Sept. 3, 2024
Best Facelift: Deep Plane vs. SMAS
No two faces are the same, so no two face lifts should be the same. Each procedure should be carefully customized to individual facial features.
Face lifts have come a long way. In the beginning, doctors simply tightened the skin. In the 1970s, they discovered that lifting and repositioning the deeper layers of muscle and connective tissue, called the SMAS, gave much better, longer-lasting results.
In the 1990s, Dr. Sam Hamra popularized an alternative approach called the deep plane face lift. This approach treats the skin and deeper layers together.
Find out which technique Dr. Bass prefers and why, the history of face lifts, and how to find the best facelift surgeon for you.
Learn more about Dr. Bass’ approach to facelift surgery, the Multiplanar SMAS Approach
About Dr. Lawrence Bass
Innovator. Industry veteran. In-demand Park Avenue board certified plastic surgeon, Dr. Lawrence Bass is a true master of his craft, not only in the OR but as an industry pioneer in the development and evaluation of new aesthetic technologies. With locations in both Manhattan (on Park Avenue between 62nd and 63rd Streets) and in Great Neck, Long Island, Dr. Bass has earned his reputation as the plastic surgeon for the most discerning patients in NYC and beyond.
To learn more, visit the Bass Plastic Surgery website or follow the team on Instagram @drbassnyc
Subscribe to the Park Avenue Plastic Surgery Class newsletter to be notified of new episodes & receive exclusive invitations, offers, and information from Dr. Bass.
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Welcome to Park Avenue
Plastic Surgery Class,
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the podcast where we explore controversies
and breaking issues in plastic
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surgery. I'm your co-host, Doreen Wu,
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a clinical assistant at Bass
Plastic Surgery in New York City.
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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,
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educator, and technology innovator.
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The title of today's episode is
"Best Facelift: Deep Plane vs. SMAS."
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Dr. Bass.
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Everyone wants to look their best and
if they're going through a facelift,
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they want to get the best possible result.
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Most people do a lot of research to pick
the best facelift surgeons who use the
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most advanced techniques.
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I agree.
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Most patients have a few consultations
and do a lot of due diligence before
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going ahead with a facelift.
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So what are the basic techniques that
patients are choosing from these days?
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The big split is deep plane and SMAS
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facelifting.
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That's the big divide currently
in the techniques being used.
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Give us the rundown. What is the history
of how we got to these two techniques?
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Facelift, which is over
a hundred years old,
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started as skin only facelifts.
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And back in the 1960s,
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facelifts were still skin only facelifts.
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A little more dissection
was done over a larger area,
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but just a space being
opened up between the skin
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and the deeper tissues so that
the skin could be tailored flat.
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Starting in the 1970s,
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dissection deep to the skin
started to be done as part of the
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facelift, and this was SMAS lifting.
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And SMAS stands for
subcutaneous musculoaponeurotic
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system.
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So it's basically the muscle
and connective tissues in layers
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that are under the skin and
under the subcutaneous fat that's
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just under the skin.
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And people started
modifying these tissues,
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pulling on them, releasing
them, and repositioning them,
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doing a variety of different things
in order to get a more complete
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correction and a more durable correction.
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And that worked out in large
measure. And by the 1980s, many,
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many surgeons, not all but many,
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were performing SMAS facelifts for
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most of their facelift.
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In the 1990s, the Deep
Plane Facelift was born,
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and this was developed
by a man named Sam Hamra,
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who we've talked about
before on the podcast.
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And he was a plastic surgeon who
trained at NYU at the Institute of
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Reconstructive Plastic
Surgery, where I trained,
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although he trained
some time before I did,
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and was practicing down in Dallas.
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And there was a lot of attention
in the 1990s on ways to boost the
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cheek and get a more
complete correction of the
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nasolabial fold that fold between
the cheek and the upper lip.
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People were trying to get that
as flattened out as they could,
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and so Dr. Hamra thought
and really deep plane is
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composite face lifting,
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if you lift the SMAS and
the skin as one unit,
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a composite together,
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he was hoping to get a more
complete draping of that
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midface area, and that's what the
deep plane facelift was really about.
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Now, since that time,
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there was a lot of study of the deep
plane and the deep plane has evolved
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in some ways to reduce some of
the nerve injury risk and some of
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the swelling and recovery time.
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But some people favor lifting
as a unit and some people
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favor lifting skin and SMAS separately.
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Now that we know the history behind
the SMAS and deep plane approaches,
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I'm curious what is the
intent of these techniques?
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So the intent is always to get
the most youthful appearance
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possible,
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the greatest correction
of all of the features.
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But as I said,
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deep plane was really
focused on midface correction
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and the advantage of maybe getting that
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more completely corrected where SMAS
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techniques were developed
both for midface and the
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neck.
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And there have been some more recent
developments in what's called deep plane
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neck work, although that's really part
and parcel of what's been done with SMAS
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techniques over time.
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So the intent is to get those areas
corrected the best way they can.
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What do you do in your facelifts Dr.
Bass and why do you take that approach?
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So I was very well trained
because Dr. Hamra trained at
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NYU, he would come up every year and
lecture and demonstrate with live
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surgery. And so I'm trained in deep plane
techniques as well as SMAS techniques,
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but most of the time I
do a SMAS technique in my
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facelift, and it's what I think of as a
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multiplanar SMAS. In other words,
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we're lifting the face in
multiple planes, the skin,
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the connective tissue in the cheek area,
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the connective tissue in the jowl
area, the superficial muscle,
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the platysma muscle, which is
part of the SMAS in the neck.
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And each of those components
can be both positioned and
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shaped individually.
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And I kind of feel that
that gives more flexibility,
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and we know as the face ages that
different parts of the face shrink and
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descend differently from each other.
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So I feel that that better
allows correction of
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what needs to be done in each
individual's zone rather than
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being compelled to move everything as a
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monounit or composite.
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Can you talk about some of your unique
modifications to the technique and why
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you choose to do them?
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So one,
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change in the face as we
age is a loss of projection
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where shrinking,
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losing bone muscle and fat volume
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and skin and connective tissue is sagging.
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So that tends to flatten the face and the
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classic skin pulling techniques and
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pull in more of a backward
direction tends to accent that
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flattening effect.
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So modern facelifts tend to involve
a more vertical component of
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lift, at least at the skin
level. But in addition to that,
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rather than pulling tissues
in a straight line direction,
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I like to rotate the tissues
into position because that allows
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greater flattening in areas that
you wanted like the gel area
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while accenting the projection
in areas that you want and have
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lost projection with
aging like the cheek area,
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which flattens out over time,
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rotating that into position
helps shape the face,
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accent the projection and
restore youthful shape.
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No two patients faces are the same,
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which in turn means no two
facelifts are the same.
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What kinds of variations are
made for individual patients?
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That's a great question and
really a critical issue.
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You said it exactly right.
No two faces are the same,
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and no two facelifts
should be exactly the same.
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Your facelift needs to be customized
to your individual facial features.
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So this involves a lot of considerations.
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So for example,
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sometimes we're fat grafting
along with lifting and
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tailoring the skin.
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Sometimes we're doing very
conservative fat removal. For example,
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in the gel area where there's an
excess of fat and we want a very
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modest removal,
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sometimes we add a chin
implant to alter the angle of
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draping and get better
leverage on the re draping.
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We also should shape
the cheek as part of the
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facelift that again, typically
flattens and loses projection.
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But how we're going to shape that
cheek depends on what you look like in
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youth, what gender you are,
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men's cheeks and women's
cheeks look differently,
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what your ethnicity is and
your basic facial shape.
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So that's all going to vary
what you're going to try to
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produce. In the neck area,
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there's a lot of variation in
what you do to tailor the muscle
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layer in the neck based on what's
giving you a good response,
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what that person's neck anatomy is,
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their bone anatomy and looking at their
muscle dynamics when they animate,
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that's all going to affect what
techniques you choose to employ in that
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individual facelift.
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Let's look ahead at
what's to come. Tell us,
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what is happening at the forefront
of facelift surgery today?
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So facelift surgery continues to evolve,
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and if we look at facelift
surgery from decades ago to
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today, it hasn't really
undergone revolutionary changes,
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but it's undergone literally
decades of evolutionary
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changes and these changes continue today.
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So people are working on further incision
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reduction, so the incisions are shorter,
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they're shorter now than
they were in the 1980s,
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but they're looking at other
ways to further reduce incisions.
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People are looking at ways of
limiting dissection to more focused
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areas rather than a
broad-based dissection,
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and they're looking at improved correction
in the neck with advanced muscle
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division techniques and
muscle repair techniques.
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And there's also a lot of examination
of ways to minimize recovery time,
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for example,
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looking at ways to
minimize bruising with the
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procedure so that recovery
time is shortened.
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Lastly, Dr. Bass,
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can you give our listeners some
parting takeaways from this episode?
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Well, we said in the title,
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best facelift is a deep plane or SMAS,
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but both approaches can achieve
excellent results in experienced
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hands. There is no best in that regard.
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Each surgeon has refined what
they do to get excellent results,
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and an experienced surgeon
who has refined his or her
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technique and customizes
it for each individual
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patient,
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that's more important to a great
result than the textbook application of
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technique X or technique Y.
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So overall, you need an experienced
surgeon who carefully assesses your needs,
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who plans with your concerns in
mind and customizes the plan for
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your features. Not a
cookie cutter facelift,
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but a custom facelift. Of course,
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surgeons need to be meticulous and you'd
like to find a surgeon you're a good
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fit with, that you feel
comfortable working with.
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Finally,
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the really important area
in face lifting is getting a
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sharp defined jawline.
That's a very
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strong feature on a man's face.
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It's a very graceful
feature on women's faces and
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getting a clean and not saggy neck
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and the excellence and completeness of
the result in the neck is really where
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the money is in facelift in
terms of making you look younger
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because sagging or hanging
skin in the neck is an
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obvious feature of age and not
just a decade or two into age,
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but several decades into aging.
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And so cleaning that area
up, which I believe is
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the focus of SMAS techniques
and the ability to do that
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zonally and multiplanar,
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is really what the excellent
facelift is all about.
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Thank you,
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Dr. Bass for sharing your insight and
expertise with us about techniques in
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modern facelift surgery.
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Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.
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Follow us on Apple
Podcasts, write a review,
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Be sure to join us next time to avoid
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coming your way. If you want to
contact us with comments or questions,
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we'd love to hear from you.
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00:13:53,830 --> 00:13:57,850
Send us an email at podcast@drbass.net
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@drbassnyc.
00:00:00,750 --> 00:00:03,780
Welcome to Park Avenue
Plastic Surgery Class,
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00:00:03,780 --> 00:00:07,380
the podcast where we explore controversies
and breaking issues in plastic
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00:00:07,380 --> 00:00:09,780
surgery. I'm your co-host, Doreen Wu,
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00:00:10,080 --> 00:00:13,200
a clinical assistant at Bass
Plastic Surgery in New York City.
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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,
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educator, and technology innovator.
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00:00:21,090 --> 00:00:25,860
The title of today's episode is
"Best Facelift: Deep Plane vs. SMAS."
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Dr. Bass.
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Everyone wants to look their best and
if they're going through a facelift,
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they want to get the best possible result.
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Most people do a lot of research to pick
the best facelift surgeons who use the
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most advanced techniques.
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I agree.
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Most patients have a few consultations
and do a lot of due diligence before
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going ahead with a facelift.
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So what are the basic techniques that
patients are choosing from these days?
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The big split is deep plane and SMAS
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00:00:58,680 --> 00:00:59,513
facelifting.
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00:01:00,000 --> 00:01:04,110
That's the big divide currently
in the techniques being used.
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00:01:05,550 --> 00:01:09,750
Give us the rundown. What is the history
of how we got to these two techniques?
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00:01:10,500 --> 00:01:14,280
Facelift, which is over
a hundred years old,
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00:01:14,730 --> 00:01:17,610
started as skin only facelifts.
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00:01:17,610 --> 00:01:20,520
And back in the 1960s,
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00:01:20,580 --> 00:01:24,900
facelifts were still skin only facelifts.
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00:01:25,470 --> 00:01:29,910
A little more dissection
was done over a larger area,
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00:01:29,970 --> 00:01:34,710
but just a space being
opened up between the skin
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00:01:35,280 --> 00:01:39,720
and the deeper tissues so that
the skin could be tailored flat.
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00:01:41,640 --> 00:01:44,160
Starting in the 1970s,
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00:01:45,840 --> 00:01:50,340
dissection deep to the skin
started to be done as part of the
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00:01:50,340 --> 00:01:54,540
facelift, and this was SMAS lifting.
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00:01:54,540 --> 00:01:56,880
And SMAS stands for
subcutaneous musculoaponeurotic
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00:01:56,880 --> 00:01:59,160
system.
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00:01:59,460 --> 00:02:04,350
So it's basically the muscle
and connective tissues in layers
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00:02:04,350 --> 00:02:09,330
that are under the skin and
under the subcutaneous fat that's
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00:02:09,330 --> 00:02:10,680
just under the skin.
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00:02:11,460 --> 00:02:15,030
And people started
modifying these tissues,
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00:02:16,020 --> 00:02:20,070
pulling on them, releasing
them, and repositioning them,
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00:02:20,850 --> 00:02:25,500
doing a variety of different things
in order to get a more complete
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00:02:25,500 --> 00:02:29,160
correction and a more durable correction.
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00:02:30,630 --> 00:02:35,100
And that worked out in large
measure. And by the 1980s, many,
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00:02:35,100 --> 00:02:38,160
many surgeons, not all but many,
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00:02:38,760 --> 00:02:43,260
were performing SMAS facelifts for
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00:02:43,290 --> 00:02:44,970
most of their facelift.
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00:02:47,340 --> 00:02:52,320
In the 1990s, the Deep
Plane Facelift was born,
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00:02:52,320 --> 00:02:55,050
and this was developed
by a man named Sam Hamra,
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00:02:55,950 --> 00:02:58,110
who we've talked about
before on the podcast.
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00:02:58,120 --> 00:03:02,530
And he was a plastic surgeon who
trained at NYU at the Institute of
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00:03:02,530 --> 00:03:05,320
Reconstructive Plastic
Surgery, where I trained,
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00:03:06,790 --> 00:03:09,880
although he trained
some time before I did,
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00:03:10,750 --> 00:03:12,910
and was practicing down in Dallas.
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00:03:12,940 --> 00:03:17,710
And there was a lot of attention
in the 1990s on ways to boost the
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00:03:17,710 --> 00:03:22,030
cheek and get a more
complete correction of the
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00:03:22,030 --> 00:03:25,690
nasolabial fold that fold between
the cheek and the upper lip.
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00:03:26,740 --> 00:03:29,620
People were trying to get that
as flattened out as they could,
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00:03:29,620 --> 00:03:33,490
and so Dr. Hamra thought
and really deep plane is
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00:03:34,180 --> 00:03:35,590
composite face lifting,
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00:03:35,590 --> 00:03:40,180
if you lift the SMAS and
the skin as one unit,
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00:03:41,140 --> 00:03:43,090
a composite together,
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00:03:43,330 --> 00:03:48,070
he was hoping to get a more
complete draping of that
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00:03:48,070 --> 00:03:52,360
midface area, and that's what the
deep plane facelift was really about.
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00:03:53,680 --> 00:03:55,540
Now, since that time,
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00:03:55,540 --> 00:04:00,520
there was a lot of study of the deep
plane and the deep plane has evolved
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00:04:00,520 --> 00:04:05,500
in some ways to reduce some of
the nerve injury risk and some of
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00:04:05,500 --> 00:04:07,510
the swelling and recovery time.
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00:04:08,230 --> 00:04:12,610
But some people favor lifting
as a unit and some people
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00:04:12,610 --> 00:04:16,180
favor lifting skin and SMAS separately.
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00:04:17,050 --> 00:04:21,100
Now that we know the history behind
the SMAS and deep plane approaches,
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00:04:21,110 --> 00:04:24,700
I'm curious what is the
intent of these techniques?
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00:04:25,600 --> 00:04:30,160
So the intent is always to get
the most youthful appearance
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00:04:30,160 --> 00:04:31,270
possible,
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00:04:32,200 --> 00:04:35,830
the greatest correction
of all of the features.
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00:04:36,550 --> 00:04:37,540
But as I said,
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00:04:37,550 --> 00:04:42,100
deep plane was really
focused on midface correction
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00:04:42,880 --> 00:04:47,620
and the advantage of maybe getting that
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00:04:47,620 --> 00:04:51,100
more completely corrected where SMAS
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00:04:52,570 --> 00:04:57,130
techniques were developed
both for midface and the
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00:04:57,130 --> 00:04:57,963
neck.
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00:04:58,270 --> 00:05:01,480
And there have been some more recent
developments in what's called deep plane
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00:05:02,170 --> 00:05:06,880
neck work, although that's really part
and parcel of what's been done with SMAS
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00:05:07,660 --> 00:05:10,870
techniques over time.
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00:05:11,410 --> 00:05:15,550
So the intent is to get those areas
corrected the best way they can.
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00:05:16,450 --> 00:05:20,470
What do you do in your facelifts Dr.
Bass and why do you take that approach?
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00:05:21,340 --> 00:05:25,600
So I was very well trained
because Dr. Hamra trained at
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00:05:25,600 --> 00:05:30,460
NYU, he would come up every year and
lecture and demonstrate with live
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00:05:30,460 --> 00:05:35,140
surgery. And so I'm trained in deep plane
techniques as well as SMAS techniques,
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00:05:35,150 --> 00:05:39,580
but most of the time I
do a SMAS technique in my
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00:05:39,580 --> 00:05:43,210
facelift, and it's what I think of as a
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00:05:43,210 --> 00:05:46,360
multiplanar SMAS. In other words,
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00:05:46,780 --> 00:05:50,710
we're lifting the face in
multiple planes, the skin,
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00:05:51,160 --> 00:05:53,680
the connective tissue in the cheek area,
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00:05:54,460 --> 00:05:58,850
the connective tissue in the jowl
area, the superficial muscle,
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00:05:58,850 --> 00:06:03,140
the platysma muscle, which is
part of the SMAS in the neck.
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00:06:03,800 --> 00:06:08,720
And each of those components
can be both positioned and
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00:06:08,730 --> 00:06:11,510
shaped individually.
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00:06:12,500 --> 00:06:16,220
And I kind of feel that
that gives more flexibility,
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00:06:16,820 --> 00:06:21,380
and we know as the face ages that
different parts of the face shrink and
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00:06:21,380 --> 00:06:24,230
descend differently from each other.
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00:06:24,230 --> 00:06:29,180
So I feel that that better
allows correction of
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00:06:29,190 --> 00:06:34,130
what needs to be done in each
individual's zone rather than
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00:06:34,130 --> 00:06:37,910
being compelled to move everything as a
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00:06:38,120 --> 00:06:41,180
monounit or composite.
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00:06:42,230 --> 00:06:46,820
Can you talk about some of your unique
modifications to the technique and why
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00:06:46,820 --> 00:06:47,750
you choose to do them?
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00:06:48,290 --> 00:06:49,670
So one,
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00:06:49,670 --> 00:06:54,290
change in the face as we
age is a loss of projection
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00:06:55,400 --> 00:06:56,600
where shrinking,
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00:06:56,750 --> 00:07:01,460
losing bone muscle and fat volume
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00:07:01,490 --> 00:07:04,460
and skin and connective tissue is sagging.
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00:07:04,520 --> 00:07:08,960
So that tends to flatten the face and the
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00:07:08,960 --> 00:07:12,950
classic skin pulling techniques and
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00:07:13,580 --> 00:07:18,440
pull in more of a backward
direction tends to accent that
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00:07:18,440 --> 00:07:19,730
flattening effect.
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00:07:20,780 --> 00:07:25,370
So modern facelifts tend to involve
a more vertical component of
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00:07:25,370 --> 00:07:29,900
lift, at least at the skin
level. But in addition to that,
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00:07:29,900 --> 00:07:33,800
rather than pulling tissues
in a straight line direction,
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00:07:34,220 --> 00:07:39,110
I like to rotate the tissues
into position because that allows
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00:07:39,110 --> 00:07:44,090
greater flattening in areas that
you wanted like the gel area
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00:07:44,780 --> 00:07:49,580
while accenting the projection
in areas that you want and have
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00:07:49,580 --> 00:07:53,750
lost projection with
aging like the cheek area,
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00:07:53,810 --> 00:07:55,490
which flattens out over time,
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00:07:55,790 --> 00:07:59,750
rotating that into position
helps shape the face,
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00:08:00,050 --> 00:08:04,310
accent the projection and
restore youthful shape.
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00:08:05,330 --> 00:08:07,640
No two patients faces are the same,
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00:08:07,760 --> 00:08:10,460
which in turn means no two
facelifts are the same.
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00:08:11,000 --> 00:08:14,030
What kinds of variations are
made for individual patients?
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00:08:14,660 --> 00:08:18,530
That's a great question and
really a critical issue.
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00:08:19,520 --> 00:08:22,790
You said it exactly right.
No two faces are the same,
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00:08:22,790 --> 00:08:25,490
and no two facelifts
should be exactly the same.
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00:08:25,490 --> 00:08:30,350
Your facelift needs to be customized
to your individual facial features.
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00:08:31,280 --> 00:08:34,370
So this involves a lot of considerations.
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00:08:34,370 --> 00:08:36,470
So for example,
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00:08:36,530 --> 00:08:41,030
sometimes we're fat grafting
along with lifting and
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00:08:41,030 --> 00:08:42,290
tailoring the skin.
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00:08:42,590 --> 00:08:47,480
Sometimes we're doing very
conservative fat removal. For example,
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00:08:47,480 --> 00:08:52,370
in the gel area where there's an
excess of fat and we want a very
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00:08:52,370 --> 00:08:53,690
modest removal,
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00:08:54,620 --> 00:08:58,800
sometimes we add a chin
implant to alter the angle of
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00:08:59,040 --> 00:09:03,990
draping and get better
leverage on the re draping.
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00:09:05,100 --> 00:09:09,990
We also should shape
the cheek as part of the
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00:09:09,990 --> 00:09:14,130
facelift that again, typically
flattens and loses projection.
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00:09:14,550 --> 00:09:19,530
But how we're going to shape that
cheek depends on what you look like in
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00:09:19,530 --> 00:09:21,900
youth, what gender you are,
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00:09:22,170 --> 00:09:25,170
men's cheeks and women's
cheeks look differently,
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00:09:26,520 --> 00:09:30,750
what your ethnicity is and
your basic facial shape.
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00:09:30,780 --> 00:09:35,760
So that's all going to vary
what you're going to try to
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00:09:35,760 --> 00:09:38,070
produce. In the neck area,
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00:09:38,070 --> 00:09:41,730
there's a lot of variation in
what you do to tailor the muscle
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00:09:41,730 --> 00:09:46,680
layer in the neck based on what's
giving you a good response,
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00:09:47,100 --> 00:09:49,200
what that person's neck anatomy is,
150
00:09:49,230 --> 00:09:54,000
their bone anatomy and looking at their
muscle dynamics when they animate,
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00:09:54,540 --> 00:09:58,320
that's all going to affect what
techniques you choose to employ in that
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00:09:58,320 --> 00:09:59,640
individual facelift.
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00:10:00,780 --> 00:10:03,510
Let's look ahead at
what's to come. Tell us,
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00:10:03,780 --> 00:10:06,750
what is happening at the forefront
of facelift surgery today?
155
00:10:07,470 --> 00:10:10,650
So facelift surgery continues to evolve,
156
00:10:10,650 --> 00:10:14,910
and if we look at facelift
surgery from decades ago to
157
00:10:14,910 --> 00:10:19,560
today, it hasn't really
undergone revolutionary changes,
158
00:10:19,560 --> 00:10:24,030
but it's undergone literally
decades of evolutionary
159
00:10:24,040 --> 00:10:27,600
changes and these changes continue today.
160
00:10:27,600 --> 00:10:32,190
So people are working on further incision
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00:10:32,190 --> 00:10:35,100
reduction, so the incisions are shorter,
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00:10:35,130 --> 00:10:38,040
they're shorter now than
they were in the 1980s,
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00:10:39,060 --> 00:10:43,170
but they're looking at other
ways to further reduce incisions.
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00:10:44,550 --> 00:10:49,020
People are looking at ways of
limiting dissection to more focused
165
00:10:49,020 --> 00:10:52,140
areas rather than a
broad-based dissection,
166
00:10:53,580 --> 00:10:58,290
and they're looking at improved correction
in the neck with advanced muscle
167
00:10:58,290 --> 00:11:01,440
division techniques and
muscle repair techniques.
168
00:11:02,130 --> 00:11:06,750
And there's also a lot of examination
of ways to minimize recovery time,
169
00:11:06,750 --> 00:11:07,320
for example,
170
00:11:07,320 --> 00:11:12,120
looking at ways to
minimize bruising with the
171
00:11:12,300 --> 00:11:15,030
procedure so that recovery
time is shortened.
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00:11:16,080 --> 00:11:17,190
Lastly, Dr. Bass,
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00:11:17,190 --> 00:11:20,280
can you give our listeners some
parting takeaways from this episode?
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00:11:20,760 --> 00:11:23,460
Well, we said in the title,
175
00:11:23,610 --> 00:11:26,250
best facelift is a deep plane or SMAS,
176
00:11:26,250 --> 00:11:31,080
but both approaches can achieve
excellent results in experienced
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00:11:31,080 --> 00:11:33,960
hands. There is no best in that regard.
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00:11:34,530 --> 00:11:38,340
Each surgeon has refined what
they do to get excellent results,
179
00:11:38,340 --> 00:11:42,720
and an experienced surgeon
who has refined his or her
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00:11:42,720 --> 00:11:47,460
technique and customizes
it for each individual
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00:11:47,460 --> 00:11:48,293
patient,
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00:11:48,450 --> 00:11:52,890
that's more important to a great
result than the textbook application of
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00:11:53,230 --> 00:11:55,240
technique X or technique Y.
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00:11:58,480 --> 00:12:03,370
So overall, you need an experienced
surgeon who carefully assesses your needs,
185
00:12:04,690 --> 00:12:09,520
who plans with your concerns in
mind and customizes the plan for
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00:12:09,520 --> 00:12:12,880
your features. Not a
cookie cutter facelift,
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00:12:12,880 --> 00:12:16,870
but a custom facelift. Of course,
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00:12:17,050 --> 00:12:21,880
surgeons need to be meticulous and you'd
like to find a surgeon you're a good
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00:12:21,880 --> 00:12:25,510
fit with, that you feel
comfortable working with.
190
00:12:27,070 --> 00:12:27,940
Finally,
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00:12:28,450 --> 00:12:33,250
the really important area
in face lifting is getting a
192
00:12:33,250 --> 00:12:37,750
sharp defined jawline.
That's a very
193
00:12:37,750 --> 00:12:39,910
strong feature on a man's face.
194
00:12:39,910 --> 00:12:44,800
It's a very graceful
feature on women's faces and
195
00:12:44,800 --> 00:12:49,600
getting a clean and not saggy neck
196
00:12:49,660 --> 00:12:54,280
and the excellence and completeness of
the result in the neck is really where
197
00:12:54,280 --> 00:12:59,230
the money is in facelift in
terms of making you look younger
198
00:12:59,230 --> 00:13:03,640
because sagging or hanging
skin in the neck is an
199
00:13:03,640 --> 00:13:07,420
obvious feature of age and not
just a decade or two into age,
200
00:13:07,720 --> 00:13:10,840
but several decades into aging.
201
00:13:11,050 --> 00:13:15,910
And so cleaning that area
up, which I believe is
202
00:13:17,620 --> 00:13:21,670
the focus of SMAS techniques
and the ability to do that
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00:13:21,700 --> 00:13:25,330
zonally and multiplanar,
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00:13:26,410 --> 00:13:30,850
is really what the excellent
facelift is all about.
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00:13:31,600 --> 00:13:31,930
Thank you,
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00:13:31,930 --> 00:13:35,560
Dr. Bass for sharing your insight and
expertise with us about techniques in
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00:13:35,570 --> 00:13:36,910
modern facelift surgery.
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00:13:37,480 --> 00:13:41,170
Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.
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00:13:41,590 --> 00:13:43,810
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210
00:13:43,870 --> 00:13:45,190
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211
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212
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213
00:13:52,240 --> 00:13:53,830
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214
00:13:53,830 --> 00:13:57,850
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