What is a Deep Plane Facelift?

A deep plane facelift is a variation of the facelift procedure that tightens the mid and lower portions of the face, recreating more youthful contours

Depending on your age, amount of sun exposure, or your genetics, your face can begin to experience varying degrees of laxity, especially along the jawline where jowls can form. Facial fat from the midface can descend and deflate, leading to an overall tired and aged look with more areas of hollowness. A deep plane facelift can rejuvenate these facial features through modification of the underlying fascia, the connective layer beneath the skin. Since the procedure involves accessing the deeper structures of the face, the overlying skin displays natural-looking long-lasting results.

To find out about the advanced techniques involved in a deep plane facelift, consider booking a consultation with Dr Riccardo Frati. Dr Frati’s world-class training grants him the expertise necessary to perform high-quality deep plane facelifts that require more in-depth techniques than standard endoscopic and mini facelifts. To find out if you may benefit from this procedure, call one of Dr Frati’s locations closest to you: 

Alternatively, you can reach a member of his staff through his contact form, and they will promptly assist you in scheduling a consultation. 

Facelift History

Research into the modern facelift, or rhytidectomy, began with primitive techniques pioneered in the early 1900s. Since surgeons did not understand the inner workings of connective tissue beneath the skin, they simply superficially tightened the skin which provided short-lived results. In the 1970s, Dr Vladimir Mitz and Dr Martine Peyronie uncovered the potential of the superficial musculoaponeurotic system (SMAS), a thin, but strong connective structure that could be tightened to change the entire outline of the face. (1) Today, all facelift procedures take the SMAS into account, even if different surgical techniques are implemented to produce similar anti-ageing results. By utilising the SMAS, surgeons can avoid creating a “windswept” appearance. Surgeons are now able to access this tissue through inconspicuous incisions around the ear or behind the hairline. 

The Deep Plane Facelift Difference 

Deep plane techniques were first introduced by Dr Sam Hamra in 1990, but his methods have since been changed and improved upon. (2) Nowadays, this unique form of facelift is growing increasingly popular, with celebrities like fashion designer Marc Jacobs choosing this method of youthful rejuvenation.

For this type of facelift, Dr Frati will release various facial ligaments so that certain subcutaneous tissues retract to a more elevated, lifted positioning. He may also reposition the malar fat pads which lie within the cheekbone area of the face, and tighten certain facial muscles. Because of these comprehensive changes, this type of facelift restores subtle volume to the midface and reduces nasolabial folds in addition to creating a more sculpted jawline. Since the SMAS extends down into the neck, a deep plane facelift can also correct these lax areas, resolving “turkey neck”. Just like other facelifts, Dr Frati surgically tightens the SMAS layer, but with deep plane techniques, the skin and SMAS remain attached throughout the procedure, preserving better blood flow. 

Ideal Candidates for the Deep Plane Facelift

Dr Frati will consider patients who are in good health without any major conditions that could interfere with the healing process. Those with uncontrolled high blood pressure or diabetes should first manage their condition before any invasive surgery. Those with severe signs of ageing will benefit most from a deep plane facelift rather than a more superficial facelift. (3)  Although the ideal patient is a non-smoking individual, you may qualify for the procedure if you commit to quitting for a few weeks to prevent complications. 

Personal Consultation

Your consultation with Dr Frati will help clear up any doubts about whether or not the deep plane facelift is right for you. During this first meeting, he will assess your facial features, skin quality, and skin laxity. He will ask you about your expectations for the procedure and the areas you would like to correct most. You will get the chance to inquire about the details of your procedure and what to expect during your recovery. If you feel inclined to learn about alternative treatments, Dr Frati will review with you other procedure options, including those mentioned in his blog

If you feel ready to take the next step, contact one of Dr Frati’s offices or book your consultation online

Preparation Steps 

Preparation for a deep plane facelift is no different than the preparation process required for a standard facelift. Dr Frati requires that all of his surgical patients stop taking anticoagulant medications that can raise your risk of unwanted bleeding during the operation. He will review your current prescriptions and over-the-counter medications to ensure that you understand which substances to avoid. Since smokers are at a higher risk for complications, Dr Frati will require that you refrain from smoking and other sources of nicotine for at least 1 month. In the days following up to your procedure, you should take extra precautions to avoid sun damage. Any UV damage to the skin can slow down your recovery. To combat this, you should apply a daily broad-spectrum sunscreen. 

What Happens During a Deep Plane Facelift? 

First, Dr Frati’s anaesthetist will place you under general anaesthesia so that you will be completely asleep during this roughly 3-hour procedure. Next, Dr Frati will make discreet incisions around each ear to gain access to the SMAS, subcutaneous fat, and deeper skin layers. He will lift and elevate these tissues as one unit to eliminate jowling, reduce smile lines, and smoothen the appearance of the neck. During this portion of the procedure, he will strategically excise ligaments, an added procedure step that is unique to the deep plane facelift. He will adjust and remove certain fat deposits to lift drooping, sunken cheeks. For further contouring of the neck, he can perform a neck lift which involves one tiny incision just under the chin. With this small opening, Dr Frati can adjust the platysma muscle, effectively reducing prominent neck bands. 

Recovery and Results

The first few days of recovery will be when you will experience the most bruising and swelling, but prescription medication will make your recovery much more comfortable. You will be required to keep your surgical bandages on for the following few days, and Dr Frati will give you further instructions on how to best care for your incisions. After about 1 week, you will go back for a follow-up appointment in which he will remove your sutures and surgical drains that serve to prevent fluid buildup. 

Many patients return to work after about 2 weeks– approximately when the post-surgical swelling begins to resolve significantly. It is usually safe to resume working out after you have completed at least 1 month of healing, but you should consult Dr Frati beforehand so that he can assess your recovery progress. Though you will likely have some residual swelling for the next few weeks, your results will settle in gradually and dramatic changes will become more apparent.

The surgical techniques of the deep plane facelift work to restore a younger version of yourself. You will notice a reduction in deep folds and jowls while also attaining more lifted, subtly fuller contours in the midface. Your final results will last 10 years or more, depending on your genetics and lifestyle factors. Even as your rejuvenated features begin to fade, you will naturally appear to age slower. 

Corresponding & Complementary Procedures 

Depending on your aesthetic needs, Dr Frati can perform a complementary procedure during your facelift, or suggest another treatment that will be more in line with your expectations. 

Eyelid Surgery

A blepharoplasty is a type of eyelid surgery that will correct overly hooded, lax tissue overhanging the eyes or reduce unwanted permanent eye bags. With a combination eyelid surgery and facelift, the new contours of your lower and midface can match more expressive and vibrant eyes. 

Facial Fat Transfer  

Using liposuction, Dr Frati can harvest a small amount of fat from another area of the body, purify it, and reinject it into the face to create youthful volume in the cheeks and soften wrinkles. If you do not require skin-tightening at all, facial fat transfer may be what you need to fill in areas of hollowness and reverse signs of ageing. You can also undergo this procedure immediately before Dr Frati performs your facelift. 

Cost of a Deep Plane Facelift in London 

The cost of your deep plane facelift will be dependent on anaesthetic costs, any additional procedures at the time of your procedure, follow-up appointments, medications, and other fees. At your consultation, Dr Frati will give you an accurate estimate that will cover the total cost of your comprehensive, quality care. To get started discussing the possibility of undergoing this transformative surgery, contact Dr Frati at one of his offices listed below or get in touch with his staff using our online form.


  1. Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plastic and Reconstructive Surgery. 1976;58(1):80-88. doi:https://doi.org/10.1097/00006534-197607000-00013
  2. Raggio BS, Patel BC. Deep Plane Facelift. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK545277/ 
  3. Plane Facelift/Rhytidectomy. Facial Plastic Surgery. 2020;36(04):376-385. doi:https://doi.org/10.1055/s-0040-1714118 
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