Facelift and Necklift in Connecticut

Deep Plane Facelift and Necklift

I would like to briefly discuss why I perform a deep plane facelift and necklift. I have been performing facelifts since the year 2000. In my fellowship I was trained to perform a SMAS (Superficial Muscular Aponeurotic System) facelift and I performed them for my first 10 years in practice. The problem I had with this type of facelift was that it was not very good for significant age-related neck changes and significant jowls. All of the patients looked great afterwards, but when you followed the patients with the heavy necks and jowls out long enough, for a percentage of them, the results did not last long. Therefore, I started performing deep plane facelifts and necklifts. The deep plane facelift / necklift is a more powerful procedure and in my opinion provides a much more natural result that is much longer lasting. I perform one or more deep plane facelifts per week.

A deep plane facelift and necklift addresses the lower half of the face and the upper part of the neck. A deep plane facelift will improve the lower part of the smile lines (the lines that start from the side of the nose and extend down toward the corner of the mouth), the marionette lines (the lines extending downward from the corner of the mouth), the jowls, and the jawline. When I use the term facelift, it always includes a necklift. Therefore, when a deep plane facelift is performed, the upper part of the neck is addressed as well. The excess skin under the chin, the vertical bands in the skin that extend down from below the chin, and the excess fat under the chin (if it is present) are improved during a deep plane facelift.

A deep plane facelift does not include a browlift or forehead lift. If a forehead lift is indicated, it can be incorporated into the deep plane facelift. This is what people would call a “full facelift” since the upper and lower parts of the face are rejuvenated, as well as the upper part of the neck. Also, a deep plane facelift does not include upper eyelid surgery or lower eyelid surgery. Those surgeries are separate procedures and are called an upper blepharoplasty and lower blepharoplasty, respectively.

A deep plane facelift can be performed either in the office under local anesthetic or it can be performed at the hospital under general anesthesia. If it is performed in the office, there are no IV medications and there are no pills like valium or Xanax to sedate you. You are awake for the procedure, and approximately 85% of my patients choose to have their deep plane facelift and necklift done in the office with local anesthetic. The majority of patients have already had Botox or fillers injected into their face, so they are comfortable with needles administering local anesthetic. If the patient is very nervous and just the thought of having surgery makes them uneasy, then the patient will have their surgery as an outpatient in the hospital under general anesthesia. In either case, the same amount of local anesthetic is used and the end results are the same. In both situations, the patient always goes home after the procedure. No hospital stays are necessary.

After the procedure you will have a large dressing around your head and neck and there will be drains that you can see. No one likes to see drains, but they serve a very important purpose. The better we remove the small amount of blood that accumulates under the skin, the less bruising you will have and the faster your recovery will be. Everything we do during and after the surgery is to make your recovery period as short as possible. You do not have to empty the drains or touch the drains.


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Perioperative Visits for a Deep Plane Facelift

A preoperative clearance is necessary for the deep plane facelift regardless if it is performed in the office or at the hospital. The preoperative clearance should be scheduled with your primary care physician at approximately one month prior to your surgical date. The preoperative clearance will include an EKG and lab tests (CBC, Chemistry, and PT/PTT). I will see you 2 weeks prior to your surgical date to review your preoperative clearance, to have you sign all of the surgical consents, and to take your preoperative photographs. I will also give you your prescriptions, your instructions, and a kit with most of the supplies you will need postoperatively.

I will obviously see you the day of surgery. You will then return to the office on the first postoperative day, at which time we will change the dressings and empty the drains. On the second day after surgery you will return to the office and the dressings will be changed and the drains will be removed. On the third day after the surgery, you will remove the dressings yourself at home and you can shower. Seven days after the deep plane facelift some of the sutures are removed and on the tenth day, all of the sutures are removed. There will be a one month follow up and the last visit will be approximately 6 months after the procedure.

Diet, Driving, and Activities Following a Deep Plane Facelift

For the first week after the surgery you will be sleeping with your head elevated above the level of your heart, and you will limit your bending, lifting, and straining. Walking is encouraged starting immediately after the surgery. You will not be lying in bed after a deep plane facelift and necklift. The final result of the surgery depends on both what I do during the surgery and how you take care of yourself after the surgery. Studies have shown that it takes approximately one month for your facelift and necklift to heal in its new position to resist the forces of you opening your mouth and turning your head. Therefore, postoperatively you can eat anything you want as long as it is chopped up into little pieces. I do not want you opening your mouth wide. When you drive, you turn your head back and forth, which pulls on the supporting sutures and loosens the lift. Therefore, I do not want you to drive for 7 to 10 days following the surgery. Activities like swimming, golf, tennis, yoga, or pilates should be avoided for the first month after surgery. After one month, you can resume all of your normal activities.

Hair and Showering After a Deep Plane Facelift

The incisions of a deep plane facelift are strategically placed so that the surgery will not change or disrupt your hairline. Once you are healed you will be able to have short hair, long hair, and wear your hair up without difficulty. During the surgery, none of your hair will be cut. If you color your hair, you should color it one week before the surgery because I will not allow you to color your hair until one month after the surgery. On the third day after the surgery, the day the last dressings are removed, you can shower and wash your hair.