1. Tranexamic acid
Tranexamic acid is used to reduce the bruising and swelling and markedly reduce recovery time. Most patients have no bruising and only a small degree of swelling with a deep plane facelift, using tranexamic acid given at the time of surgery. This usually produces a shortened recovery, similar to or even less than a mini-lift. Most people are presentable within a week to 10 days. Pre and post-op of a deep plane facelift patient 10 days later.
2. Dr. Keller’s unique approach
Dr. Keller’s unique deep plane facelift approach allows a directional facial repositioning that can be artistically customized for each patient. Most deep plane facelift surgeons reposition the face in only one direction. By freeing the “2ixed SMAS” with a unique “high SMAS” approach, Dr. Keller creates a deep plane surface that allows for either a vertical, diagonal, or horizontal lift of the face. It also gives a
better “lift” in the jowl area near the chin, as he has illustrated in peer-reviewed articles. Lifting the skin and muscular/fascia in one layer from a more posterior point, he releases all of the facial ligaments rather than a select few, creating a sturdy 2ixation area.
3. Performing a Mid-Face lift with Deep Plane Lift
Performing a “subperiosteal” mid-face (cheek) lift with most “deep plane” lifts relieves the “tired look” and artistically restores the natural, youthful position of the cheek and nasolabial folds and lifts additional layers of fat that are not lifted with the deep plane lift (SOOF- -under eye- -and subperiosteal fat pads). As a result of this cheek elevation, an “artistic 2low” is produced between the
face, the eyes, the cheek, the jowl, and the neck, and the folds between the nose and
the mouth are usually reduced in depth. Dr. Keller’s (cheek) procedures, published in peer reviewed literature and textbook chapters, can restore natural, youthful beauty and avoid a “face-lifted” look.
Lifting the Mid-Face to relieve the tired look. This patient has not had a facelift.
The following patient has had a deep plane facelift, and more youthful, natural appearance is restored by lifting the cheek (subperiosteal mid-face lift).
FaceTite, a bipolar radiofrequency “energy” device works above and below the skin to tighten the skin simultaneously with the neck lift. FaceTite has a computer-controlled ability to avoid overheating the skin. It is especially useful with skin that is overly loose or has excessive wrinkles. It can help, to a degree, with both horizontal neck lines and “leather like” sun-damaged neck skin. Horizontal lines and “leather like” skin improved after a deep plane facelift with simultaneous FaceTite.
5. Unique neck lifting techniques
Unique neck lifting techniques tighten and lift the neck in a natural manner. An “extended neck lift”, used by Dr. Keller for over 35 years separates and incises the muscles and fascia in the neck, so that the platysma muscle can be pulled more ef2iciently backward for tightening. In addition, a form of internal suturing of the neck to tighten it upward and emphasize the neckline along its entire border (Ellevate and Trampoline Platysmaplasty). This “web neck” procedure can be done without an incision under the chin. For heavy necks, or more extreme cases, a “corset platysmaplasty” and more extensive work might be necessary, but over 95% of patients can achieve neck tightening and platysma muscle tightening without a deforming “under the chin” incision. Trampoline Platysmaplasty creates a “web” of suture that can be tightened like “lacing up your shoelaces” and avoids a scar under the chin. No facelift is performed for this patient.
A Masterlift deep plane facelift facelift is safer than most deep plane facelifts. The “deep plane” layer is a natural layer that was not well understood until Dr. Keller and Dr. Chiara Amaretto Amadeo de2ined it in their landmark papers in 2010-13. It is a layer that lifts the face under the skin and SMAS
(super2icial muscle and fascia layer) and over the covering (deep fascia) of the muscles of expression that move the face. This approach preserves a greater blood supply to the face and improves the skin healing. It also improves the safety of the deep plane facelift by preserving the layer that covers the nerves. Most deep plane lifts remove this layer. Dr. Keller has used his procedure for over 35 years
(calling it a “supra2ibromuscular” layer), but it was only recently that Dr. Amadeo and Dr. Keller de2ined the anatomy.
JAMA Facial Plast Surg. 2014;16(1):36-41. doi:10.1001/jamafacial.2013.53
Published online June 27, 2013.