A Leading Plastic Surgeon Shares Everything to Know About the Deep Plane Facelift

For sufferers visiting Newport Beach, CA plastic surgeon Sanjay Grover, MD, they get a one-stop-shop for all of their aesthetic wants. “What’s nice is that some patients can get all of their treatments performed at one center, or by one surgeon,” says the Stanford-trained physician who’s been training for 20 years and makes a speciality of the face, nostril, breast and physique. “Our practice is called Grover Aesthetics, and our surgery center is Grover Surgical Arts, but we have our medspa at Grover Aesthetics, so we offer a number of treatments here—everything from fillers and neuromodulators to lasers, microneedling and other minimally invasive treatments.”

In phrases of facial rejuvenation particularly, Dr. Grover says he’s seen an uptick in since COVID—amongst many different cosmetic surgery procedures—whether or not that’s “due to people seeing themselves on Zoom calls, or whether they are on social media doing more selfies. Or perhaps they have more time to recover now because they’re working from home, or they have more money because they aren’t traveling.” Whatever the purpose, Dr. Grover welcomes these facial rejuvenation sufferers with open arms. “After my Stanford training, I did an additional aesthetics surgery and ocuplastic surgery fellowship in Atlanta, so I’m very well-versed in treating patients for facial and oculoplastic aesthetic procedures. We also have a brand-new, fully accredited outpatient surgery center that’s state-of-the-art, so our patients are in good hands.”

One process that he’s significantly well-versed in is the deep aircraft facelift, which he performs recurrently. Here, the surgeon tells us every thing we’d like to learn about the process, and extra.

Is a deep aircraft facelift the most thorough facelift you may get?

“Yes, I’d say that’s accurate because this type of lift addresses where the tissues are actually sagging or drooping. There’s a natural tissue plane, or gliding plane, underneath the SMAS layer, so by going directly to the area that’s becoming relaxed and addressing it, you’re getting a much better lift and can really put things back into a youthful position. The results are very natural, there’s minimal bruising and the scars are hidden very well around the contours of the ear. And because we’re putting the tension on the underlying muscular tissue—the SMAS—as opposed to the skin, the scars heal beautifully.”

Is this process reserved for individuals who are older with extra superior indicators of growing old?

“Actually no. In many ways it’s ideal for a younger patient—someone in their early 40s—but it’s also useful for patients in their late 70s and early 80s.”

Interesting. Who is the supreme candidate?

“A deep plane facelift can help give improvement in the midface with the nasolabial folds and the smile lines, as well as the jowls and neck bands. It can also improve the contour of the neck and create a more distinct jawline. As we age, we lose volume in our midface and the angle of our jaw due to bony loss, so it can really help to reposition the tissues.”

Because you’re manipulating the SMAS layer, is the restoration longer for the sort of facelift?

“It’s actually not because there’s less bruising in general due to less direct undermining of the skin.”

What sort of anesthesia is critical?

“It can be done under twilight or general anesthesia—it really depends on the surgeon. I prefer to do mine under general anesthesia. The length of the surgery depends on the extent of what we’re doing—the face and neck, just the face, the face and eyes, etc.—but typically ranges somewhere between three to six hours.”

If you’re combining a laser remedy with a facelift surgical procedure, what order do you carry out these procedures in?

“When we’re combing lasers and facelifts, the nice thing about the deep plane facelift is that there’s less undermining of the skin, so you can perform laser-resurfacing treatments more safely. We can actually do them at the same time. With a fractionated laser, you have to remember we’re only treating about 20 to 25 percent of the skin, but it looks like you’ve had 100 percent of your skin treated—this allows for more rapid healing. Whereas with a full ablative laser, especially the ones we were using in the ‘90s, we’re treating 100 percent of the skin.”

What different nonsurgical remedies do you generally pair for sufferers?

“We have a number of offerings for nonsurgical facial rejuvenation, including fractionated CO2 lasers and microneedling with RF (Vivace), which we’re combining for a number of patients. That way the Vivace addresses the deeper dermis and enhances skin tightening, texture and overall collagen synthesis, whereas the fractionated CO2 is a nice refresher on the surface of the skin. We’re seeing patients be more open to having a combination of procedures for a more natural-looking result, than just one procedure.”

Can these be carried out on the similar day too?

“Yes. We do the Vivace first and then follow it up with a light fractionated CO2 laser on the face, neck and chest afterward. For patients who have more sun damage, we’ll either do photofacial treatments and potentially combine those with fractionated CO2 as well, or we’ll do the Elluminate treatment, which is a series of laser treatments that include four different lasers all done at one time, spaced one month apart. Patients will usually do three sessions, and those have minimal downtime.”

Are there some other facial rejuvenation procedures which are standard at your apply?

“I also perform Y-Lift procedures and Ellevate neck suture suspension procedures. The Y-Lift procedure is a closed facelift using fillers alone to reestablish the bony structure, or the pillars of the face, to help elevate the sagging soft tissues. That’s done under local anesthesia here in the office.”

What does the “Y” stand for, and the way is that this totally different than a “liquid lift”?

“The ‘Y’ really tries to show the pillars of the face. The two upper arms of the Y, one that extends over each side of the midface; the central part of the face being the base of the Y; and the lower face, the jawline, being the two arms of the Y upside down. it was developed by a maxillofacial surgeon in New York. As we age, not only do we lose volume, but also bony volume. With a Y-Lift procedure, we’re actually injecting filler on the surface of the bone to act and feel like bone, so it helps redrape the underlying soft issues that have started to droop and has a longer-lasting effect. Whereas a ‘liquid facelift’ is injecting the fillers more in the soft tissues, and that’s where you can potentially have a puffy look.”

You additionally talked about the Ellevate neck process. What are you able to inform me about that one?

“This is a permanent, nonabsorbable thread under the surface of the skin in the subcutaneous tissues, which I do in the neck to improve some of the bulky soft tissues there. Usually, I combine that with some liposuction of the neck and Renuvion plasma treatments for better skin tightening.”

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