Full deep plane facelift surgery is an elective procedure for people with combined midface, lower facial and neck ageing. It works by releasing and repositioning deeper soft tissue rather than relying on skin removal alone. The operation may be considered when the lower eyelid-cheek transition, cheeks, jowls, jawline or neck have changed enough that a skin-only approach is unlikely to address the underlying descent. The aim is to restore facial contour while retaining each person’s individual features.
The term deep plane does not describe one identical operation in every practice. The planes, ligaments and tissues released vary according to facial anatomy and the goals agreed during assessment. A surgeon should explain which areas will be treated, why each plane is being entered and which adjacent structures are at risk. Medical history, medicines, smoking status, previous facial procedures and recovery capacity can affect whether surgery is appropriate.
Surgery cannot remove every age-related change or stop the ageing process. Bruising, swelling, discomfort, scars and temporary changes in facial sensation or expression may occur, while revision is sometimes required. For patients considering the procedure in South Africa, the consultation should establish realistic goals, explain alternatives and provide clear recovery instructions. Follow-up care is important so that healing can be monitored and concerns addressed promptly.
What a full deep plane facelift involves
A deep plane facelift focuses on lifting and repositioning the deeper facial structures rather than simply tightening the skin. This technique improves midface drooping, jowls, and laxity around the lower face and neck, allowing for a more youthful and refreshed contour.
During a deep plane facelift, selected deeper tissues are released from their retaining attachments and repositioned to address descent. The dissection may involve the midface, superficial musculoaponeurotic system and neck tissues. The extent depends on the areas being treated, and a planned neck lift is not automatically part of every facelift.
Why tissue release matters
- It can address movement affecting the cheek, lower eyelid-cheek transition and jowl regions.
- It allows deeper tissue to be repositioned instead of placing all tension on the skin envelope.
- It may be combined with a separately planned neck procedure when skin laxity or platysmal bands are present.
Enhances the cheeks, jawline, and lower face simultaneously Reducing tension on the skin is one objective of the technique, although wound healing and scar quality still vary between individuals. The operation does not correct every age-related feature or create a facial appearance that was not present earlier in life.
Facial areas commonly addressed
The full deep plane facelift addresses structural sagging in multiple facial regions. By releasing and repositioning deeper tissues, it targets:
Drooping cheeks Deep nasolabial folds Jowls and jawline definition Neck laxity and bands These changes often develop together, but their severity differs between people. A complete facial examination is therefore more useful than choosing a technique solely from photographs. The treatment plan may include a facelift alone or separate procedures for the eyelids, skin, neck or other areas.
Who may be a suitable candidate
There is no single correct age for facelift surgery. A person may be considered when there is clinically evident midface or lower facial descent, loss of jawline definition and neck laxity that cannot be addressed adequately with non-surgical treatment. Skin quality, facial bone structure, overall health and the amount of tissue to be repositioned all influence the likely result.
Surgery may be deferred if there is an active infection, an uncontrolled medical condition, an inadequate understanding of the process or expectations that the operation cannot meet. Smoking can impair wound healing and increase complications, while some medications may need to be adjusted under medical guidance. These issues should be discussed before a theatre date is confirmed.
What happens during the consultation
A surgical consultation should include a medical and medication history, smoking status, previous operations and a full facial examination. Photographs may be taken in a standardised position to assess the cheek, jawline and neck from several angles. The surgeon should also examine skin thickness, facial movement, dental factors and any features that may alter the technique.
The discussion should cover the intended result, alternative treatments, incision placement, anaesthetic, recovery, risks and possible revision. It is also reasonable to ask whether the surgeon is registered with the relevant professional body. Registration can be checked independently through the Health Professions Council of South Africa. A second opinion is helpful when the proposed plan is extensive or important concerns remain unanswered.
How the procedure is performed
A full deep plane facelift is performed under an anaesthetic and normally requires a hospital setting. Incisions are commonly placed around the temple or hairline, in front of and around the ear, and into the hair-bearing scalp behind the ear. The exact route depends on the facial areas being treated and whether the neck is included.
- Tissue elevation: The skin is elevated carefully so that the deeper layers can be assessed without placing unnecessary tension on the skin.
- Deep release and repositioning: Selected ligaments and tissue attachments are released according to the facial anatomy and operative plan.
- Optional neck treatment: Loose neck skin, platysmal bands or other structures may be addressed if included in the consent and surgical plan.
- Closure and recovery care: The tissues are repositioned, the wounds are closed and postoperative instructions are provided. Drains are not used in every operation.
Not all surgeons describe or perform a “full deep plane facelift” in the same way. The consent process should identify the intended planes and anatomical areas rather than relying on the procedure name alone. The final operation remains individual and should be based on the examination and agreed objectives.
Setting realistic goals
A facelift may improve contours affected by descent, but it does not stop biological ageing or automatically change the nose, eyes, lips or jaw bones. Good communication about the degree of change you are seeking helps prevent misunderstanding. Your surgeon should explain what the procedure can address, what will remain unchanged and why a different or combined procedure may be more appropriate.
Before-operative photographs also provide a reference for comparing healing and contour later. Avoid relying on edited images or guarantees based on a particular age. Outcomes vary with anatomy, skin quality, smoking, healing, associated procedures and the degree of existing ageing.
Recovery and return to daily activity
Recovery from a full deep plane facelift is typically more comfortable than many expect due to reduced tension on the skin.
Comfort still varies according to the extent of surgery, associated procedures and individual healing. Pain medication, wound care, activity instructions and the timing of follow-up appointments should be provided before discharge. Contact details for the surgical team are also important in case unexpected symptoms occur after leaving hospital.
Early recovery milestones
Swelling and bruising gradually decrease over 1–2 weeks Most patients return to normal activities within 14–21 days These preserved milestones are guides rather than guarantees. Swelling can fluctuate, and the visible result may continue changing for several months as soft tissues settle. Work plans should reflect the nature of the job, exposure to the public and the rate of individual recovery. Wearing compression garments or undertaking strenuous exercise only when specifically advised can help protect the healing tissues.
Risks and possible complications
Every operation carries risks. Possible complications include bleeding, haematoma, fluid collection, infection, delayed wound healing, scar formation, asymmetry, contour irregularity, fat injury, hair loss near incisions and dissatisfaction with the result. Anaesthesia also carries risks, and smoking or poorly controlled medical conditions can increase the likelihood of complications.
- Deep facial dissection can affect sensory nerve branches, causing temporary or, less commonly, persistent altered sensation.
- Motor nerve injury may cause temporary weakness or changes in facial movement, and some deficits may not fully resolve.
- Problems with wound healing or blood supply can lead to scarring, skin breakdown or a need for further treatment.
- Some changes remain subtle, while others may require revision once healing and tissue settling are complete.
Urgent medical assessment is appropriate for uncontrolled bleeding, rapidly increasing one-sided swelling, severe worsening pain, fever, difficulty breathing or other acute symptoms. Knowing the postoperative contact pathway before surgery helps ensure that concerns are reported early.
Frequently asked questions
How long do deep plane facelift results last?
Results often last 10–15 years due to the restructuring of deeper facial layers.
This is an average range rather than a guarantee. Ageing, genetics, skin quality, smoking, sun exposure and facial anatomy influence how long any result remains apparent.
Is deep plane facelift surgery painful?
Pain and discomfort differ between people and depend on the extent of surgery and associated procedures. Analgesia, wound care and activity guidance form part of postoperative care. Bruising and swelling may be more noticeable during the first two weeks than discomfort itself.
How soon can I return to work?
Many patients resume light daily activities within two weeks, depending on healing and individual comfort.
A role involving physical strain, heat exposure, prolonged periods in a mask or frequent public contact may need additional time. Your surgeon should individualise the return-to-work plan rather than relying on a fixed date.
Can a facelift be combined with other procedures?
Yes. Complementary treatments such as eyelid surgery or fat grafting may be recommended for enhanced facial harmony.
Combination surgery may improve coordination between facial regions, but it also extends the operation and recovery. Each procedure should have a clear anatomical purpose and be based on the examination rather than added automatically.
Will a deep plane facelift leave visible scars?
Scarring varies according to incision placement, skin biology, healing and aftercare. Incisions are often placed where they may be concealed by hair or natural facial contours, although scars can remain visible. Sun protection and following wound-care instructions are important during healing.
Discuss whether a facelift is appropriate
A photo review can provide a starting point, but it cannot replace an examination or establish whether surgery is appropriate. Dr Deon’s team can assess the information available, identify questions that require an in-person consultation and explain the likely next steps.
If you are considering a full deep plane facelift, submit your photographs and consultation details through the Online Consultation & Photo Review form. You can also call 011 875 1694 to arrange a consultation.
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Medical disclaimer: This article provides general educational information about full deep plane facelift surgery and is not a diagnosis, treatment plan or guarantee of outcome. Individual risks, alternatives and expected recovery depend on a clinical examination, medical history and the procedures performed. Discuss your suitability and any concerns with a suitably qualified healthcare professional.
