Deep Plane Facelift
A deep plane facelift is designed to significantly reduce the visible signs of aging in the face and neck.
What Is A Deep-Plane Facelift?
A deep-plane facelift is an advanced surgical technique designed to significantly reduce visible signs of aging in the face and neck. Unlike traditional facelifts that focus only on the skin, the deep-plane approach repositions and lifts all layers of facial tissue — including fat pads and underlying muscles — for more natural and longer-lasting results.
This technique requires exceptional surgical expertise, as it addresses both structural aging and surface concerns. For optimal results, the procedure should be carefully customized to your unique features, skin quality, heritage, and personal aesthetic goals — ensuring a refined, youthful appearance that enhances, rather than alters, your natural beauty.
What Does A Deep Plane Facelift Accomplish?
- Improves the appearance of sagging cheeks and jowls.
- Addresses double chin & turkey neck with fat removal, gland repositioning, and skin/muscle tightening.
- Restores a more youthful facial shape and aesthetic contours.
- Repairs loose skin and elasticity.
- Sculpts a defined jawline and a harmonious neck contour.
The Dr. Azizzadeh Difference
Dr. Azizzadeh combines advanced facelift techniques with an artistic eye and meticulous attention to detail, ensuring superior patient outcomes. He rejects a one-size-fits-all approach, instead developing customized treatment plans considering each patient’s unique anatomy, aging process, and aesthetic goals.
Dr. Azizzadeh is globally recognized as one of the foremost experts in natural deep-plane facelifts and is frequently consulted by other plastic surgeons when they experience facelift complications or challenges. His deep understanding of complex facial nerve anatomy and facial reanimation allows him to provide the safest and most effective surgical approaches, distinguishing him from his peers.
Dr. A's Insider Tips
“A facelift doesn’t replace the need for Botox®, as they serve different purposes. While a deep plane facelift repositions sagging tissues, it doesn’t address dynamic wrinkles caused by repetitive muscle movements.“
Deep Plane Facelift
Non-Surgical Alternatives
For those not ready for a deep plane facelift surgery, select non-surgical treatments can enhance your appearance and help delay visible signs of aging. Maintaining healthy skin through medical-grade skincare is essential at any age — prevention is the ultimate luxury.
Top non-surgical alternatives include:
Laser Resurfacing & Chemical Peels
Treatments like fractional CO2 DEKA laser refine texture, correct discoloration, and improve skin tone.
Microneedling with Radiofrequency
Advanced devices such as SylfirmX™ and Morpheus8™ tighten and firm the skin while stimulating collagen.
Volume Restoration with Fillers
Premium fillers — Restylane®, Juvéderm®, RHA® — restore lost volume in the lips, temples, chin, and cheeks, creating balanced, youthful contours.
Collagen Stimulation
Injectables like Radiesse® and Sculptra® trigger natural collagen production for improved elasticity.
Wrinkle Relaxers
Botox® and Daxxify™ soften expression lines by gently relaxing targeted facial muscles.
A tailored combination of these treatments can help preserve a natural, refreshed appearance — allowing you to age with grace, without rushing into surgery.
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FAQ
It’s normal to have questions before a procedure. If you have additional questions or concerns, book a consultation today.
We do not determine the ideal age for deep plane facelift surgery based solely on chronological age but rather on your aging process and natural anatomy. We evaluate your specific facial structure and the extent of aging to decide if a deep plane facelift or another procedure is the best option for you.
Some individuals genetically have recessed chins and heavy cheeks and necks, which may lead them to seek surgical solutions as early as their 30s and 40s to achieve optimal results. Others may experience premature jowling and skin laxity in their 40s that necessitates a deep plane facelift. Conversely, some people in their 50s and 60s may age more slowly and might only require non-surgical treatments like energy-based devices such as SylfirmX™ or Morpheus8™.
We always aim to “preserve” or “reset” your youthful appearance. It is often advisable to perform a deep plane facelift earlier rather than later, as skin elasticity undergoes significant changes in the latter part of your 40s. Skin elasticity, the skin’s ability to stretch and then return to its original shape, is crucial for achieving natural results from a facelift procedure. High skin elasticity allows the skin to adapt smoothly to the underlying changes during surgery. As skin elasticity decreases with age, addressing aging concerns earlier can lead to more favorable and lasting outcomes.
Regardless of your age, it is essential to have an open conversation about your goals to determine the best treatment plan, whether surgical or non-surgical, that aligns with your needs.
The most natural and authentic facial rejuvenation outcomes are achieved when the forehead, eyes, face, nose, and neck are addressed in a harmonious and continuous manner. A deep plane face and neck lift primarily focuses on the midface, lower face, and neck region and does not incorporate the eyes, brows, and forehead.
We may recommend additional procedures to complement the deep plane facelift during your consultation. These can include blepharoplasty (eyelid lift), brow lift, laser resurfacing, fat grafting, and other treatments to ensure a balanced and cohesive rejuvenation of the face and neck. Your personalized plan will depend on your unique anatomy, aging process, and goals. This comprehensive approach ensures that all areas of concern are addressed, leading to a more harmonious and natural-looking result.
Twilight anesthesia, or conscious sedation, involves anesthetizing facial tissues with lidocaine (Novocaine) while administering sedatives and pain relievers without the need for a breathing tube. This keeps you relaxed and pain-free while remaining partially awake. In contrast, general anesthesia renders you completely asleep during the procedure, ensuring no awareness or pain. Both approaches are excellent options for facial plastic surgery when performed under the supervision of an experienced anesthesiologist or nurse anesthetist.
For a deep plane facelift, we prioritize facial nerve monitoring and safety. General anesthesia is the superior option as it eliminates the need for lidocaine injections, which can blunt the activity of nerves and muscles and potentially compromise nerve monitoring accuracy. This approach ensures optimal safety and precise outcomes during the surgery.
Completing a deep plane facelift surgery usually takes about three to four hours. Additional time may be required depending on the extent of facelift surgery and if a procedure is conducted in conjunction with other facial rejuvenation treatments.
Numbness in the ear, cheeks, and neck is common after facelift surgery, but it usually disappears within a few months of treatment.
Preparation
For the best results and swiftest recovery, we recommend the following leading up to your procedure.
Preparing for a deep plane facelift involves several key phases to ensure optimal surgical outcomes and a smooth recovery. Every patient is unique, and protocols may vary, so it is crucial to consult with Dr. Azizzadeh and his team for a personalized preparation and care plan tailored to your specific needs.
Discontinue smoking, vaping, and any nicotine products, as these can impair healing and negatively impact surgical results. If you have undergone or planned any laser treatments, ensure appropriate skincare preparation. Schedule a pre-operative medical appointment with your primary care physician to evaluate your overall health. Focus on maintaining a balanced diet, staying hydrated, and engaging in regular exercise. Make arrangements for time off work and plan for necessary post-operative care. Ask Dr. Azizzadeh about temporarily stopping any non-surgical treatments, such as botulinum toxin, fillers, or biostimulators, to ensure optimal surgical outcomes.
Complete any necessary pre-operative medical clearances and tests, such as bloodwork (e.g., complete blood count and coagulation profile) and, if applicable, an EKG or chest X-ray based on age or medical history. Discontinue aspirin, anti-inflammatory medications, and certain herbal supplements that can increase the risk of bleeding. This period is also a good time to manage personal grooming needs, such as hair appointments, as these activities may be restricted after surgery.
Attend a pre-operative consultation with Dr. Azizzadeh to finalize your surgical plan, discuss expected outcomes, and review potential risks. During this visit, you will sign informed consent forms and receive comprehensive pre- and post-operative care instructions. Prepare for your recovery by stocking up on essential supplies, such as ice packs, prescribed medications, and comfortable pillows to help with head elevation. Ensure you have a responsible adult available to drive you home and assist you for at least the first 24-72 hours following surgery.
On the night before surgery, avoid eating or drinking after midnight if you will be under general anesthesia. Use relaxation techniques to ease any pre-surgery anxiety and aim for a restful night’s sleep. If prescribed, take any anti-nausea medications as directed. On the morning of your procedure, shower with antibacterial soap (if instructed) and avoid applying makeup, lotions, or skincare products. Wear loose-fitting clothing that fastens in the front for easy dressing post-surgery. Arrive at the surgical facility as instructed, typically 1 to 1.5 hours before your scheduled procedure.
Approaching your deep plane facelift with a positive and focused mindset can significantly enhance your experience and recovery. Feeling nervous before surgery is normal, but techniques like positive visualization, meditation, guided imagery, and mindfulness can help reduce anxiety and promote a smoother healing process. Discuss any mental preparation strategies that resonate with you with Dr. Azizzadeh and his team to incorporate them into your care plan.
By adhering to these preparation steps and working closely with Dr. Azizzadeh and his team, you can optimize your readiness for a deep plane facelift and enhance both your surgical outcomes and recovery experience.
Recovery
During this initial phase, swelling and bruising are most noticeable but will begin to subside. You should rest but also take short walks in shaded areas outdoors to help you recover more quickly. You can usually start resuming daily activities, work, and errands towards the end of this period.
Patients experience the most noticeable swelling and bruising, which gradually begin to subside. The chin will appear to be a lot bigger and projected than what you will obtain once fully healed. The chin and lower lip may experience numbness and some movement issues which can be normal but should be reported to your surgeon. This initial phase requires ample rest, but short walks in shaded outdoor areas are encouraged to promote circulation and aid in recovery. Towards the end of this period, most individuals can start resuming their daily activities, including work and errands, as comfort levels improve.
You will start looking presentable and can attend social events. However, some redness at the incision sites may still be visible. You can return to normal exercise and physical activity three weeks after surgery.
Most soft tissue healing occurs during this time. Swelling continues to decrease, and your face will look more natural. Numbness around the ear and face will normalize.
The incisions will fully heal within 12-18 months, resulting in thin, nearly invisible scars. Treatments such as scar gels, lasers, and sometimes steroid injections may be used during this time to make the incisions undetectable.
Pain Management: For most patients, pain is manageable with over-the-counter acetaminophen (Tylenol). You will also be prescribed pain medications to manage any breakthrough pain. It is important not to exceed 3 grams of Tylenol in a 24-hour period due to the risk of liver complications. Be aware that prescription medications like Percocet, Vicodin, Tylenol #3 (Tylenol with codeine), and Norco contain acetaminophen, making this dosage limit critical. Avoid ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) as they can increase the risk of bleeding and bruising. If you experience severe pain, contact your surgeon immediately.
Medications and Supplements: To ensure optimal healing and reduce the risk of complications, avoid blood thinners and certain medications for 2 weeks before and 2 weeks after surgery. These include Aspirin, NSAIDs (such as ibuprofen, Advil, and Naprosyn), fish oil, herbal supplements, and vitamins. Additionally, refrain from smoking, vaping, all nicotine products, cannabis/marijuana, and illicit drugs during this period.
Swelling and Bruising: In the first 72 hours after surgery, use cold compresses for 20 minutes per hour while awake to reduce swelling and bruising. After this initial period, switch to warm compresses applied for 20 minutes, three times a day, to help alleviate bruising and promote healing. Additionally, you will be given arnica and bromelain to help reduce swelling and bruising. Arnica is a natural remedy known for its anti-inflammatory properties, and bromelain, an enzyme found in pineapples, helps decrease swelling and bruising. At the time of surgery, you will also receive a dose of steroids to minimize swelling. In some cases, a short course of steroids may be prescribed after surgery to manage excessive swelling. This regimen helps manage discomfort and accelerates the recovery process.
Nausea and Diet: With modern anesthesia methods and our special protocol, post-operative nausea is much less common and very manageable. During surgery, your anesthesiologist will administer intravenous anti-nausea medications and specialized anesthetics that limit gastrointestinal issues. Additionally, you will be prescribed Emend™ to take three hours before surgery to prevent nausea and Ondansetron (Zofran®) for breakthrough discomfort. Avoid complex or heavy foods 24 to 48 hours after surgery. Consume clear liquids and bland, easy-to-digest foods such as broth, plain toast, or crackers. Gradually reintroduce solid foods to ease digestion and minimize discomfort. Hydration is crucial in the post-operative period. If submandibular gland modifications are performed, follow a bland diet, avoid spices, and opt for soft foods to minimize discomfort and swelling in the neck area.
Incision Care: In the first week, gently clean your facelift and neck incisions with half water and half hydrogen peroxide once a day for the first 7 days. After cleaning, apply an antibiotic ointment, such as Neosporin or Mupirocin, over all incisions three times daily to prevent infection and promote healing. After the first week, discontinue hydrogen peroxide and antibiotic ointment. Steri-strips or silicone gel will be recommended to support further healing. For areas with crusting, applying Vaseline can keep the skin moist. Minor irregularities behind the ear are normal and may be treated with massage, scar gel or, occasionally, steroid injections.
Hair Management: In the initial phase after facelift surgery, we recommend wearing your hair down to help conceal any healing incisions. It is advisable to color your hair a few days before the surgery, and you may resume hair coloring three weeks post-surgery. Final healing can take a few weeks to several months, but you can comfortably wear your hair back in a ponytail if desired during this period. For men, special attention is given to maintaining a natural look, particularly around the sideburns and beard area. Incisions are carefully placed to ensure sideburns blend seamlessly with the natural hairline, allowing for normal shaving and grooming practices without noticeable scarring. This meticulous approach ensures a masculine and natural appearance post-surgery.
Additional Support: We often recommend comprehensive post-surgical aftercare with skilled nurses, ensuring you receive the highest level of attention and support during your recovery. These facilities help you have a smooth and stress-free post-operative period, allowing for optimal healing and peace of mind. Additionally, incorporating hyperbaric oxygen therapy (HBOT) as part of your post-operative care can further enhance your recovery. Hyperbaric oxygen therapy delivers concentrated oxygen in a pressurized chamber, promoting accelerated healing by increasing oxygen supply to tissues, reducing swelling and inflammation, and improving collagen synthesis. Research has shown that HBOT can aid in reducing post-operative complications, enhancing wound healing, and minimizing scarring, making it a beneficial option for many patients undergoing facial and neck procedures. Discuss with Dr. Azizzadeh and his team whether hyperbaric oxygen therapy is appropriate for your specific post-operative care plan.
Post-Surgery Warning signs: After a deep plane facelift procedure, it is essential to monitor your recovery closely and contact your doctor if you experience any concerning symptoms. Warning signs include change in vision, pressure in eye socket, sudden or severe swelling, bruising that worsens instead of improving, intense pain unrelieved by prescribed medications, or any signs of infection such as fever, redness, warmth, or drainage at the incision site. Additionally, difficulty breathing, chest pain, or numbness or weakness in the face or neck should be reported immediately, as these may indicate complications. Prompt communication with your healthcare provider can ensure timely intervention and a smooth recovery process.
Healing can vary from person to person, and some individuals may experience a longer recovery period.