Deep Plane Facelift Turkey Before and After:A 47-Year-Old Patient from Estonia, One Month On

The Patient's Goals

This 47-year-old woman from Estonia came to AKM Clinic with sagging of the face and neck and with drooping of the upper eyelids. Neither is unusual in the late forties. Together, however, they meant the change was not confined to a single area. The lower face and neck and the upper face were both contributing to how she looked, and the plan had to take account of each.

In surgical terms, sagging of the face and neck is a problem of support, not of skin alone. As the deeper soft tissues of the cheek and jaw descend, the jawline loses its edge and the transition from chin to neck softens. Treating only the skin of such a face leaves that descent where it is. The depth of the lift was therefore the central planning question for the face and neck.

The upper eyelids were a separate matter. A face and neck lift acts on the cheek, jawline and neck; it does not reach the eyelids. Had the drooping lids been left untreated, a lifted lower face would have sat beneath an unchanged upper face. That is why the eyelids formed part of the same plan.

Surgeon's Expert Approach

Assessment

The assessment centred on the concerns she had come with: sagging across the face and neck, and drooping of the upper eyelids. In such a case the questions that matter are which tissue layer the change sits in, and which areas a given operation actually reaches. Those questions determined the combination of procedures.

Why a deep plane face and neck lift

Sagging caused by descent of the deeper facial tissues is corrected at that depth. A deep plane facelift works beneath the SMAS, the fibromuscular layer that carries the soft tissue of the cheek and jowl. The descended tissue is returned as a single unit, rather than the skin being pulled over it. Skin-only tightening risks a stretched look while the descent beneath remains. Working at depth avoids that compromise.

The neck belongs in the same operation because, anatomically, face and neck are continuous. The SMAS of the lower face runs into the platysma, the thin muscle sheet of the neck. Lifting the lower face above an unchanged, sagging neck would create a visible step at the jawline. Treating both as a continuous unit keeps the line from cheek to jaw to neck coherent.

Why upper eyelid surgery

A facelift does not reach the upper eyelid. Its lifting vectors act on the cheek, jawline and neck, so the drooping upper lids would have remained exactly as they were. Upper eyelid surgery dealt with the other area she had come with. The upper and lower face were treated together, rather than one being corrected and the other left behind.

How the techniques work

• Deep plane facelift: Through incisions placed around the ear, the surgeon enters the plane beneath the SMAS. The retaining ligaments that tether the descended tissue, such as the zygomatic and masseteric ligaments, are released there. Skin, fat and SMAS then move together as a composite flap and are repositioned. Because the deeper layer carries the support, the skin is closed without tension.
• Neck lift: The platysma is tightened and repositioned, laterally towards the area behind the ear and, where needed, centrally through a small incision beneath the chin. This redefines the line between jaw and neck.
• Upper eyelid surgery: The incision lies in the natural crease of the upper lid, where the scar is concealed when the eyes are open. Excess skin is removed, and where indicated a strip of muscle or fat. When the droop involves the lid margin itself rather than the skin above it, the muscle that raises the lid is addressed instead. Distinguishing these situations is part of the eyelid examination.

Doctor's note

A deep plane face and neck lift and an upper eyelid procedure were performed in May 2026, and recovery was uneventful. The after photographs were taken one month after surgery. At that stage a face and neck lift is still within its healing period, and the tissues continue to settle over the following months.

The patient was operated on by Op. Dr. Göknil Gültekin.