Do I Need A Deep Plane Facelift For My Facial Transformation?

Q: Dr. Eppley, I am a young male, reaching out to inquire about Dr. Eppley! I’m a big fan of his work and believe his aesthetic eye matches my express transformational goals of a contoured, chiseled, slim face, jawline and neck. For context, I have a genetic chipmunk face and neck, despite being an athlete with <10% body fat. After doing diligent reading and studying, I am interested specifically in the following: 1. Aggressive cheek, jaw, jowls and submental liposuction 2. Deep plane neck lift / sub-platysmal work 3. Chin augmentation (Custom 3D-printed implant) 4. Buccal fat removal I had Orthognathic surgery with Sliding Genioplasty, I’ve attached photos for the Dr. in case they are helpful! Thank you so much for your help and consideration. 

A:Thank you for your inquiry and sending your picture. With your type of facial shape and degree of lipodystrophy it is challenging to create defined facial shapes.  As you have correctly surmised it is going to take a combination of skeletal augmentations and fat reductions to make the best possible improvement. I think, however, the ratio of the distributions between augmentation and defatting is a bit imbalanced in the plan you have propose. The key to remember is you cannot reduce a face for great definition. You have to have good definition to start or create it so that the reductions can more fully show the underlying structure. Well it is true that you need significant fat reductions via a submentoplasty, buccal lipectomies, perioral/lateral facial liposuction, and buccinator myectomies but these are really ancillary procedures to try to reveal more of what lies underneath. This is why you really need a wraparound jawline implant to more clearly separate the face from the neck and not just a chin augmentation alone. Beach and augmentation would certainly be beneficial but it only affects the project import of the chin I’m is not going to help anything with the structure behind.

The role of the deep plane facelift is very dubious in your case. I see a lot of young people believe that procedure is going to create create better facial definition when in fact it really won’t. It follows the basic principle that you cannot soft tissue reduce your way into better facial definition, you have to have it to start with.  It is also important to remember that facelift surgery is based on having loose tissues which can be mobilized, relocvated and resuspended . In young people however that is rarely the case and the degree of improvement from it is far less. In other words it’s a lot of effort for a very limited benefit. That is a procedure that I would put as secondary and have all of the other things done first and then judge whether there’s some benefit to the procedure. The question is not whether hey deep playing facelift can be done but whether that degree of effort is worth it

Dr. Barry Eppley

World-Renowned Plastic Surgeon