An “RBF” (Resting Bitch Face) was a term I first heard from a friend who jokingly mentioned that she felt her face looked “mad” or “tired” even when she wasn’t. She said, “My expression just doesn’t match how I feel.” This comment resonated with many of my patients who share similar experiences, not because of emotion, but because of the natural changes that occur with age.
As we get older, our cheeks and jawline tend to drop, along with the brows, neck, and eyes. While there is some loss of volume, much of this change is due to the gravitational descent of the cheek fat pads, jowl muscles, and skin. Weight loss, medications such as Ozempic, stress, and poor nutrition can accelerate this process, contributing to a facial expression that may appear “mad, sad, or tired.”
The Vertical Deep Plane Facelift: A Natural Solution
Vertical Deep Plane Lifts with mid-face lifts can help reverse these changes. Using advanced, proven techniques, we lift the skin, muscles, and fat pads as a unit to restore them to their original positions. This approach safely repositions the deeper structures of the face, giving a refreshed and natural look, not the “pulled” appearance often seen with traditional lifts.
I was proud to see at our recent annual meeting that most surgeons now using deep plane facelift techniques have adopted methods I first described between 1993 and 1996 — techniques that protect the nerves and achieve natural results. The Vertical Glide Plane Natural Facelift, which I developed and published in the 1990s, relies on a facial layer we defined and have used in thousands of deep plane lifts. This discovery provides both safety and a naturally youthful result.
My colleague, Dr. Chiara Amoretto Amodeo, an Italian plastic surgeon, and I further defined this vertical deep plane glide plane through anatomical studies presented at international meetings. Her work earned her a PhD in anatomy from the Sorbonne and will soon be referenced in Grey’s Anatomy. I’ve also trained most of the UCLA Facial Plastic Surgery fellows to safely follow these facial fascial “highways” in performing these techniques.
Restoring a Natural, Refreshed Expression
Our work in the mid-face and deep plane facelift offers patients a natural, more youthful, and balanced appearance. By safely restoring the underlying structures, this lift removes the “mad, sad, tired” look my friend described as “RBF”, bringing back the expression of youth and vitality without anyone realizing that a facelift was performed.
By lifting the facial structures together as a unit, the face is naturally rejuvenated, not changed, but restored.
Dr. Gregory Keller
www.gregorykeller.com
