Deep Plane Technique

What is a Deep Plane Facelift?

The Deep Plane Facelift involves lifting not just the skin, but also the SMAS (Superficial Musculo-Aponeurotic System) layer, which is the deeper tissue structure beneath the skin. By repositioning this layer along with the skin, the surgeon can achieve more dramatic and long-lasting results, particularly around the lower face, jawline, and neck area.

- Focus on Deeper Layers of the Face While traditional facelifts may only lift the skin, the deep plane technique lifts both the skin and the underlying SMAS layer. This deeper lift addresses the sagging of facial fat pads and muscles, rather than just pulling on the skin.By releasing the SMAS and repositioning it along with the skin, a more dramatic and long-lasting result is achieved, which looks more natural because it preserves the natural contours of the face.

-Reduces the Risk of "Pulled" or "Tight" Look : The key benefit of the deep plane technique is that it allows for a more natural result because it doesnt just stretch the skin. The result is a smoother, more harmonious rejuvenation that restores youthful facial contours without the overdone or pulled appearance that can sometimes occur with more superficial facelift techniques. The repositioning of the deeper tissues also provides a more subtle lift of the jowls and neck, helping to restore definition to the jawline and improve neck contours.

-Improved Jawline and Neck Contour : The deep plane facelift offers a more effective lift for the lower face and neck area than traditional methods. It can smooth out deep nasolabial folds, tighten the skin under the chin, and define the jawline by repositioning the deeper tissues, rather than just trimming excess skin. The technique can also improve the overall appearance of the neck, lifting sagging skin and addressing neck bands or fat that contribute to a "turkey neck" appearance.


-Longer-Lasting Results : Because the underlying tissues are repositioned and secured, the results of a deep plane facelift are typically longer-lasting than those of a traditional facelift. The effects can last anywhere from 10 to 15 years, making it a good option for patients looking for more permanent rejuvenation.
The deep plane facelift also typically requires fewer revisions than other methods, due to the more thorough lift.

Surgical Technique: Incisions

- Incisions: The incisions for a deep plane facelift are similar to those of a traditional facelift, often starting in the hairline near the temples, extending around the ears, and ending in the lower scalp. However, the technique involves deeper dissection of the facial tissue beneath the skin.

-Release of the SMAS Layer: The surgeon will carefully lift and release the SMAS layer from the deeper muscles and tissue. This is done in a precise manner to ensure that the lift is both effective and natural-looking.


- Repositioning the Tissues: After releasing the deeper layers, the surgeon repositions them in a more youthful position and tightens the skin. The goal is to restore volume and smoothness in the lower face, chin, and neck.

- Closing the Incisions: The incisions are closed with sutures, which are usually placed in a way that hides the scars within the natural creases around the ears and hairline. The scars from a deep plane facelift tend to heal well over time, becoming less visible.


Benefits of a Deep Plane Facelift
- More Natural Results : Since the procedure addresses both the skin and deeper facial structures, the results are more subtle and natural-looking compared to more superficial techniques.

- Longer-Lasting Effects: By lifting and repositioning the deeper tissues, the results typically last longer, often for up to 1015 years, with minimal risk of the face falling prematurely.

- Improved Definition: The procedure provides significant improvement to the jawline, neck, and mid-face, restoring youthful contours and creating a smoother, more balanced appearance.

- Comprehensive Facial Rejuvenation : The deep plane facelift targets a broader area of the face compared to a traditional facelift, including the mid-face and neck, offering overall rejuvenation that addresses more than just skin sagging.

- Less Tension on the Skin: Since the underlying tissues are lifted first, there is less tension on the skin. This leads to a more natural result and reduces the risk of scarring or a "stretched" appearance.


Recovery And After Care
Recovery from a deep plane facelift typically takes a bit longer than a traditional facelift due to the more extensive nature of the procedure. Most patients can expect some swelling and bruising for 2-3 weeks, and while the majority of swelling will subside in the first month, full recovery may take up to 3 months to see the final results.

A compression garment may be worn around the neck and face to help reduce swelling.The surgeon will provide detailed instructions on how to care for your incisions, manage any discomfort, and what to do during the healing process.

Most patients can resume light activities after 2-3 weeks, though strenuous exercise and activities should be avoided for at least 6 weeks.

Breast lift INFO

Recovery And After Care

Recovery from a breast lift is a gradual process, with most patients resuming normal activities within 6-8 weeks. Full recovery can take up to a year, especially for scars to fully mature. Be patient with your healing process and stay in close communication with your surgeon if you have any concerns.

- After Surgery you will be fitted with a surgical bra or bandages to help support your breasts and reduce swelling and you may feel groggy or nauseous as the anesthesia wears off, This is normal. You could have soreness, swelling, or tightness in your chest area. Your surgeon will prescribe pain medications or recommend over-the-counter pain relievers.

-In the First Week Rest is essential, You should plan for a few days to rest and avoid heavy lifting, straining, or raising your arms above shoulder height.

Its also important to avoid any activities that could put strain on your chest muscles. Swelling and bruising are common and can last for several weeks. Cold compresses can help alleviate swelling and discomfort.
- Weeks 2-4 you could do light activities like walking or gentle stretching. However, continue avoiding strenuous exercise or activities that could put pressure on your chest. You will need to wear a compression bra or surgical garment for a few weeks to help support your breasts and reduce swelling.

  • After 1- 2 Months You able to return to more normal activities, including light exercise,  you can do high-impact or strenuous activities after at least 1 year, depends on personal recovery conditions.
    - After 6 momths By this time, most of the swelling should be gone, and your breasts will settle into their permanent shape and size. Scarring will also start to fade, although it can take up to a year for scars to fully mature and become less noticeable. The incision scars are permanent, they will typically fade and become less conspicuous with time. we recommend scar treatments like silicone sheets or topical creams to promote healing.
    -Your breasts may continue to change shape and feel as the tissue settles. If you notice any significant changes, unusual pain, or concerns about your healing, contact your surgeon.
 A breast lift doesnt prevent future changes in breast shape due to aging, weight fluctuations, pregnancy, or gravity. However, the results can last for many years with proper care. The skin on your breasts may remain sensitive for a while after surgery, but this should improve over time. 

           

TIPS FOR GOOD RECOVERY

  • Follow your surgeons aftercare instructions carefully
  • Take pain medication as prescribed, but dont overuse it.
  • Wear a support bra 24/7 for the first few weeks, especially when sleeping.
  • Stay hydrated and eat a balanced diet to promote healing.
  • Avoid smoking and excessive alcohol consumption as they can impair healing.
  • Avoid hot tubs, swimming pools, or baths until your surgeon clears you to do so (usually after a few weeks).


- If you experience any of the following, contact your surgeon immediately

  • Increased swelling or pain that isnt relieved by prescribed pain medication.
  • Signs of infection such as fever, redness, or pus at the incision sites.
  • Unusual hardening or lumps in the breasts. Shortness of breath, chest pain, or dizziness, which could indicate a serious complication like a blood clot.



General Risk

Although breast lift surgery is generally safe, like all surgical procedures, it carries some risks and complications

- Infection : Any surgery carries the risk of infection, which may require antibiotics or additional treatments. Signs of infection include redness, swelling, warmth, or discharge from the incision sites. Having a proper aftercare, including keeping the surgical area clean, can minimize infection risk.
- Scarring : Scarring is inevitable with breast lift surgery, but the extent and visibility of scars can vary depending on the incision type, skin type, and healing response. But Over time, scars typically fade and become less noticeable. Your surgeon may suggest scar creams or silicone sheets to promote healing.
- Changes in Sensation : Some women experience changes in nipple or breast sensation after the procedure. This could be temporary or, in rare cases, permanent bacause of Nerve damage during surgery can cause numbness or heightened sensitivity in the breasts or nipples.
-Poor Healing or Delayed Recovery : In some cases, the skin or tissues may not heal as expected, especially if there's significant swelling or the patient doesn't follow aftercare instructions. Proper post-operative care, including wearing compression garments, avoiding heavy lifting, and attending follow-up appointments would help your recovery
- Asymmetry : There is a chance that your breasts may not be perfectly symmetrical after surgery, although this is relatively rare. Surgeons typically try to achieve balance, but some minor asymmetry is natural and can be improved with a secondary procedure if needed.
- Blood Clots (Deep Vein Thrombosis) : Any surgery poses a risk of blood clots forming, particularly if you are immobile for an extended period.
Prevention: Staying mobile and following post-surgery activity restrictions can reduce this risk.
- Hemorrhage or Seroma : Hemorrhaging or the formation of fluid collections (seromas) can occur. If this happens, additional treatments or drainage may be necessary.Be Careful monitoring and avoiding excessive physical activity during recovery are important to minimize this risk.
- Anesthesia Risks : As with any surgery that requires general anesthesia, there are risks related to the administration of anesthesia, such as allergic reactions, breathing difficulties, or complications from underlying health conditions.To prevent this we will assess your health beforehand and take steps to minimize these risks.
- Unfavorable Aesthetic Results : While most patients are satisfied with the results, theres always a chance that the outcome might not meet expectations, such as undesirable scars, uneven results, or dissatisfaction with the shape. Clear communication with your surgeon about your goals and expectations before surgery can help minimize this risk.
- Loss of Nipple/Areola Complex (Very Rare) : In rare cases, a complication may occur that leads to the loss of the nipple or areola complex due to compromised blood flow or infection. Careful planning and technique during surgery to ensure proper blood flow are key to minimizing this risk.

While complications from a breast lift are rare, it's important to be aware of the risks. Choosing a board-certified and experienced plastic surgeon significantly reduces the chances of these issues. Following your surgeon's aftercare instructions, attending follow-up appointments, and understanding the risks involved can help ensure the best possible outcome.

Breast Lift Techniques

Periareolar (Around the Areola) Technique

The periareolar breast lift technique, also known as the circumareolar technique, involves making an incision around the perimeter of the areola (the dark area surrounding the nipple). This technique is often used for women who have mild to moderate sagging and want a more subtle lift with minimal visible scarring.

- Incision Placement: The incision is made along the edge of the areola, typically only around the top half or full circumference, depending on the amount of lift required.

- Best For: Mild to moderate ptosis (sagging), where there is not much excess skin to be removed.

- Outcome: The procedure tightens and lifts the breast tissue, improves shape, and enhances breast symmetry. The scar, being along the edge of the areola, is usually well-hidden and blends with the natural pigmentation of the areola, making it less noticeable.


Benefits : Minimal Scarring because the scar is hidden around the areola, so it is less visible compared to other techniques, such as the anchor or vertical lift.
Ideal for Subtle Lifts: Perfect for those with only slight sagging or those seeking a modest enhancement.

-Can Be Combined with Augmentation: This technique is often combined with breast augmentation (implants) to enhance volume and achieve a fuller, more lifted appearance.


- Limitations : it provides a subtle lift, the periareolar technique may not be enough for women with significant sagging or loose skin. For more extensive lifts, other techniques like the vertical or anchor lift may be more appropriate.

 

Vertical (Lollipop) Technique

The vertical (lollipop) breast lift technique is a popular method for reshaping and lifting breasts with moderate sagging. It involves an incision that circles the areola and extends vertically down to the breast fold, creating a lollipop-shaped scar.
- Incision Placement: The incision is made around the areola (like the periareolar lift) and continues vertically down the center of the breast to the breast fold       (in the shape of a lollipop). This allows the surgeon to remove excess skin and reposition the breast tissue to achieve a more youthful, lifted appearance.
-Best For: Moderate ptosis (sagging) and breast reshaping. This technique is often chosen by women who want a more significant lift compared to the periareolar lift but who dont need the extensive incisions of an anchor lift.

  • The vertical lift offers a more noticeable improvement in breast shape and position than the periareolar lift. It lifts and reshapes the breasts while maintaining a natural, youthful contour. The vertical incision allows the surgeon to reshape the breast tissue more effectively than with a periareolar lift, providing both an elevation and a tightening of the breast skin.
Benefits:
  • Significant Lift: The vertical incision provides more lifting power than the periareolar technique, making it ideal for moderate sagging.
  • Minimal Scarring: While the scar is more extensive than the periareolar technique, it is still less noticeable than the anchor (inverted T) technique. The vertical scar is often well-hidden within the natural breast contour.
  • Natural Shape: This technique helps achieve a rounder, youthful breast shape without excess skin.


This Technique Can Be Combined with Augmentation: Like other breast lift techniques, the vertical lift can be combined with breast augmentation (implants) to add volume while improving shape and position.

  • Moderate Scarring: While the scar is more discreet than the anchor technique, it is still visible, especially if the skin is very thin or if the patient has darker skin.
    Not Ideal for Severe Sagging: For women with severe ptosis or a large amount of excess skin, the anchor lift may be more appropriate to achieve the desired results.

Anchor (Inverted T) Technique
he anchor (inverted T) breast lift technique is the most comprehensive method for reshaping and lifting the breasts, especially for women with significant sagging or excess skin. It involves three key incisions: around the areola, vertically down the center of the breast, and horizontally along the breast fold (in the shape of an anchor or inverted T).
- Incision Placement: The anchor lift includes three incisions:
  • Around the Areola: A circular incision around the perimeter of the areola.
  • Vertical Incision:A vertical incision from the areola down to the breast fold.
  • Horizontal Incision: A horizontal incision along the breast fold.

This technique allows the surgeon to remove excess skin, reposition the breast tissue, and reshape the breast for a more youthful, lifted appearance.
- Best For: Women with severe ptosis (sagging) or significant excess skin, often after pregnancy, weight loss, or aging. This technique is also used for women who have larger breasts and need more extensive lifting and reshaping.

  • The anchor technique provides the most dramatic lift and reshaping of the breast. The extensive incisions allow the surgeon to remove a larger amount of skin and reposition the breast tissue for a fuller, firmer, and more youthful shape. The horizontal incision at the breast fold allows for more tissue removal, which is especially important for women with larger or drooping breasts.
- Benefits
  • Maximum Lift: The anchor lift provides the most significant elevation of the breasts, making it ideal for women with severe sagging or excess skin.
  • Breast Reshaping: This technique offers a more defined and youthful breast shape, correcting drooping and improving overall breast contour.

Can Be Combined with Augmentation: If you're also looking to increase breast volume, this lift can be performed alongside breast augmentation (implants), adding both lift and fullness.


Limitations: 

  • Visible Scarring: The anchor technique results in more visible scarring compared to other methods due to the three incisions, including the horizontal scar along the breast fold. However, with time, scars can fade, and experienced surgeons often place incisions in less noticeable areas.
  • Longer Recovery: Because its a more invasive procedure, recovery may take longer than with other lift technique


reduction inf

Breast Reduction Techniques
  • Traditional (Anchor) Technique

Incisions : Involves an incision around the areola, vertically down to the breast fold, and along the fold itself. This method allows for significant tissue removal and reshaping.

Best For: Larger breast reductions or significant reshaping.

  • Vertical (Lollipop) Technique
    Incisions: Similar to the traditional method but without the horizontal incision along the breast fold.
    Best For: Moderate reductions with less scarring compared to the anchor technique.
  • Periareolar Technique
    Incisions: A circular incision around the areola, suitable for minor reductions.
    Best For: Patients seeking minimal scarring with less significant size reduction
Recovery And After Care

In the first few days post-surgery should limit physical activity. You should take pain medications as directed, as soreness is common and may peak in the first few days but typically decreases over time. It's also essential to keep the surgical area clean and dry; follow your surgeons instructions regarding hygiene and when its safe to shower.
- As you progress through recovery, light activities can usually be resumed after one to two weeks, but it's important to avoid heavy lifting and strenuous exercise for at least four to six weeks. follow-up appointments needed for monitoring your healing process after one week, sutures may be removed during these visits if non-dissolvable stitches are used. Scars will gradually fade over time, using silicone gels or ointments could help.
In the long term, continuing to wear a supportive bra as advised will help maintain breast shape and support healing. Be vigilant for any signs of complications, such as increased redness, swelling, or unusual pain, and contact your surgeon if you notice anything concerning. As you ease back into your normal routine, low-impact activities like walking can usually begin within a week, while more strenuous exercise should be introduced gradually after about a month.


General Risk

While breast reduction is generally considered safe, like any surgical procedure, it carries certain risks and potential complications. Understanding these risks can help you make an informed decision.

- Scarring: All surgical procedures result in scarring, and some individuals may experience more noticeable scars than others. The extent of scarring depends on the surgical technique used and individual healing processes.
- Infection: There is a risk of infection at the incision sites, which may require treatment with antibiotics. Proper wound care can help minimize this risk.
Changes in Sensation: Some patients may experience temporary or permanent changes in nipple or breast sensation, including numbness or heightened sensitivity. This can occur due to nerve damage during surgery.
-Asymmetry: After surgery, there may be slight differences in breast size or shape. While surgeons strive for symmetry, natural variations can occur.
Poor Healing: In some cases, incisions may not heal properly, leading to complications such as delayed healing or wound dehiscence, where the wound reopens.
- Blood Clots: There is a risk of blood clots forming in the legs or lungs, especially during the recovery period when mobility is limited.
- Anesthesia Risks: General anesthesia carries its own set of risks, including allergic reactions, respiratory issues, and complications related to pre-existing medical conditions.
- Need for Revision Surgery: Some patients may require additional procedures to achieve their desired results or to address complications that arise after the initial surgery.

Incusion Technique

Inframammary Incision
This incision is made in the natural fold under the breast. Its the most common approach, as it allows for precise implant placement and usually results in a discreet scar that is well-hidden
Periareolar Incision
This technique involves making an incision along the lower edge of the areola (the darker area surrounding the nipple). It can provide good access to the breast tissue while the scar often blends well with the areola.
Transaxillary Incision
The incision is made in the armpit, allowing the surgeon to place the implant without any visible scars on the breast itself. While it avoids breast scars, it can limit the surgeon's access and may require special techniques

Breast Augmentation Technique

Subglandular Placement
The implant is placed above the pectoral muscle but beneath the breast tissue. This method can result in a more natural appearance and shorter recovery time, making it suitable for individuals with adequate breast tissue.
Submuscular Placement
The implant is positioned beneath the pectoral muscle. This technique can provide a more natural contour and may reduce the risk of complications such as capsular contracture. It often requires a longer recovery period but is ideal for those with less breast tissue
Dual Plane Placement
This technique combines elements of both subglandular and submuscular placements. The upper portion of the implant is placed under the muscle, while the lower part is above it. This method offers the benefits of both approaches, providing a natural look and reducing the visibility of the implant edges.

Information

Recovery And After Care
  • Sleep in an upright position and try not to sleep on your side for at least a month post surgery. 
  • To avoid unnecessary swelling or bleeding, do not bend over, strain, exercise or do any other activities that could increase pressure in your chest during the first few weeks.
  • You must wear your compression bra day and night for 8-12 weeks post surgery and you can switch to a good quality supportive sports bra during this time. Do not go braless for the first 12 months as you are actually still in the healing stage
    Once your stitches are removed (usually 7 days post op) massage your breasts to keep them softer, avoid capsular contracture and keep them in proper position. Your surgeon will advise you of the correct way to massage 

- its common to experience soreness, tenderness, or a tight sensation in the chest area. This discomfort can usually be managed with prescribed pain medications.
-Expect some swelling and bruising around the breasts, which may take a few weeks to subside.
-Some patients may experience temporary numbness or tingling in the breast area or nipples, which typically resolves over time.
-Some individuals notice changes in breast sensitivity, either increased or decreased. This usually stabilizes over time.

General Risk Of Breast Augmentation
  • Bleeding - Excessive bleeding during or after surgery can occur, potentially leading to the need for a blood transfusion or further surgical intervention.
  • Infection - There is a risk of infection at the incision site, which may require antibiotics or additional treatment.
  • Capsular contracture - When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breasts appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.
  • Implant rupture - Breast implants are not lifetime devices and cannot be expected to last forever. If you decide to have a lift later in life then it is advisable to change the implant. The new implants available now are of a very high quality but they are still not expected to last a life time.
  • Changes in Nipple Sensation - Some patients may experience temporary or permanent changes in nipple sensitivity following surgery.
  • Breast Cancer Screening - If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. Your plastic surgeon, in some instances, may recommend other types of examinations such as ultrasound or magnetic resonance imaging. An implant may obscure some of the mammogram.
  • Other risks - Other risks include changes in sensation of the nipple or breast and changes in the ability to breastfeed.   Changes in sensation may either be increased or decreased or altered sensation. These changes may be temporary or permanent.Also, implant visibility, rippling, and asymmetry may also occur.
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