Deep Plane Facelift

While every patient’s pain tolerance is unique, most report that discomfort following a deep plane facelift is moderate and well-controlled with prescribed pain medication. Because the technique involves repositioning deeper facial tissues, initial soreness, tightness, and swelling can be more pronounced than with superficial facelifts, but these symptoms typically improve rapidly within the first week. 

Many patients find that pain is manageable and less severe than they anticipated, especially when following post-operative care guidelines closely. Over-the-counter medications can often be resumed once prescription pain relief is tapered off. Ultimately, most patients describe the recovery phase as tolerable and feel the long-term rejuvenation results are well worth the temporary discomfort.

Generally, with a deep plane facelift, you can expect to have at a minimum, four core appointments: your initial consultation, a pre-operative visit, the surgery, and one or more follow-up appointments. Your pre-operative visit is essential for going over your surgical plan once more, ensuring you’re medically cleared to proceed, taking before photos, and answering any last-minute questions. After your surgery, follow-up appointments ensure that you are healing safely and that your results are progressing as expected.

Throughout recovery, you can expect different results at different stages. The final results will become apparent at the 12-month mark, indicating that swelling, bruising, and tightness have completely subsided, and you can enjoy the full benefits of the surgery. However, you don’t have to wait until then to start enjoying some of your results. After about a month, you’ll appear “socially acceptable” to participate in outside activities, and gradually, as swelling subsides, you’ll continue to see improvements.

Since the deep plane facelift targets deeper layers of tissue for more natural and longer-lasting rejuvenation, it pairs well with surgeries that enhance other areas of the face. Common combinations include eyelid surgery (blepharoplasty) to address sagging lids or under-eye bags, a brow lift to elevate drooping brows, and fat grafting to restore youthful volume. Non-surgical options, such as laser resurfacing or dermal fillers, may also be recommended to refine skin texture and tone. We will help you determine which treatments best complement your goals, ensuring safety and a smooth recovery timeline.

At the Bitar Cosmetic Surgery Institute, we prioritize patient safety and satisfaction above all else. With every facelift, including the deep plane facelift, we follow strict protocols to minimize complications, from thorough pre-operative preparation to using state-of-the-art surgical centers with board-certified anesthesiologists.

Dr. Bitar is an expert in safety when it comes to outpatient cosmetic surgery procedures. He is the lead author of a study on 4,774 patients who underwent cosmetic surgery safely, along with guidelines to ensure continued safety.

Our surgery center is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), which ensures the highest levels of safety and first-rate medical care.

Board-certified anesthesiologists administer our anesthesia to ensure the highest standards of anesthesia care.

General complications can occur with any surgery. Cosmetic surgery is typically a safe procedure performed on healthy patients and, like all surgeries, carries a low risk. To further reduce the risk of complications, we operate at a first-class surgery center with board-certified anesthesiologists and nurses. To avoid postoperative complications, we advocate for early mobilization – patients seen in our office one or two days after surgery- and active participation in their own postoperative care. When we create a partnership, the results invariably improve.

• Bleeding
  Bleeding after a facelift occurs in approximately 1-2% of patients. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians and by lab tests. The use of a tumescent solution is performed during a facelift to minimize bleeding and reduce postoperative swelling. Furthermore, the use of drains also helps manage any post-operative bleeding. In our practice, the rate of significant bleeding is about 1-2%. The treatment of a hematoma or blood clot under the facial skin involves opening the incision and removing the blood clot. Typically, this is a straightforward procedure.

• Infection
  The most important step in avoiding infections is to undergo surgery at a first-rate surgical facility with board-certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotic coverage throughout the surgery. During the surgery, the patient’s skin surface is cleaned thoroughly. After the procedure, our patients are prescribed antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a facelift is extremely rare.

• Open Wounds
  In a facelift, a relatively large amount of skin is manipulated, and the skin is closed under mild tension. Because the incisions are under tension, there can be either loss of some skin or a small opening of the wound around the hairline or near the ears. To minimize this potential complication, we urge our patients to stop smoking two weeks before and two weeks after surgery, to improve the result of their facelift. Open wounds, if they occur, are treated with dressing changes and wound cleaning in the office as needed. This occurs in approximately 1% of patients. Usually, the wounds heal very well, and nothing further needs to be done with nicely hidden scars. Very rarely, we may need to perform a scar revision to improve the appearance of the scar.

• Nerve Injury
  The rate of significant facial injury is about 1-2%. In our facelift technique, we perform the dissection away from the major nerves to minimize the risk of injury. The result is a minimal rate of nerve injury. Sometimes, temporary loss of sensation or function from a “stunned” nerve or a bruised nerve may occur in the time period after surgery. This may result in a temporarily uneven smile, but full nerve function usually returns within a few days to a few weeks.

• Smoking
  Smoking is an absolute contraindication for a facelift. The carbon monoxide and nicotine in cigarette smoke cause a severe reduction in blood supply to the skin during healing. This results in delayed wound healing, wound separation, skin death, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.