The evolution of facelifting
A facelift typically addresses loose tissue along the lower face and sometimes the neck. Through the last 30-40 years, facelifting has evolved substantially. Older versions of facelifts attempted to pull the skin as tight as possible, in the hope that this would lift the face, however results looked unnatural and were short lived. Subsequent surgeons realized that the deeper layer of the face called the "SMAS" provided more support, so they would tighten this layer by pulling with sutures. This "SMAS plication" style facelift still has it's place, but it requires a great deal of tension, and thus over time results can fade. A "SMAS Flap" facelift attempts to tighten the deeper layer by removing a portion of it, and sometimes performing a limited dissection underneath the SMAS, Despite this advance, results can still be limited in nature.
In 1990, the "Deep Plane Rhytidectomy" (Rhytidectomy is the scientific word for facelift) was invented by Dr. Hamra, and revolutionized facial rejuvenation with it's combination of natural-looking and long-lasting results. Despite it's benefits however, the Deep Plane Facelift did not become widely adopted because it is technically challenging and has an increased risk of dangerous complications if performed by inexperienced surgeons.
Even today, many Plastic Surgeons and Facial Plastic Surgeons are not trained in Deep Plane Facelifting, and regard it with equal amounts of fear and respect. There are very few surgeons in our region with the education, anatomical knowledge, training, and technical skill to safely perform this procedure. Dr. Givens is widely regarded as Eastern Iowa's facelifting leader. He frequently performs Deep Plane, Extended Deep Plane, Minimal Access Deep Plane, Deep Neck, and other facelifting techniques to help restore a youthful appearance to his patients. He is double Board-Certified in Facial Plastic and Reconstructive surgery, and specializes in both surgical and nonsurgical facial rejuvenation. Patients from across Iowa, as well as from the Chicago-area seek out Dr. Givens for his artistic and technical talent, and his caring bedside manner.
What is a Deep-Plane Facelift?
The key differentiating factor with a deep plane facelift is the release of several retaining ligaments in the face to allow for repositioning of the deeper facial structures without tension. What this means, is that instead of using the skin or suture to pull the deeper structures (which is prone to fail over time and can look un-natural), the surgeon instead precisely targets the deep structures that are holding the face in a drooping aged postition, releases these tethering structures, and then gently repositions the tissue. A deep plane facelift rebuilds the underlying structure of the face, and the skin envelope is gently draped over the surface. This allows for a much more natural appearance, because the face's structure more closely resembles it's natural more youthful appearance. Results are semi permanent, because there are no high-tension stitches that are prone to pull through or relax over time.
Who is a good candidate for a Deep Plane Facelift?
The short answer is, this technique can be appropriate for any patient who notices signs of facial aging, who is able to undergo surgery. The procedure is frequently performed in our office surgical suite with local anesthesia and relaxing medications. Because patients are not under general anesthesia, the risk and recovery is much less. A Deep Plane facelift can be customized to each patient, with smaller incisions (minimal access) for younger patients, and more standard-length incisions (shown in the picture above) when significant amounts of skin redraping are necessary. Because the tethering ligaments are released, results are extremely natural appearing and long lasting.
What about a Mini-lift?
Despite the advantages of a deep-pane lift, some patients prefer more limited operations, with shorter recovery times. Dr. Givens is also a regional leader in these less-invasive procedures. There are many names, and even brand names for certain facelift techniques, and these can be both tempting and confusing to the patient. For this reason, consultation with a Board Certified Facial Plastic Surgeon is essential to help determine what type of treatment is best for you.