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Deep-Plane Facelift

This audio podcast has been transcribed using an automated service. Please forgive any typographic errors or other transcription flaws.

This podcast is on the deep-plane facelift and what that means exactly what the deep plane is, why it’s important and why I use it. So the traditional facelift is called SMAS. SMAS stands for superficial muscular operatic system. It is a lift that I have done for many years over a decade, but I switched over to the deep plane a few years ago because I’m getting significantly better results now with it. And why is that? The basic reason to understand is that you get a release of ligaments, that some are above the SMAS, which is this mixture of muscle and collagen tissues that is what you lift when you do a facelift, that’s what you lift and some are below. And so if you don’t release these ligaments, you really don’t get a sustainable elevation of the tissues. You have to really pull very hard and hopefully that everything will sustain itself on the long end.

But in my opinion, if you don’t release these ligaments, you do not get a very natural result. And what I mean by natural is a result where everything is evenly lifted. And the other key point of this is what things I don’t release because I believe that when you start to release tissues around the eyes and around the mouth, you start to get on an unnatural elevation where there’s a change or distortion to the eye and the mouth area, which is unacceptable. So I’m going to go through each of these ligaments and tell you why they’re so important in terms of elevation and what this means. So the first one I’m going to talk about is the most inferior ligament. It’s called the mandibular ligament. This ligament it’s a tissue that’s connected from the outer skin layer, down to the deeper tissue.

So it’s a very superficial ligament. It resides above the SMAS or again, this SMAS the tissue I’m elevating and it actually wraps like a U shape ligament below the chin and this area, if you don’t properly release as ligament, you’re not going to get a proper elevation of the tissues. Uh, very simple to do. You basically just elevate that until you feel a give a release around this area. And I think that a lot of people that are untrained doctors or are frightened to touch anything and they don’t make this release and when it’s in fact a quite a simple release, but it is a three dimensional release. What’s interesting is if you Google this or look up mandibular ligament is that most often they talk about this ligament just being right on the chin bone, and that’s true.

There is a component of that, but if you just gently put your finger and feel it, it actually rides all the way under the chin. So you’ve got to provide a proper release of this ligament. To me, this is one of the most fundamental ligaments who release. The second ligament that is incredibly important to release is called the posterior retaining ligament. This is a ligament or tissue that’s bound down where it’s on the anterior border of the sternocleidomastoid, a muscle that goes down the neck. If you sort of squeeze the side of your neck, you can feel that thick muscle that turn your neck back and forth. I’m in front of it. It is the platysma or that’s you know, the Turkey gobbler neck area where it hangs that that ligament between those two areas is another area that just needs to be simply elevate and release and separate it.

If you don’t do this, you’re not going to get a sustainable elevation of the neck. The other two are not quite as important, but they do impact the results. I would say it adds about 20% improvement in the total result and adds a little elevation of the mid facial tissue. So, the most important is called the zygomatic ligament and the second ligament is called the prodomaceteric. And you can just feel this area that’s not as bound down. After I’ve released these ligaments, I gently just pull up on the tissues and I can see the release. If it’s not properly released, I know that I haven’t released the ligaments properly. I never had any nerve issues on the long end. It is so safe in my hands, but this is something that is obviously the concern for people that are not comfortable doing a deep plane lift, but I’m very conscious of the anatomy. I know how to do it, how to do it safely. I’ve done it repeatedly. I do one to two facelifts every single week and so I’m very, very comfortable elevating these tissues with sustainable, safe results. But if I believe if you do not lift or excuse me, if you do not release these little ligaments that are binding down the tissues, you are not going to get a very good lift or one that is sustainable in any shape or fashion. So this short blog about ligament releases for deep plane facelifts, hopefully you’ll have you understand exactly why I perform the kind of lift that I do. One aside also is that you’ll hear a lot of different types of marketing terminologies for lifts and I just try never to use anything more than a description of the lift and a deep plane or a SMAS lift are very categorical textbook descriptions. Whereas a lot of times you’ll hear a million types of marketing terms that people just use to brand their product. And I just really try to avoid these marketing terminologies cause I don’t think they help anything. They just confuse people because they’re just meant to for Google searches, etc. So, that’s just a point of clarification. So if you come in here and you asked me, do you do a blank lift, I will probably say, well, what the heck does that mean? And could you describe it to me? And most times they have no idea because it’s just a marketing term. So I try to avoid those marketing terms of best of my ability.