Subscribe
Share
Share
Embed
Hello and welcome to The Trillium Show with Dr. Jason Hall!
This podcast is all about navigating the changes in our lives, whether they be through plastic surgery, adopting new habits, or making positive life improvements. Dr. Jason Hall, a renowned plastic surgeon and lifestyle expert, is here to guide us through the ups and downs of transformation.
Throughout this series, we'll explore topics such as body positivity, self-confidence, healthy living, and much more. Dr. Hall will share his expertise, as well as invite special guests to join us in the discussion.
So, whether you're considering plastic surgery or simply looking to make positive changes in your life, this podcast is for you. Get ready to be inspired, informed, and empowered on The Trillium Show with Dr. Jason Hall.
Welcome to the Trillium Show, where we discuss different tips and tricks to help you improve your mind, your body, and your life. I'm your host, board certified plastic surgeon and medical director of Trillium Plastic Surgery and Trillium Aesthetics, Dr. Jason Hall. Today we want to talk about one of my most popular procedures year in and year out.
And that is a deep plane face and neck lift. The deep plane is one of those procedures that has been having a moment on social media and on the internet in the last couple of years and is really a, not a new operation necessarily, but has been having a renaissance because of the results, the longevity, and just the overall improvement that you can get in the face and the neck with the deep plane technique.
Thank you. Okay. Just for a little backstory, the deep plane facelift is an adaptation of a facelift technique that was pioneered back in the nineties by Dr. Sam Hamra in Dallas, and is a more aggressive facelift that instead of pulling and tightening things, which is what Older versions of the facelift did the deep plane facelift releases all of the attachments between the kind of muscular connective tissue layer of the face and everything else allows that to be repositioned with very little tension and So you don't get the problems that you saw with some of the old facelifts that kind of windblown wind tunnel appearance Look that was common with some of those older facelift techniques, because all of the repositioning is done on the muscle, there really is no tension at all in the skin.
And tension, as we've talked about in previous shows, really is responsible for poor scarring. So in this show, what I want to do is kind of break down, what the deep plane facelift is. does what it doesn't do. Procedural details, recovery, kind of go soup to nuts through the procedure itself so that you get a better understanding of kind of what we're talking about.
So first off, what are the goals of a deep plane face off? So there's four of them. One is to improve the jawline contour and improve jowling. So down low jawline and jowling. Number two is to improve the neckline or eliminate a double chin. Um, Number three is slightly improve the nasolabial creases and the marionette lines.
And the improvement that we get here really varies patient to patient based on how those folds are in you. What needs to be done to correct them. We can't pull those folds out, but if they're shaped correctly, we can reposition things around it and make them much less noticeable. And lastly, we, with a deep plane, we remove excess skin and fat.
We tighten muscles, sculpt and shape the deep layers and the salivary glands of the neck, if we need to. And replace emptiness in the cheeks with fat grafting if that's something that is appropriate for you. And this is where the custom nature of the deep plane facelift really comes into play. There isn't one facelift that we do for everybody to get the same result.
Everybody is going to need something a little bit different. So now that we understand what the goals of a facelift are, what it does, let's talk about what it doesn't do, because that's just as important to understand. So a deep plane facelift does not get rid of the creases here. It will soften them, but it will not eliminate them.
And there really isn't anything that's going to completely eliminate them, but what we can do to fill those in is use deep plane. injectable filler, which is predictable, but not permanent. We can use your own body fat, which is permanent, but not as predictable. But the facelift by itself without one of those other things is not going to significantly soften this crease.
Another common misconception of what a facelift does that it doesn't do is take care of wrinkling around the mouth or around the eyes. These are wrinkles that are skin problems that need skin treatments to fix, and we typically, I will typically recommend a laser or a series of chemical peels to really help with that.
The same goes for fine textural wrinkles on the neck. However, laser on the neck can be problematic, can cause issues. issues and really what we're, what we're looking at with these fine wrinkles on the neck is skin care is, uh, in some cases, fat or filler injections to help minimize those. A deep plane facelift won't get rid of freckles, won't get rid of spots, won't get rid of sun spots or sun damage.
You need light treatments, skin care. even makeup to help cover some of those things, but those will not be improved with facelift surgery. Facelift surgery, deep plane facelift surgery works on the lower face. So draw a line from your nose to your ear and that below that line is what our deep plane facelift works on.
Above that line, so eyes, eyelids, eyebrows. Do not get improved with a facelift. We need other surgeries, blepharoplasties, brow lifts, and the like, to really improve those areas. And we do those at the same time, but we have to talk about what that is. A facelift doesn't do it by itself. And then lastly, the long upper lip.
Hidden upper teeth. A facelift isn't going to elevate your lips. A lip lift will do that. We can add that to the procedure, but it is not part of a routine facelift. We now understand what a facelift does, what the goals of a facelift are, what it does not do. So let's talk a little bit about the procedure and recovery itself.
Deep plane facelift incisions are a tiny incision hidden under your chin in the, in the kind of crease that's below your chin, and then around the ears. From the hairline here around following the natural contours of the ear back behind and down in the hairline, the front and the back of those incisions can be hidden a little bit, but those are typical.
Sometime in men in the neck, we will do what's called a hemostatic net. So that's actually sutures that go through the skin that are left in place for two or three days. Because men's skin, because it's got hair, it's hair bearing skin, that hair bearing skin tends to be very vascular. And so we do that to prevent blood clots underneath the skin.
In women, it's less an issue because there is no hair bearing skin in their neck. And so it's very rare to have to do that hemostatic net in women. A deep plane facelift in my practice is done in the operating room under a general anesthetic. You're asleep with a breathing tube. Um, we'll make another whole show about the difference between general anesthesia and, and conscious sedation for facial surgery.
But in my practice, we do this under general anesthesia. You're asleep. You don't know anything that we do. Wake up. Next thing you know, you wake up and you're at home. Which brings us to the recovery period. So, recovery after deep plane facelift surgery, in the surgery center, you're here for between 30 minutes and 30 in an hour right afterwards.
You go home, you have to have a driver take you home, a responsible adult to stay with you overnight just to help out. Um, you feel pretty good the first day. We see you the next day, check in, make sure everything is going well. Typically, you will have a drain underneath the skin here, and that drain stays in anywhere from 24 hours to 2 or 3 days, kind of depending on how much fluid is coming out of that.
And I've made a video here that will link about how to handle drains and what drains are just so you'll kind of understand what that looks like. Swelling from a facelift typically peaks at about 72 hours. That's when the really scary look, if you've ever seen somebody who's had a facelift before, they really look scary at 72 hours and then the swelling starts to go away fairly rapidly.
I divide recovery from work and kind of social recovery into two phases. What I've kind of, Learned, I think I heard it somewhere, I can't remember who I heard it from, referred to as the restaurant recovery. And this is when you're able to go out to a restaurant, you go out in public, and you see the random stranger, and they don't look at you like, what in the world have you just done?
You don't look like you've had surgery by two weeks to people who don't know you. I tell people, if you want to take time off of work, two weeks is a good amount of time to take off of work. By three weeks, you're not going to have much bruising. If you had any bruising and swelling, most of that is gone.
And so your restaurant recovery is that two to three week span. Then there's the other. phase of recovery, which I refer to as your red carpet recovery. And now this is recovery. If you're going to have your picture taken and it's going to end up on somebody's mantle, you want to give yourself about three months, give or take before a big event.
So weddings, class reunions, meetings, And it's not because you're not ready. Most people are ready well before that. I like to have people budget that amount of time because if we have an issue, if there's a healing problem, if we have a little hematoma, we'll talk about problems here in a second, but if we run into an issue, it gives us time to fix it or have that issue fix itself and you're still okay for your event.
It's important to note that incision lines are going to remain pink for three to four months. So if you're going to go somewhere, you probably ought to cover your incisions with a little bit of makeup. And it takes, and I tell everybody, it takes a year before your final results are kind of what they are.
And that's just general plastic surgery. Healing takes about a year. In terms of exercise, lifting, things like that, two weeks at the absolute minimum and then over the next month can kind of ease back into your normal routine. Really the big reason you don't want to hurt yourself, you also want, you know, if you exercise, get your heart rate up, you're gonna swell a little bit more and you don't want to You know, precipitate or make that swelling worse.
So give yourself some time. Don't try and hop on the treadmill or exercise for a couple of weeks after surgery. What are the procedures can we do with a facelift? We kind of hinted at some of them in in the section about what a facelift doesn't do. Um, things that are common. Brow lift in conjunction with a deep plane facelift is very common.
Both upper and lower eyelids, very common to do at the same time as we do a deep plane facelift. Laser resurfacing, also very common, although we do have to be careful in the areas around our incisions with the laser. You know, the areas that we really want to focus on there, really around the mouth, um, and then forehead and around the eyes, so the T zone.
So forehead and then down the center. is the safest area. We can still do cheeks. We just have to be a little bit more careful. And then lip lift surgery is also something that we can add with a facelift. Who's not a candidate for a deep plane facelift? And there are really Very few people who aren't good candidates that are specific to the procedure.
It's more facial surgery and plastic surgery in general. Uh, the first is the, that patient with really poor tissue quality. You've got really, really thick heavy skin or really, really papery thin skin. Both extremes there can make getting a good result difficult and can make our incidence of complications higher Second person probably shouldn't have this is somebody who who Just despite all of this doesn't believe me, when I give you a realistic expectation of what we can expect and you want more than what we're able to deliver.
And that really goes across plastic surgery. You have to realize this is unnecessary. This is cosmetic. Plastic surgery is unnecessary surgery. You have to understand it is surgery. Problems happen. Perfect results are impossible and you have to accept that if it's going to be something that is going to be workable for you.
The third thing is people with significant medical problems. So patients on blood thinners, patients with, bleeding problems or patients with uncontrolled high blood pressure or heart troubles just from an anesthesia and, and bleeding complication standpoint, it is not worth having an unnecessary surgery where we know there is a very, very high chance of problems.
Those are really , the specific things that we try and avoid when we're doing, deep plane facelift surgeries. What are some kind of general warnings for deep plane facelift surgery? We'll talk about this at your consultation. Everybody has asymmetries in their face.
I do. You do. If we look, there are little things. Jawlines are a little bit different. Sides of the face, one side of the face can be wider than the other. Eyes can be a little off. Jawlines can be a little off. And when we do a facelift, a deep plane facelift, and we're tightening things up, it can make some of those asymmetries a little bit more noticeable.
Sometimes we've, we'll go by and fat graft at the same time to try and even out some of those things, if they're volume asymmetries. Some of those are unfixable, and we try, we create problems trying to correct, some God given asymmetries. And so understand that there will still be some asymmetries after surgery.
Scars can always be an issue. Revision surgery is, is always an issue. The facelift revision rate, uh, for problems is fairly low, but it still happens. And then lastly, probably the hardest part of the facelift surgery is, The view from underneath so that kind of we call the view the dog's view We're looking up from underneath your chin if you've ever taken pictures that way that's why we don't take pictures from the chin up because that is the Probably everybody's worst Angle and the view from that area you will always be able to find some little Issue if you're looking constantly at the dog view of the world Complications in deep plane facelift surgery are fairly rare.
Um, hematomas happen, the blood clots, blood collections under the skin that need to be drained out. Typically less than 5 percent in my practice will have a hematoma. 95 percent of those We take care of in the office and they don't cause any problems other than a little bit of firmness around the site of that hematoma, which can last a little bit longer.
That's one of the reasons that we, I want you to give me about three months before we have a big event, but fortunately that is very rare. Seromas or little fluid collections under the skin can happen, and these are really more pesky than anything else. If we have these, we can drain those out with a little needle in the office.
They rarely come back, and you forget you've ever had it, after a week or two. Temporary numbness around the kind of outer parts of the face is very common. Everybody says, my outer side or out here is still numb after my facelift, my neck, central neck is still numb after my facelift. That is very common.
And that can take months for that numbness to go away. But in the vast majority of cases, it go goes away. Permanent numbness is very, very rare. Likewise, nerve weakness. So we're working right around the nerves that, allow your face to move. Nerve weakness is fairly common, especially the nerves that let you lower your lower lip can get bruised because we're working right around them.
The vast majority of those in my practice, a hundred percent of those get better permanent weakness or nerve damage where you can't move. A muscle in your face is exceedingly rare, less than 1%. , but it's something that we're very cognizant about and with a deep plane facelift, especially we're working right on top of those nerves, very careful not to injure those, , poor scar healing happens.
Everybody's scars heal differently. If we, the big key there is to remain vigilant and watch as the scars are healing, and if we see scars not healing well, to make sure that we catch it early and intervene. The vast majority of those times, if we can catch it early, we can prevent poor scars from forming in the first place.
And lastly is skin loss. And in Deep plane facelifting, because there is so little skin that is lifted off of everything else, you know, most of the work we're dealing with a fairly healthy flap of skin and fat and muscle, it is what we call a composite flap. Skin flap loss in deep plane facelifting is fairly rare.
Less than, say, a dime may happen one in a hundred times. typically behind the ears where it's hard to notice unless you're wearing your hair up and usually those heal without an issue anyway. Significant skin flap loss is fortunately very, very rare and is the reason that we're so careful with dressings, with laser, with things that can injure the skin to prevent that skin compromise early in the healing process.
So you have just gotten a ton of information, kind of soup to nuts about deep plane face and neck lifting. I'm going to link here to the preparing for a facial consult. I'm going to also link to the how our face ages consult. Both of those are good videos to watch. If you found this interesting and are thinking about deep plane facelifts at home. Otherwise, uh, thank you for listening. If you enjoyed the show, please leave me a review on Apple Podcasts. This will help other people find the show. If you have an idea you would like to see made into a show or have a question you'd like answered, send me an email media@drjasonhall.com or drop me a DM on Instagram or x @drjasonhall. You can also click on the link in my Linktree bio on Instagram and leave a voicemail which you can be anonymously featured on the podcast. There's a really cool new tool that we're using. So as always, Thank you for listening. We'll see you on the next show.