Facelift and Neck Lift

DPFL means that the cheek is elevated below the muscle and fascia layer known as the Superficial Musculo-Aponeurotic System or SMAS.

Deep plane dissection and elevation can allow for a more structured result, but being overzealous may cause an overly flat, tight contour and swelling for several months. There is also a risk of creating dimples or irregularities.

A thin face has a very thin SMAS layer, and it is usually safer to perform a plication of the SMAS rather than to attempt a deep plane approach.

DPFL, and indeed any facelift, will reposition fat that has descended off the cheekbone, but it will not add volume, which is why fat injection is so invaluable in restoring the facial volume lost with age and weight loss.

A thin face after a dramatic weight loss may have a very thin SMAS layer, and it is usually safer to perform a plication of the SMAS rather than to attempt a deep plane approach in these cases.

The platysma muscle is elevated in the neck and suspended with stitches at the back of the neck in the crease beneath the angle of the jaw, just below the earlobe, to create a youthful jawline.

No. These bands are caused by the front edge of the platysma muscle splitting apart. They are known as platysmal bands and they are responsible for loss of the youthful angle between the chin and the neck, which is a hallmark of a youthful neck.

Neither a DPFL nor a neck lift increases chin projection. However, both help to define the chin. Aging may lead to flattening of the lower half of the front of the chin and/or descent of chin fat, resulting in a witch’s chin deformity. This may be further exaggerated with a dropping nasal tip, loss of bone in the jaw and fat loss with thinning of the lips.

A DPFL will help to improve jowls and the lines that extend from the angle of the mouth into the neck, also known as marionette lines.

No, DPFL does not affect the buccal fat pad. This can be removed through a DPFL approach, but I prefer to remove it through a separate incision inside the mouth, which gives me direct access to the fat with less risk of injury to small branches of the facial nerve.

No, a DPFL does not elevate the eyebrows, although the upper part of a facelift may lift the outer third of the eyebrow, but this is not in the deep plane.

No. An endoscopic brow lift is performed in the subperiosteal plane, which is deeper than the deep plane. Brow lifting is performed through incisions in the scalp and elevates the brows.

No. The upper lip often lengthens with age and is a marker of aging.

No. A DPFL does not add volume and is usually combined with fat injections to the cheeks, chin, and lips.

No, bags under the eyes and excess skin in the upper eyelids are not corrected with a DPFL. Bags under the eyes are due to fat that has herniated forwards. Lower eyelid lifts will help to remove and reposition fat in the lower eyelids. Excess skin of the upper eyelids may be corrected with a brow lift but usually requires removal of skin of the upper eyelid.

There is no set age, but the most natural results are generally achievable between 45 and 65, before signs of aging take over. Dr. Kirwan achieves beautiful results in patients into their 80s, and increasingly sees patients seeing a plastic surgeon for the first time later in life.

Generally no. “Mini,” “lunchtime,” or short-scar facelifts tend to give minimal results of minimal duration. Dr. Kirwan performs a mini-facelift only as a secondary procedure to correct skin relaxation after a standard facelift.

Almost all facelifts are performed under local anesthesia with conscious sedation. Compared to general anesthesia it offers more stable blood pressure, a significantly lower risk of hematoma, less nausea, a quicker recovery, and no sore throat from a breathing tube.

Yes. Every patient is a VIP. From your first consultation through your last follow-up visit, you see Dr. Kirwan himself at every single appointment. He is available to you before, during, and after your procedure.

Most procedures are performed under local anesthesia with conscious sedation in Dr. Kirwan’s AAAASF-accredited surgical suite in Norwalk, Connecticut. Patients unsuitable for conscious sedation for medical or other reasons are treated at Greenwich Hospital / the Leona M. and Harry B. Helmsley Ambulatory Surgical Center, or Sasco Hill Surgery Center in Southport. The practice confirms the facility and anesthesia plan for each patient.

Candidacy depends on your health, anatomy, and goals, not a specific age. The only way to know for certain is a one-on-one consultation, where your medical history and aesthetic goals are reviewed and the appropriate options are explained.

Use the form on this page or call the practice at (203) 838-8844. Every consultation is a one-on-one evaluation with Dr. Kirwan.