Advanced Facial Rejuvenation Surgery
The deep plane subperiosteal facelift is an advanced facial rejuvenation technique that represents the pinnacle of modern facelift surgery. This comprehensive procedure combines two powerful surgical approaches to address ageing changes throughout the entire face, from the forehead to the neck, delivering natural and long-lasting results.
Facelifting remains the most beneficial treatment for patients over 40 years of age who wish to address changes associated with facial ageing. According to systematic reviews published in Aesthetic Plastic Surgery, deep plane facelift techniques achieve patient satisfaction rates of 94.4%, compared to 87.8% for traditional SMAS approaches. The deep plane subperiosteal facelift builds upon these excellent results by adding the benefits of subperiosteal techniques derived from craniofacial surgery.
What is the Deep Plane Subperiosteal Facelift Procedure?
The deep plane subperiosteal facelift is a signature technique that combines two established surgical approaches to achieve comprehensive facial rejuvenation. Unlike traditional facelifts that work primarily on the skin or the superficial musculoaponeurotic system (SMAS), this advanced procedure addresses the deeper structures of the face.
The deep plane component involves dissection beneath the SMAS layer with release of the ligamentous attachments that tether the face. This allows the facial tissues to be repositioned as a single unit, creating more natural movement and longer-lasting results. Research indicates that deep plane facelift results typically last 12 to 15 years, whilst traditional SMAS techniques last 10 to 12 years on average.
The subperiosteal component, derived from craniofacial surgery techniques, addresses the forehead and midface at the deepest level, directly on the bone. The forehead is treated through either an endoscopic or open approach, whilst the midface is repositioned through an incision inside the mouth. By operating below the layer of the facial nerve, there is a reduced risk of nerve damage.
The procedure uses a proprietary tumescent solution that allows for safe dissection of facial tissues in the correct plane. This solution minimises bleeding during and after surgery and reduces the risk of postoperative haematoma formation. The combination restores the face to its youthful position whilst maintaining harmony and balance of the facial structures.
Not every patient requires the full technique. The approach is modified depending on individual requirements for facial rejuvenation, making it a highly personalised treatment.
When would you recommend Deep Plane Subperiosteal Facelift?
The deep plane subperiosteal facelift is indicated for patients experiencing moderate to significant signs of facial aging who desire comprehensive rejuvenation. The procedure addresses multiple areas including the forehead, midface, lower face and neck in a single operation.
Key indications include sagging skin and soft tissue descent in the cheeks and jowl area, deep nasolabial folds running from the nose to the corners of the mouth, loss of definition along the jawline, excess skin and fat in the neck area, and descent of the forehead and brow causing a tired appearance. The procedure is particularly beneficial for patients whose ageing changes involve multiple facial zones.
Studies involving over 10,000 patients show that deep plane techniques provide superior midface rejuvenation compared to more superficial approaches. This makes the deep plane subperiosteal facelift especially suitable for patients with significant midface descent and deep folds who want natural-looking, long-lasting results.
Who is a Suitable Candidate for Deep Plane Subperiosteal Facelift?
The ideal candidate for a deep plane subperiosteal facelift is typically aged 40 years or older with visible signs of facial ageing that cannot be adequately addressed through non-surgical treatments. However, the right timing varies significantly among individuals, with some patients in their late 40s to early 50s achieving more subtle, natural results because they require less extensive correction.
Good candidates should be in generally good health and fit for general anaesthesia. Non-smokers are strongly preferred, as smoking significantly increases the risk of complications including skin necrosis and poor wound healing. If you smoke, you will be required to stop for several weeks before and after surgery.
You should have realistic expectations about what the surgery can achieve. Whilst the procedure can dramatically improve facial ageing, it cannot stop the ageing process entirely or create perfection. Candidates should understand that some scarring is inevitable, although incisions are placed in concealed locations.
The procedure may not be suitable for patients with certain medical conditions, those taking blood-thinning medications that cannot be stopped, or those with unrealistic expectations. A thorough consultation will determine whether this advanced technique is appropriate for your specific needs.
What Happens During the Deep Plane Subperiosteal Facelift Consultation?
The consultation is an essential first step in your facelift journey. Mr Ivo Gwanmesia will assess whether you are a suitable candidate and develop a personalised treatment plan based on your unique facial anatomy and goals.
Mr Gwanmesia will take a detailed medical history and perform a thorough physical examination, evaluating your skin quality, the depth of facial folds and the degree of ageing in different zones. Old photographs may help facilitate discussion about realistic outcomes.
This is your opportunity to ask questions about the procedure, expected outcomes, risks and recovery. Understanding all aspects helps you make an informed decision and set realistic expectations.
Preparation for Deep Plane Subperiosteal Facelift Surgery
Proper preparation is crucial for optimal results and safe recovery. You must stop smoking at least four weeks before surgery and throughout recovery, as smoking severely impairs blood flow and healing. Stop aspirin, ibuprofen, vitamin E and other blood-thinning substances two weeks before surgery.
Arrange for someone to drive you home and stay with you for the first few nights. Prepare your home with a comfortable recovery area. Complete blood tests and medical clearance as directed, have prescriptions filled in advance, and fast from midnight before surgery.
Deep Plane Subperiosteal Facelift Recovery
Recovery requires patience and careful adherence to your surgeon’s instructions. The subperiosteal approach is associated with more swelling than superficial techniques, but this subsides progressively over several weeks.
Immediately after surgery, your face will be dressed with bandages and compression garments. You may stay overnight for monitoring. Drains are typically removed within the first few days. During the first two weeks, expect significant swelling and bruising. Keep your head elevated and avoid bending or straining.
At four to six weeks, most swelling has subsided and you can resume normal activities. Avoid strenuous exercise for six weeks. Numbness around incision sites typically resolves over several months. Full recovery takes several months, with final results becoming apparent as tissues settle. Many patients enjoy visible benefits for a decade or longer.
Risks of Deep Plane Subperiosteal Facelift
As with any surgical procedure, the deep plane subperiosteal facelift carries certain risks. Understanding these risks helps you make an informed decision. The most common complication following facelift surgery is haematoma, occurring in approximately 1 to 3% of patients. This may require surgical drainage if significant.
Nerve injury is a rare but serious concern. The facial nerve controls the muscles of expression, and damage can cause temporary or permanent weakness. Most nerve injuries are temporary and resolve within weeks to months. Permanent nerve injury is very rare, occurring in less than 1% of cases. The subperiosteal approach may offer some protection as it operates below the facial nerve layer.
Infection is uncommon, occurring in approximately 0.2 to 0.9% of cases. Skin necrosis, where areas of skin die due to poor blood supply, is more common in smokers. Scarring is inevitable but incisions are placed in concealed locations and typically fade over time. Asymmetry, changes in skin sensation, and dissatisfaction with results can also occur.
Serious complications such as deep vein thrombosis, pulmonary embolism and major anaesthetic complications are rare, reported at approximately 0.1% in large surveys. Choosing an experienced surgeon like Mr Ivo Gwanmesia significantly reduces all risks.
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Deep Plane Subperiosteal Facelift FAQ
The price for deep plane subperiosteal facelift is £16,500.
The deep plane subperiosteal facelift typically takes four to six hours, depending on the extent of the procedure and whether additional treatments such as necklift or brow lift are performed simultaneously.
Traditional facelifts primarily tighten the skin or the SMAS layer. The deep plane subperiosteal facelift works at a deeper level, repositioning the facial structures as a unit and addressing the forehead, midface and lower face comprehensively.
Results typically last 12 to 15 years, which is longer than traditional SMAS techniques. You continue to age from a younger baseline, and many patients enjoy visible benefits for a decade or longer with proper skin care.
Most patients return to desk-based work after two to three weeks. However, visible bruising and swelling may persist, so some patients prefer to wait longer before social engagements.
Incisions are placed in concealed locations such as within the hairline, around the ears and inside the mouth. Scars fade significantly over time and are typically well hidden.
The surgery is performed under general anaesthesia, so you feel no pain during the procedure. Postoperative discomfort is usually mild to moderate and well controlled with prescribed pain medication.
Common complementary procedures include necklift, brow lift, lip lift, eyelid surgery (blepharoplasty) and fat transfer for volume restoration. Your surgeon will recommend combinations based on your individual needs.
Suitable candidates are typically aged 40 and above, though this varies based on individual ageing. Patients in their 60s and 70s often achieve excellent results. Your surgeon will assess your candidacy based on your health and goals rather than age alone.
The deep plane subperiosteal technique is specifically designed to create natural results by repositioning tissues rather than simply pulling skin tight. Patient satisfaction rates of over 94% reflect the natural appearance achieved.
Choose a board-certified plastic surgeon with specific training and experience in deep plane techniques. Review before-and-after photographs, read patient reviews and ensure you feel comfortable during your consultation.
The deep plane subperiosteal facelift represents the most comprehensive approach to facial rejuvenation currently available. By combining deep plane and subperiosteal techniques, this advanced procedure addresses all areas of the aging face in a single operation, delivering natural, harmonious and long-lasting results for patients seeking to restore a more youthful appearance.
