| Technical term | Facelift, deep-plane lift, HighSMAS lift |
|---|---|
| Goal | Rejuvenation of the face and neck (see also Neck lift) |
| Duration | approx. 5 to 7 hours, depending on effort |
| Anaesthesia | General anaesthesia |
| Hospitalisation | At least 1 overnight stay |
| After the operation | Wash hair, shower and bathe after removing the drains and head bandage after 1 - 2 days; Make-up after approx. 1 - 2 weeks; Hair colouring and perms after approx. 6 weeks; Sport and heavy physical labour after approx. 6 weeks; Sunbathing, visits to the solarium, sauna and steam bath after approx. 6 months; |
| Pain | Low to medium |
| Aftercare | Removal of the drains and the head bandage after 1 to 5 days; Stitches, staples and plasters are removed after 7 to 14 days; Accompanying lymphatic drainage; 2 to 4 wound healing checks; |
| Scars | Barely visible scars on the ear and hairline |
| Social and labour skills | After approx. 3 to 4 weeks (very individual) |
| Durability | 10-15 years |
| Risks | Asymmetries and mask-like facial expression; Injury to nerve tracts with local signs of paralysis; Injury to hair roots; Shifting of the hairline; Hair loss at the sites of the small skin incisions; Dying off of skin (necrosis); Unsightly scarring; General operational risks; |
| Side effects | Swelling; Bruising; Temporary numbness; Feeling of tension; Sensory disturbances; |
The facelift is a very popular method. In recent years in particular, the number of facelifts performed worldwide has increased enormously. Since 2019, there has been an increase in facelift operations of around 45 % worldwide (source: ISAPS Global Survey 2023). One of the reasons for this is that the methods we use are leading to ever better results that satisfy our patients. In this context, a buzzword has taken over the internet and gone viral in recent years: the deep plane facelift.
As there is a lot of confusion about the meaning of this term and the techniques behind it, Dr Noack believes it is important to explain the facelift, the background, the techniques and the best method for a deep plane SMAS facelift in more detail.
In the mid-1970s, the SMAS lift technique was first described by Swedish plastic surgeon Tord Skoog, which involves lifting a layer of tissue, known as the "apex". Superficial-MuskuloAponeurotic-Systems, between the skin and the muscles of the face.
The technique was a breakthrough compared to previous facelifts, which only pulled at the skin, and led to softer, more natural and more lasting results. The technique spread from Europe to the USA in the mid-1980s.
There, the plastic surgeon Sam Hamra gave this technique a new name with minimal modifications: Deep Plane - Facelift(Journal: PRS, July 1990"Deep plane rhytidectomy"). Some problems and limitations of this deep-plane facelift technique soon became apparent, so that this form of SMAS facelift began to develop further with improved techniques.
The vectorial train of the Deep-plane facelifts in the direction of the ears (Fig. 1) produced unnatural results, distorting the face too much to the side.
As the tissue in the face sinks downwards as it ages, the correct regenerative restoration for a natural facelift therefore requires a vectorial pull upwards (Fig. 2).
It was not until many years later (Journal: PRS, July 2016) that Sam Hamra modified his technique of Deep Plane Facelifts through a vertical vector and henceforth called the procedure composite rhytidectomy (composite facelift). This technique never caught on. Plastic surgeons Fritz Barton and Bruce Cornell recognised the problems in the late 1990s and modified the original deep-plane technique in favour of an improved, biomechanical effect, known as the high-SMAS technique.Facelift.
The main difference was an improvement in the lifting of the midface (the area below the eyes, directly next to the nose and above the corner of the mouth, Fig. 3) and a better separation of the "skin" and "SMAS" tissue layers from each other. This prevented results that looked unnaturally pulled ("Joker Face" or Joker "Smile"). The plastic surgeon Richard Warren from the USA founded a similar technique known as the MAPS lift. The Belgian surgeons Patrick Tonnard and Alex Verpaele developed the MACS lift in parallel, which uses the same vectorial traction of the SMAS tissue layer, but with less risk to the nerves of the face due to the technical design.
Facelift expert Dr Noack
Dr Niklas Noack is a renowned specialist in plastic and aesthetic surgery, awarded by the Berlin Medical Association. In order to receive this prestigious title, he had to fulfil numerous requirements. These included a successfully completed degree in human medicine, a licence to practise medicine, regular further training in his specialist field and proof of having performed at least 800 independent operations under the guidance of an experienced plastic surgeon. Since obtaining his specialist title in 2008, Dr Noack has successfully performed over 5,000 operations.
Dr Noack also holds a certificate of continuing medical education (CME) from the Berlin Medical Association, which is renewed every five years. This certificate serves as proof and confirmation of continuous medical quality assurance and demonstrates his commitment to the highest treatment standards in his practice.
Nowadays, the facelift is an internet phenomenon, especially in terms of labelling. The term Deep Plane or Extended Deep Plane Faceliftis the most popular on the internet. Patients mistakenly associate it with a more extensive, improved, more natural effect of this facelift technique compared to others. However, the term is also widely used by surgeons.each other, and everyone seems to be Deep Plane Faceliftto understand something different and to carry it out yourself. The term has thus become detached from the original techniques.öand is used more as a sales argument. Due to the history described above, no one performs a classic deep-plane facelift anymore. The most honest description of a deep-plane facelift is that the facelift is not only performed directly under and with the skin, but also in and with deeper layers of the face.
Which specific technique is best is a matter of great debate. Especially because even we plastic surgeons cannot judge which technique is best.öWhen we look at a facelift result from the outside, we can see the exact technique used. Contrary to theöPublic perception has different facelift-techniques have much more in common than the media, advertising and surgeons would have us believe.
And so it is möPerhaps this one piece of the puzzle, which aFacelift makes a good facelift and brought about a paradigm shift: fat tissue injection. This has been known at least since the early studies by Val Lambros (Journal: Clin Plast Surg 1992) on the loss of volume in fatty tissue during the ageing process in the face.
As we age, our skin, facial volume and bone structure change. The biggest part of this is deflation, i.e. the loss of volume, as if you let some air out of a bulging balloon. The skin of the balloon then develops wrinkles and dimples. The injection of autologous fat tissue during facelift surgery compensates for this loss of volume, particularly in the regions of the eyebrows and temples, the lower eyelids, the midface and the jawline and, when applied correctly, makes every Facelift technique for a better, natural facelift.
In addition, different preparations of fatty tissue (microfat, nanofat) bring additional stem cells to the affected regions, which in turn leads to a natural regeneration boost and has a positive effect on the metabolic processes of ageing tissue.
Dr Noack is convinced of the synergistic effects of Deep-plane techniques and the Autologous fat treatment in the same procedure convinced and applies both in almost 100% of its operations to.
A facelift can be thought of as a kind of modular system. In the narrower sense, the term facelift is used in specialist circles to mean a tightening of the cheeks and, in the best case, the midface region. If one or more other regions, such as the forehead, eyebrows, upper and lower eyelids, lip, chin, neck and jawline are also treated, this is also referred to as a full facelift.
Dr Noack will discuss the necessity of individual measures with you in a detailed consultation,öand your own wishes are at the forefront of the planning process which are, due to the complexity of these operations,essential.
Dr Niklas Noack uses deep-plane facelift methods and techniques to meet the individual needs of his patients. By combining these procedures, he achieves optimal natural results that are tailored to the unique wishes and conditions of each patient. Here we clarify some terminology:
SMAS (Superficial Musculo Aponeurotic System) Lifting: Tightening of the SMAS tissue layer in the face using so-called SMAS plicatures, which ultimately corresponds to a tightening of the SMAS.
Deep-plane lifting: refers to an SMAS lift in the deeper layers of the face, i.e. the SMAS is lifted and mobilised, not just tightened. The decisive factor here is the loosening of the so-called retaining ligaments under the SMAS in order to maintain a great deal of variability for a natural tightening during the operation. Dr Noack prefers the HighSMAS technique as a deep-plane facelift, which was popularised by the internationally renowned American facelift specialist Dr Timothy Marten from San Francisco.
Midfacelift:Lifting of the cheek area under the eyes and next to the nose (the midface) to correct volume loss, sagging cheeks and the nasolabial fold. Often part of a facelift.
Temporal lift (brow lift, gliding brow lift): Tightening of the temple region to improve the lateral eyebrow position and reduce wrinkles at the temples.
Endoscopic or open forehead lift: Lifting and smoothing of the forehead skin to reduce forehead wrinkles and lift the eyebrows.
Face-neck lift or neck-jowl lift:Combined tightening of the face and neck using deep-plane techniques to achieve a harmonious and rejuvenating effect on the entire appearance, including the jawline (Jawline).
Deep-plane neck lift or deep neck lift: Tightening of the skin and muscles in the neck area to improve the contour of the jawline and neck and to reduce wrinkles and sagging skin. The individual anatomical characteristics of the neck are taken into account and any necessary treatment of the platysma muscles, the fatty tissue, the digatricus muscle and the submandibular gland is carried out to achieve the best possible result.
Endolift: This laser-assisted method is not a surgical facelift in the true sense of the word, but a technique for achieving shrinkage and fat reduction by applying heat to the tissue. The Endolift is performed without surgery under a light local anaesthetic and with minimal downtime.
The success of a facelift depends largely on thorough preparation and individualised planning. Dr Niklas Noack attaches great importance to providing his patients with comprehensive advice and responding to their individual wishes and needs. The procedure and preparation are divided into several steps:
Performing a deep-plane SMAS facelift requires the utmost precision and careful planning. Dr Niklas Noack ensures that you receive the best possible care and attention during the procedure. Here you will find information on the duration, anaesthesia and incision and technique guidance:
An important aspect of a facelift is careful aftercare to prevent possible risks and achieve the best possible results. Dr Niklas Noack accompanies his patients after the procedure and ensures that their recovery is optimal. The following topics are covered:
The testimonials and feedback from our patients are extremely valuable to us. They offer an authentic insight into the work of Dr Niklas Noack and illustrate how impressive the results can be under his expert care.
In Germany, it is forbidden for doctors to advertise with before and after pictures. Nevertheless, you can see the impressive results for yourself during your consultation appointment at the practice and get an idea of Dr Noack's work.
The cost of a facelift can vary depending on individual needs and the techniques used. Dr Niklas Noack attaches great importance to transparent pricing and offers his patients various financing options:
To take the first step towards a rejuvenated appearance, we cordially invite you to contact us and arrange a consultation. Dr Niklas Noack looks forward to getting to know you personally and working with you to develop the optimal treatment plan.
Many questions can arise when deciding to have a facelift. Dr Niklas Noack answers some frequently asked questions here to help you get started. If you have any further questions, please do not hesitate to contact us or arrange a personal consultation.
As with any surgical procedure, there are certain risks involved in a facelift. These include infection, bleeding, swelling, numbness, permanent nerve damage, scarring and asymmetry. During your consultation, Dr Noack will inform you in detail about possible risks and give you advice on how to minimise them.
A facelift is suitable for men and women who suffer from signs of ageing and want a firmer, fresher and perhaps slightly more youthful appearance. It is important that you are in good health and have realistic expectations of the results of the procedure. During the consultation, Dr Noack will assess your suitability for a facelift and suggest alternative treatments if necessary.
The decision to have a facelift is an important step and we would like to support you in your decision as best we can. To arrange an individual consultation with Dr Niklas Noack, please use one of the following options:
Click on the "Arrange a consultation appointment now" button to go directly to our online booking system.
Our practice is located in:
Alte Schönhauser Straße 23
10119 Berlin
Our opening hours are from Monday to Friday from 10:00 to 17:00. We look forward to getting to know you personally and accompanying you on your way to a firmer and more aesthetic tummy.
Treatments Head & neck
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