Who Is a Good Candidate for Deep Plane Facelift?

What Is Deep Plane Facelift — A Brief Overview

Deep plane facelift is a technique that operates beneath the superficial musculo-aponeurotic system (SMAS), directly releasing the retaining ligaments of the face and repositioning tissues closer to their original anatomic location. Compared to standard SMAS techniques, this deeper dissection allows for more durable, natural-looking results — particularly in the midface and jowl regions. A detailed comparison between techniques is covered in a separate article.

Who Can Be a Candidate?

### Age Range

There is no rigid age cutoff for deep plane facelift. What matters is the biological aging of the face, not chronological age alone. That said, the most commonly evaluated group is patients in their **mid-40s to early 70s**.

• From the mid-40s onward, midface volume and support loss often become noticeable — this is the primary target for this technique.
• In the 50s and 60s, jowl formation and disruption of the neck-jawline contour become more prominent; deep plane offers more comprehensive correction than superficial approaches in these cases.
• For patients over 70, the assessment is highly individualized, weighing overall health, skin quality, and realistic expectations.

### Facial Anatomy and Sagging Type

**Midface descent:** Cheeks that have migrated downward, deepening the nasolabial folds and creating a fatigued or drawn facial expression.

**Pronounced jowling:** Tissue accumulation along the jawline that disrupts lower face contour. Deep plane directly addresses the retaining ligaments that contribute to jowl formation.

**Loss of neck-chin angle:** Platysmal banding or blurring of the neck-lower face junction. A neck component (platysmaplasty) can be incorporated when needed.

**Relatively preserved skin elasticity:** The skin must be of sufficient quality to tolerate the mechanical forces of the lift.

**Prior facelift with unsatisfactory results:** In revision settings, deep plane dissection can work beneath scar tissue and address limitations of previous procedures.

### General Health Requirements

Candidates must be able to safely undergo general anesthesia or deep sedation: controlled cardiovascular status, normal coagulation values, smoking cessation (active smoking impairs healing), and careful evaluation of diabetes and connective tissue disorders.

Who Is Not a Suitable Candidate?

• **Uncontrolled systemic disease:** Increases surgical risk significantly.
• **Active smoking:** Markedly raises the risk of skin necrosis and poor healing.
• **Unrealistic expectations:** A facelift does not stop aging; it slows its visible progression.
• **Premature consultation — insufficient sagging:** Less invasive options are considered first.
• **Poor skin quality:** Skin treatment may need to precede surgery.

Why Personalized Planning Matters

Facial anatomy varies substantially between individuals: bone structure, fat compartment distribution, skin thickness, and elasticity all directly influence outcomes. A one-technique-fits-all approach is inadequate. Identifying the right candidate and building a realistic expectations map requires a thorough in-person examination with a surgeon experienced in facial plastic surgery.

Conclusion

In the appropriate candidate, deep plane facelift achieves anatomical repositioning of the midface and jowl — restoring a rested, refreshed appearance without a pulled or artificial look. To arrange a consultation in Istanbul with Op. Dr. Hüseyin Arslan, please get in touch. Remote preliminary assessments are available for international patients.