Extended Deep Plane
Facelift, Necklift oN MAUI
Surgical cosmetic procedures by Dr. Ivey
Book ConsultationSurgical cosmetic procedures by Dr. Ivey
Book ConsultationDr Ivey performs extended deep plane face lifting technique to naturally redistribute lax skin and tissue. Although more technically demanding, this technique lends itself to authentic, lasting results. He restores underlying tissues to their more youthful positions in the plane they have aged in.
He is one of the most busy and experienced extended deep plane facelift surgeons in Hawaii performing between 2-4 lifts per week. The Deep Plane Facelift is the gold standard technique in facial rejuvenation. Only a small portion of plastic surgeons performing facelifts will enter the deep plane. It is technically complex with a greater learning curve that most surgeons avoid altogether. Even fewer will adequately release the ligaments or debulk the structures in the neck needed for a truly long lasting result.
It leaves nearly invisible scars, avoids a “pulled” appearance, and creates a natural, rejuvenated look. This is all related to the fact that after proper release there will be no tension on either the deep plane or skin.
The cheek or midface is lifted with this procedure (unlike in mini-lifts or smas facelifts) and because of this fact there are two other areas that may need to be addressed. These two areas are the lateral brow/temple and also the lower lid.
If the lateral brow and temple area shows “bunching” when the cheek lift is simulated this is a sign that a temple/lateral brow lift must be performed in order to lift the cheek in the proper vector. Because of this Dr. Ivey includes the temple lift as part of his extended deep plane facelift.
If there is excess lower lid skin before the surgery, it could appear to have even more excess skin after the procedure. This is why Dr. Ivey often addresses this with laser or “skin pinch” blepharoplasty.
The deep plane facelift most often includes a neck lift. A patient can have changes in the neck related to aging or genetics. A genetically bad neck will not look ideal even at a young age or healthy bodyweight. If the neck angle looks poor at a healthy weight in a young patient it will only get worse with time. Often an incision under the chin is needed to properly treat the contents of the neck. Most often he chooses to treat the neck with a deep plane sub-platysmal approach rather than liposuction alone.
In order to provide a harmonious facial rejuvenation that leaves no sign of surgical intervention the patient must trust my artistic judgment. Prior to consultation for facial rejuvenation I ask my patients to bring in photos from each decade starting with 20s 30s 40s and so on. At the consult, we will go over in detail the patients concerns and I will give a comprehensive treatment plan.
One area that I never mention unsolicited to the patient - as it is not necessarily related to aging - is the nose. If you have any concerns about your nose please bring them up to me.
Of course the patient can do as much or as little as they like. Interestingly, many times an untoward and obvious surgical result comes from leaving areas of the face unaddressed. This is precisely why a comprehensive rejuvenation is preferred. Doing more - can look like less - and be noticed less as surgery.
The following procedures are often added to the extended deep plane lift to obtain a comprehensive result. They are listed in approximate order of popularity in my practice.
Your own fat is transferred using a very small needle and this is injected directly into the deep transverse neck wrinkles. This in addition to the skin undermining during surgery will lessen their appearance.
Stem Cell Rich nano-fat is collected (typically from lower abdomen or thighs) and processed with hyaluronic acid (Versa™, Juvederm®, Restylane®) and a neuromodulator (Botox®, Jeuveau®, Dysport®) . This mixture is then microneedled into your skin. The stem cell effect takes approximately 8 months to become apparent but the microneedling, neuromodulator, and the hyaluronic acid will give your skin an immediate glow.
There is good evidence that suggests the treatment reduces UV spots, wrinkles, brown spots.
Unlike when we inject Botox® into the muscles of facial expression, the microneedled Botox® shrinks pore size and decreases sebum production. This helps skin look smooth and clear.
Craftsmanship takes time. Dr. Ivey will decide during the planning process of your case how much can be safely accomplished in one session. Often if there has been significant aging a full correction may take two stages. These stages may be days, weeks, or months apart depending on the circumstances.
In some cases it is possible. Many times this is a younger patient in their 30s or 40s. However, many times failure to adequately lift the neck can actually come from failure to lift the midface/cheek or failure to shift enough of the soft tissue. The other issue is that if the neck has been completely corrected it can make an uncorrected jowl more noticeable.
It is better to perform the procedure at an earlier age as the aging is less severe and will take less surgery to correct the issue. The tissues are stronger so we expect the result to last longer in younger patients.
No, Dr. Ivey performs deep plane facelifts with limited incisions (ponytail facelift) in younger patients or in those with less aging.
If performed by surgeons with experience with the anatomy and technique the technique it is very safe. Dr. Ivey has dedicated his practice to facial rejuvenation and deep plane facelifting. Our patients have not experienced any permanent nerve injury.
Facial aging is very individual. What I mean by this is that individuals age differently and they also have variable tolerences for aging. Aging is determined primarily by genetics (bone structure, skin quality etc.) followed by the amount of sun damage that one is exposed to. I have performed deep plane necklifts and facelifts on patients from late 20s to early 80s. Age really is just a number!
The Buccal Fat pad also known as Bichat’s fat pad is commonly manipulated with a deep plane face and neck lift. If there is fullness in the anterior lower face it can increase fullness along the jawline with aging.. Surgical reduction or repositioning of this fat pad is commonly done in Dr. Ivey’s practice through a small incision hidden inside the mouth. This give a more contoured look to the face. If it is performed in appropriate patients it will not cause hollowing of the face.
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