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Deep Plane
Face and Neck Lift
The Deep Plane facelift, or deep plane face and neck lift, is an advanced evolution of the traditional facelift, designed to achieve natural, long-lasting facial rejuvenation. Performed by Dr Anas Gherissi in Tunis, this technique repositions the face's internal supporting structures rather than simply tightening the skin, producing a result that looks refreshed rather than "operated on".
The Principle of the Deep Plane Facelift
With age, the face changes in two ways: volume loss around the cheekbones and temples, and laxity of the deep supporting tissues. This shows up as deeper nasolabial folds, marionette lines, sagging cheeks, and excess skin along the jawline and neck.
The traditional, or SMAS, facelift lifts the skin, tightens the SMAS (Superficial Musculo-Aponeurotic System), and removes the excess skin — a technique that acts mainly at a superficial level. The Deep Plane facelift goes further: the skin, SMAS and deep cheek fat are mobilised together as a single composite unit, after releasing the ligaments that anchor the face at depth. This allows the surgeon to reposition facial volumes along a vertical vector, closer to the natural direction reversed by aging, rather than simply pulling the skin sideways.
- Natural result, without a "pulled" or overly tight appearance
- Long-lasting repositioning of facial volumes, not just skin removal
- Scars concealed within the hairline and around the ear
- Results generally last longer than a traditional SMAS facelift
This technique is suited to patients with moderate to significant facial and neck laxity, most often from around 45–50 years of age, as well as patients who have already had a facelift in the past and are seeking a further correction.
The Procedure
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Before Surgery
A thorough preoperative consultation with Dr Anas Gherissi allows an assessment of skin quality, the degree of laxity, and the patient's expectations. The surgeon explains the anesthesia, the expected postoperative course and the recovery period. Preoperative tests are requested, smoking cessation is recommended for several weeks before and after surgery, and anticoagulant or aspirin-based treatments must be suspended in agreement with the patient's physician.
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On the Day of Surgery
The Deep Plane facelift is performed in the operating theatre, under anesthesia suited to the procedure and to the patient's profile. The surgeon first marks the reference points on the skin. Small incisions are made along the hairline and around the ear, providing access to the deep facial plane. The supporting ligaments are released, and the skin-SMAS-fat composite unit is repositioned upward without excessive tension; the excess skin is then trimmed precisely before the incisions are closed. The procedure can be combined with a neck procedure (platysmaplasty) for complete rejuvenation of the lower face and neck.
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End of the Procedure
A light compression dressing is applied to limit swelling. Depending on the case, the procedure may be performed on an outpatient basis or may require a short overnight stay, as recommended by the surgeon.
Postoperative Follow-up and Recovery
The first few days after surgery are spent resting with the head elevated, using cold compresses to limit swelling. Some swelling and bruising are normal during this phase and gradually subside.
Sutures or staples are removed between day 7 and day 10. By around the second week, most of the swelling and bruising has settled enough to allow a return to social and professional activities. Strenuous physical activity should be avoided for around four to six weeks.
The result continues to refine gradually over several months, as the deep tissues settle into their new position and any residual swelling fully resolves; the final result is generally assessed between month 3 and month 6. Because the deep tissues are structurally repositioned, the effect of a Deep Plane facelift tends to last longer than that of a traditional skin-only facelift, with results that can remain visible for many years, varying from patient to patient.
A schedule of follow-up visits is arranged with Dr Anas Gherissi to monitor healing and confirm the favourable evolution of the result.
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