misinformation based on one bad case.” Ahead, we separate truth from fiction with Dr. Hatef, together with all the things to learn about the well-liked process earlier than going underneath the knife.

What is the distinction between a standard facelift and a deep airplane facelift?

“A deep plane facelift is where we raise what is called the SMAS—the superficial musculoaponeurotic system—of the face, which is basically the resting fascia of the facial muscles that moves your face and help you smile, kiss, all of your facial expressions. There’s a fascial layer that surrounds those muscles, so we lift the superficial aspect of that fascia off of those muscles and we relocate it in a more superior and more youthful position to get a better jawline, to correct the jowls and to improve the neck. The reason we do it is because when you see aging, when you see jowling, those things are a result of that loosening over the muscles and sliding down. So when we reposition that, that’s the best way, in my opinion, to reposition facial fat.”

What makes a deep airplane facelift extra dangerous than others on the subject of facial-nerve injury?

“When we do the surgical procedure, we’re dissecting very near the branches of the facial nerve. There’s little question that we’re getting close to them and even touching them and and we see them throughout this facelift, however to say that it’s unsafe is totally unscientific.

Patients will generally smile humorous for about two or three weeks after surgical procedure—kissy faces may also be a bit weaker for this era—and that’s partially since you’re stretching the nerves out while you do the dissection, but it surely’s additionally since you’re doubtlessly injuring the musculature, particularly the platysma, while you’re doing a deep airplane facelift. But I’ve by no means seen any long-term issues from it. Over time, the muscle tissue will strengthen once more.”

What ought to a affected person do in the event that they discover themselves on this state of affairs after a deep airplane facelift?

“It relies on their examination, and that’s why it’s so vital to go to a board licensed plastic surgeon or board licensed facial plastic surgeon who focuses on the surgical procedure and who does it incessantly, in order that they may have the confidence to have seen it earlier than and perceive that it’s going to go away. I feel the worst factor you are able to do is is reopen and probe for nerve harm, when there’s doubtless no accidents.

Now if somebody went to a non board-certified one who calls themself a beauty surgeon and their total face isn’t shifting, on this state of affairs we all know that both each branches are lower or there’s a suture that’s looping a big department. That’s totally different. But when it’s an remoted department,  that’s usually simply from stretching, trauma from surgical procedure and irritation.”

What is the number-one factor a affected person can do to attempt to keep away from these dangers?

“Going to a board licensed plastic surgeon. Of course there are dangers, however these are identified dangers of facelift surgical procedure. We’re not producing automobiles off the meeting line—it’s surgical procedure and issues don’t at all times go nicely. Most of the time they do, particularly in the palms of an ideal surgeon, however generally they don’t. Generally, these items will resolve with time.

Anytime you’re touring for surgical procedure, you perhaps don’t set up pretty much as good of a relationship with that surgeon, and they also’re not capable of maintain your hand as nicely. When you’re contemplating an enormous surgical procedure like this, you’re most likely higher off staying on the town the place you reside and discovering a board licensed plastic surgeon or facial plastic surgeon, not facial beauty, not beauty—there are solely two boards which can be acceptable for doing this sort of surgical procedure.”

What does downtime and potential scarring seem like after a deep airplane facelift?

“For a deep airplane facelift like I do the place I mobilize a excessive SMAS, I make my incision the place the typical hairline begins and I am going down behind the tragus of the ear, underneath the ear lobe and behind the ear, after which again into the hairline. We do this on each side. And then I make a couple of two-inch incision beneath the chin, on the neck.

The downtime is mostly about three weeks. If the affected person has loads of subplatysmal fats, I allow them to know that I’ll be taking extra out to offer them optimum jawline contouring. But once I do this, I take out the lymph nodes in the neck, and so in that case the downtime is much more, and that’s as a result of they swell a lot. When they arrive in for his or her first post-op appointment at week one, they give the impression of being wonderful and so they’re so glad. And then swelling actually kicks in in that space of the neck and they also’re swollen for a very good six weeks after that, however when that subsides they find yourself trying wonderful.”

Is there something the affected person can do to cut back the swelling at house?

“Eating a high-protein anti-inflammatory diet, lymphatic massage and compression, compression, compression. Those things help to make it so that we have more even swelling and so that three to six months down the road, they just have a nice flat jawline contour.”

What would you advocate for these on the lookout for important tightening outcomes however are usually not prepared for a facelift?

“The things that we do in patients who have a little bit of jawline laxity but aren’t ready for the facelift are jawline rejuvenation with filler where we use filler to artistically augment the jawline. So you’re augmenting that area and creating a highlight, and then at the edge of that highlight is a strong shadow. So it’s a little bit of light physics that we’re manipulating when we do that. It’s also just the fact that adding volume to the jawline splits their soft tissues and reduces the laxity. The other option is internal radio frequency in the area.”

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