Question
Which is best, the Deep plane midface lift or the suture suspension?
What would you recommend?
1) suture suspension midface lift
2) the deep plane mid face lift?
Is the deep plane mid face lift really better? I have to make a decision soon between the two procedures and don't know which one to chose.
I am a 53, female. I have strong nasal folds and my lip corners now go downwards. I didn't have that when I was younger. My lower face looks fine as I had a good mini lower face lift last year. Please inform me about your experiences and I thank in advance.
Answers (3)
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1
November 13, 2008
It's all about the timing...
It is my theory that the right procedure at the right time will give the best possible outcome with the optimal lasting power. For example. If you are young and have just experienced a drastic weight loss then a treatment to tighten up the jaw line may be reasonable; however, that same technique will not be substantial enough for elder skin that is much less supportive.
A SMAS "style" facelift should last between 8-10 years successfully! A neck lift or mini facelift is not supported in the same fashion and therefore the results begin to deteriorate about 3 years out. So in my opinion, it is best to address the problem of time and gravity with the appropriate technique. Because not all 50 year old skin is the same or ages the same, it is absolutely necessary to make adjustments. Every facelift I perform is, in some way, customized to the individual receiving it. The proper facelift will age gracefully, with you; a rapid change or deterioration of the procedure may indicate that you didn't get the optimal procedure for your timing.
Best wishes to you,
Marshall T. Partington, MD FACS
2
October 21, 2008
You have a good doctor!
Your doctor has taken good care of you based on my reading of your letter to Dr. Gross. Please understand that NO surgical procedure will eradicate the nasolabial folds and that improving your jawline and neck was a safe and effective rejuvenation for you. The problem with midface lifting is that the results are subtle and hard to see in photographs and the procedures are fraught with complications the more aggressively the midface is approached. There isn't an answer to whether suture suspension or deep plane techniques are better because it depends on the patient, their tissues, and the experience of the surgeon.
In general, it is best to stay as simple as possible in the midface region. The last thing you want is a lower lid malposition problem that is very hard to fix!
3
October 16, 2008
they may be both appropriate
Unfortunatley it is difficult to give a general answer for all patients for this question.
The surgical plan is developed uniquely for each patient and depends on their unique anatomy, skin, volume, underlying bony support, as well as each patients goals and time for recovery.
That said i am not a fan of procedures that rely only on "threads" or sutures to do all the "work" of rejuvenation. There are typically just too many things going on to get a good result with only suture suspension. Many times when an "open' procedure sutures are used internally as part of the procedure.
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Check out more Q+A about Deep plane facelift
How long does a deep plane facelift last?
Answered by Richard P. Rand, MD, Seattle Plastic Surgeon
Read all 2 answers
10/17/08
Dear Dr. Gross,
Thank you very much for your response.There is so much information out there, and it is easy to become confused as a lay person.
My plastic surgeon didn't made me look ugly but he wasn't that good in communicating. He told me about different procedures but he didn't tell me what the right procedure for ME is. So, *I* made a decision for a lower mini face lift and fat grafting under the eyes. I told him what to do. But he should have told me what to do, and then let me make a decision. Back then, I thought I have enough information to make a decision but it turns out now that it was not the case.
I have now a rather young looking face but an older looking midsection in the middle of my face. That older spot in my face is weird. It doesn't fit in my rejuvenated face.
I wish my PS would have told me that this should be lifted too with the fat grafting under the eyes, as now I have to start this all over...
Please understand me right, he did a nice lift job in the area he operated. I still think he is skilled, but I was thinking that it would take care of the mid area too. Which it did not.
I still have these nasal folds, and kind of baggy skin hanging over them but it seems more just skin and a bit fat and the muscle underneath does not seem to be sagging. And the mouth corners go slightly down.
Just with the help of my finger I can smooth that up and it looks really great when that little bit of flabby skin is pushed out of my mid face.
I don't think that any fillers will handle that, right? I think the only way to get rid of it is to cut it out. Lasers don't help with flabby skin either, correct?
I wonder if a mini surgical procedure would take care of the midsection and the mouth corners and perhaps in 10 years I do a deep plane face lift and not do the proceedings step by step, little by little.
My mini face lift was done with sutures. My neck and jowls looks really nice just as I was in my 20s. But the big question is of course: how long does it last?
But as I have already one mini procedure, I might just add another mini procedure to it and in a couple of years when all together all sucks ;) I mean sags again, I am getting a state of the art facelift?
Does that make some sense or not?
Best wishes,
Gabrielle