The deep plane facelift has become the gold standard in facial rejuvenation surgery, and for good reason. It addresses the underlying structural causes of facial ageing rather than simply tightening the skin — producing results that look natural, last longer, and avoid the telltale signs of a face that has been operated upon. This post explains what the procedure actually involves, how it differs from other facelift techniques, who is best suited to it, and what the experience and recovery look like at this practice in Auckland.
Why the Face Ages the Way It Does
To understand why the deep plane facelift works, it helps to understand how the face ages. Ageing of the face is not simply a matter of skin losing elasticity. It involves a combination of processes happening simultaneously: skin quality changes, but so does the underlying fat — which redistributes and descends — and the deeper structural tissues of the face, which are anchored to the skeleton by a series of ligaments, gradually loosen and descend over time.
The result is predictable: jowling along the jawline as tissue falls from the cheek, deepening of the nasolabial folds, loss of definition at the neck and under the chin, and a general heaviness to the lower face. These changes are structural. Addressing them at the skin level alone — by pulling and trimming — creates tension that the skin cannot sustain, and results that look operated-upon rather than rejuvenated.
What Makes the Deep Plane Different
The distinguishing feature of the deep plane facelift is the level at which the surgical dissection occurs. Rather than working at the skin or immediately below it, the deep plane approach involves dissection beneath the SMAS — the Superficial Musculo-Aponeurotic System, the structural layer of the face that connects the facial muscles to the overlying skin.
Working at this deeper level allows the surgeon to release the retaining ligaments of the face — the fibrous anchor points that tether the deeper tissues to the underlying skeleton. Once released, the SMAS and the overlying soft tissue composite can be repositioned as a unit, moving the descended tissue back toward where it sat in youth. The skin is then re-draped over this repositioned foundation without tension, and only the excess is trimmed.
This is the key distinction: in a deep plane facelift, it is the deeper tissue that is moved, not the skin. The skin follows. This is why the results look natural — there is no pulling at the corners of the mouth, no distortion of the hairline, no unnatural tightness. The face simply looks like a younger version of itself.
How This Compares to Other Techniques
SMAS plication — an alternative approach in which the SMAS layer is folded and sutured rather than dissected — does not release the retaining ligaments. Without releasing these anchors, the lift is more limited, can feel lumpy, and may widen the face rather than lift it vertically. It is a less demanding operation, but the trade-off is a less thorough and less lasting result.
Mini facelifts and thread lifts address only the most superficial layers of the face and are best suited to very early, mild changes. For patients with meaningful jowling, descent of the mid-face, or neck laxity, these approaches will produce an incomplete result. I have used these techniques in the past and found them unable to provide reliable, lasting outcomes for the majority of patients who seek meaningful facial rejuvenation.
Skin-only lifts, where excess skin is removed without addressing the deeper structures, produce the tight, windswept appearance that most patients specifically want to avoid. Skin pulled without underlying structural support does not hold — results are typically short-lived and the appearance unnatural.
The Neck — An Essential Part of the Procedure
A facelift that addresses the face without attending carefully to the neck produces an incomplete result. For most patients, I perform the deep plane facelift in combination with a comprehensive neck lift as a single procedure — the Deep Plane Face and Neck Lift (DPFNL).
The neck work involves tightening the platysma muscle — the broad, flat muscle that runs from the jaw down into the chest and is responsible for the banding and laxity that develops in the neck with age. A corset platysmaplasty, in which the left and right edges of the platysma are brought together and sutured from the chin to the lower neck through a small incision beneath the chin, dramatically improves neck and jawline definition. Submental fat — the fat beneath the chin — can be removed at the same time. Liposuction of the jowl area can also be incorporated where appropriate.
The result is a continuous, natural improvement from the mid-face through the jawline and into the neck — which is what the eye reads as genuine rejuvenation.
Who Is a Good Candidate?
The deep plane facelift is appropriate for patients experiencing meaningful signs of facial ageing — jowling, descent of the mid-face, nasolabial fold deepening, and neck laxity — who are in good general health and have realistic expectations about outcomes.
There is no fixed age. The procedure is most commonly performed in patients in their late forties to mid-seventies, but what matters more than age is the degree of change present and the patient’s overall health. I have performed the procedure in patients aged 40 and in patients aged 78. Earlier intervention often produces a more refined result and a faster recovery, because the tissues are in better condition and the changes being corrected are less advanced.
Health factors that require careful assessment include cardiovascular disease, diabetes, a history of smoking, and medications that affect bleeding. Smokers carry a meaningfully higher risk of wound healing complications, and I require patients to cease smoking well in advance of surgery. These matters are discussed in detail at consultation and during pre-operative assessment.
The Procedure at This Practice
Surgery is performed under general anaesthesia, administered by an experienced specialist anaesthetist. The duration depends on the complexity of the plan — a deep plane face and neck lift typically takes between four and six hours. For patients combining the facelift with eyelid surgery or fat grafting, operating time extends accordingly.
Most patients are treated as day cases, returning home the same evening with a support person present. Patients from out of Auckland, or those whose health history warrants closer monitoring, may stay overnight at the private hospital.
The incision pattern for a facelift begins in the hairline near the temple, follows the natural contour in front of the ear, passes behind the ear, and extends to the hairline at the back of the neck. Although the overall incision is long, it is designed to sit within natural shadows and contours, and heals well in the vast majority of patients. The incision behind the ear and in the hairline is typically imperceptible once fully healed.
Recovery — What to Expect
Recovery from a deep plane facelift is real and should not be underestimated. The trade-off for a thorough result is a genuine recovery period, and I am direct with patients about this from the outset.
Week one — Bruising and swelling are significant and at their peak. A drain may be placed during surgery to reduce fluid accumulation and is removed at the first post-operative visit. Patients should rest at home with their head elevated. Light activity is appropriate; nothing strenuous.
Weeks two to three — Bruising resolves substantially. Swelling begins to settle, though the face remains noticeably fuller than the final result. Most patients are comfortable at home but not yet ready for social or professional settings.
Weeks four to six — The majority of swelling has resolved. Most patients feel comfortable returning to work and social activities at around the four to six week mark, though this varies by individual and by the complexity of the procedure.
Months two to six — Residual swelling continues to resolve gradually. The final result becomes increasingly apparent over this period, with most patients seeing their definitive outcome by around six months. Scars continue to mature and fade for twelve months or longer.
Exercise restrictions apply throughout recovery. Light walking from the first week is encouraged. More vigorous exercise — running, weights, anything that raises heart rate substantially — should be avoided for at least six weeks.
Results and Longevity
The deep plane facelift produces durable results. Because the deeper tissues are repositioned rather than simply the skin tightened, the result holds better over time. Most patients can expect the result to remain meaningful for ten to fifteen years, though the ageing process continues and is not stopped by surgery.
The goal of this operation is not to make a patient look dramatically different — it is to make them look like a refreshed, rested version of themselves. Patients who achieve the best outcomes are those who understand this distinction and approach surgery with realistic expectations.
Cost and Consultation
At this practice, a Deep Plane Lower Face and Neck Lift (DPFNL) starts from NZD $31,000. When the procedure includes a submental incision, removal of fat beneath the chin, corset platysmaplasty, and jowl liposuction, the approximate cost is NZD $38,000. Combining with upper eyelid surgery typically brings the total to around NZD $45,000–$50,000, depending on operative time. Follow-up appointments for up to twelve months are included in the surgeon’s fee.
A formal, itemised quote is provided following consultation, once the surgical plan has been established for your specific anatomy and goals.
If you are considering a deep plane facelift and would like to discuss whether it is appropriate for you, I encourage you to book a consultation at the practice.