Deep Plane Face Lift with Tumescence | London, UK | Mr. Ivo Gwanmesia Skip to main content

One of two standard techniques is commonly used to perform a facelift and necklift procedure. The first one is referred to as the skin/SMAS two-layer technique. The SMAS, otherwise known as the superficial muscular aponeurotic system, is the stronger, deeper layer of tissue between the muscle and fat. This is the type of facelift performed by most surgeons.

The other technique is the skin/SMAS composite flap. This procedure repositions every part of the face that displays signs of aging. It provides the unique benefit of giving the patient a superior range of movement in the cheek and malar tissues, which creates a more natural result and prevents the facial stiffness that has been associated with previous facial plastic surgery techniques. Using this method, Mr Gwanmesia manipulates the skin within this area to achieve a multidimensional result that tightens and lifts the face.

Using elements of the composite flap technique with tumescence, Mr Gwanmesia has developed a new method of performing facelift and neck lift surgery, known as the DPT facelift and necklift, that has shown exceptional results.

The Deep Plane Tumescence Facelift

Mr Gwanmesia’s deep plane facelift and necklift technique involves a standard retrotragal facelift incision, which is partially hidden inside the ear canal, and this incision extends into the posterior hairline. Once the incision has been made and the skin has been elevated, the incision is then deepened through the connective tissues that encase the muscles of the face.

Prior to this incision, the SMAS layer is injected with special tumescent solution that includes steroids, local anesthetic, hyalase and saline in order to reduce swelling. This also allows for a more thorough visualization of the skin layers and facilitates the elevation of the SMAS layer in a bloodless field. Additionally, this technique minimizes the risk of injuring branches of the facial nerve, particularly as the dissection is performed deeper within the facial tissue.

The dissection is carried anteriorly as far as the nasolabial folds (the creases between the nostrils and the outer corners of the mouth), which allows for the release of all neighboring ligaments, thereby enabling complete elevation and repositioning of the cheek skin to correct signs of aging.

At the level of the neck, the dissection is performed on either side of the neck beneath a thin layer of muscle, which allows for recontouring of the neck area. When the soft tissues are being redraped, any excess SMAS is excised and can be used as a graft if required. The cut edges of the SMAS are sutured using a non-absorbable material, which allows for a smooth transition between the SMAS edges.


Here are a few advantages of this innovative technique:

  • A more youthful appearance through total elevation and repositioning of the cheek’s soft tissues
  • Less bruising due to the procedure being performed at a deeper level
  • Reduced risk of skin necrosis
  • Greater improvement in patients with deep nasolabial folds
  • Shorter recovery time
  • Excellent procedure results to date

Case Study

Demonstrated below is a 55-year-old woman who requested to undergo facial rejuvenation. She received our deep plane facelift with tumescence procedure. After three months, she returned to our office with significant improvement to her appearance with zero complications. She noted that she had not experienced any bruising throughout her recovery.

These photos show the patient prior to the surgery (left) and after three months of recovery (right).

If you are interested in learning more about this innovative facelift technique, feel free to contact our office at 020-7474-1300. 

You can get to our London office through the Oxford Circus and Bond Street Underground in Marylebone. We are located on the 10 Harley Street next to the Cavendish Square Gardens.

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Dr Ivo Gwanmesia

Dr Ivo Gwanmesia is one of Harley Street’s most experienced and renowned craniofacial plastic surgeons. With over a decade of professional experience, he has transformed the lives of countless patients from all over the UK & abroad.

Due to his vast and hands-on training in the UK and the US, Dr Ivo now specialises in more than a dozen different aesthetic, craniofacial and transgender procedures. Some of them include face, neck, and brow lifts, upper and lower blepharoplasty, breast reduction & breast uplift as well as facial feminisation surgery, to name a few.

Dr Gwanmesia has also conducted pioneering research, which led to the development of a new technique for the reconstruction of the middle vault of the nose, known as the ‘Fulcrum Spreader Graft’. He was also part of a study comparing the efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft. The study has since been published on PubMed and the Journal of the American Society of Plastic Surgeons.