Some surgeons say the results between SMAS and deep plane are identical? Other surgeons say deep plane is better and long lasting. It's so confusing for us prospective patients.
I’ve done both and no doubt deep plane is better. The only people who still like SMAS are those too scared to do deep plane. Just looking at trends at major meetings, SMAS lectures in the past 5 years occupy like 5% of the podium time. Almost every major thought leader has moved away from SMAS.
That was very helpful to understand, thank you. One day I may have the deep plane as I appreciate the principal of less pulling and working closer to the issue. For the time being I practice facial massage using thumb and forefinger working the same spot simultaneously to break up any tension.( Inside and out.) This has prevented some problems by encouraging circulation and a smoother appearance. The deep plane is ideal for when it becomes the desirable maintenance. :)
Excellent educational video thank you Doctor! I haven't found any other video on RUclips that fully explains the differences between High SMAS (not Classic SMAS) and the Deep Plane techniques.
Hi Dr Sam, love your opinions and channel. What are your thoughts on buccal fat removal? I’m in early 30s and they’re starting to sag into bulldog cheeks, but confused due to all the conflicting perspectives from other doctors.
Yes, this is a tough one. If you are seeing progressive thinning of the face, then I would be very careful to do it. If you have always had a very full face, especially in ethnic individuals who remain quite full overtime then buccal fat removal can be undertaken. I’m always on the more conservative side because once you have removed that precious fat, you can’t put it back in because normal fat does not look like buccal fat, does not work like buccal fat, so it is some thing that it would be on a case by case basis.
From an outsider, I personally wouldn't remove any fat from my face. It happens in your forties on its own. I always had round cheeks, now they are quite defined...purely with age.
if you are doing a secndary neck lift on a patient who had the giam pappa stitch plication suture in the first surgery,do you think it is difficult to remove the gortex cable or should it be left in? I would really like to remove it is possible. I am no a fan of this technique that was used on me in 2016.
@@Babygirl16457 no, they don’t need to be. Once you elevate the tissues into the new position, they scar down to the new place acting like new ligaments.
Dr. Sam, can buccal fat pad be reached with SMAS techniques? How is it done? this is what I found:"After skin elevation and SMAS flap elevation, the fascia that surrounds the buccal fat pad is opened up to take out the buccal fat". Thanks for your help
I'm looking around to do this but it's hard to know which are the skilled docs in Korea or Taiwan. Are there you know around asia pacific. It's pretty scary to see the botched jobs.
Dr i am going to get s deep plane but hrs siggested there epuld be Pickering and so an endoscopy to lift the brow and bring the scat higher in the hair line. What are your thoughts as now this doesnt sound like deep plane
Hi, I am a 48 year old man About to undergo deep plane surgery including eyebrow lifting (not with the endoscopic method) incisions behind the hairline The doctor tells me that I don't have to worry about hair loss because it is not going to damage the hair follicles. Is this even possible? Do I really need to worry about hair loss? I would love to receive an answer from you Do you recommend undergoing this facelift surgery despite its risks?
I can’t speak of this since I do this but of course there’s always risk for hair loss if you are elevating those tissues. In most cases, it’s temporary. You can use my Folliflo spray from Amazon to help manage hair shedding.
Hi Doc, I’m only 37 and I’m planning to get a SMAS lift coz of my middle face n jowls r sagging already.. not sure how long it will last so… I’m thinking maybe after 15-20 years I can get a deep plane lift.. what’s ur thought bout this?
I do only deep plane even for 30 some year olds or isolated deep necks if the neck is the problem. I’m just not a fan of the SMAS. I don’t think it does enough in any age.
Really helpful. Appreciate it! how about mid aged male patients who needs to avoid ear/front scars? Do you think deep plane techniques with endoscope could help without removing any skin?
@@FN_FN the ages were all over the place: late 30s, mid 40s, 50s, 60s, and 70s. I didn’t need to touch the sides in the 38 year old since the skin redraped and he didn’t need his jowls elevated.
Forever, minus further aging. The best way for me to phrase it is think if you have an identical, twin sister that in 10 years you should still look significantly younger than she does if you can control all variable like lifestyle, sun, exposure, stress, etc.
@@Dusankoa the ligaments prevent an elevation of the tissues. Once the ligaments are released, and you elevate the tissues, the tissues reattach in a higher position so you don’t need to re-approximate any ligaments. The scar tissue is what is creating the adhesion in a higher position.
THANKS DR SAM THIS THE BEST EXPLANATION I HAVE SEEN FOR THE FACIAL RETAINING LIGAMENTS
Thank you for the kind words
Some surgeons say the results between SMAS and deep plane are identical? Other surgeons say deep plane is better and long lasting. It's so confusing for us prospective patients.
I’ve done both and no doubt deep plane is better. The only people who still like SMAS are those too scared to do deep plane. Just looking at trends at major meetings, SMAS lectures in the past 5 years occupy like 5% of the podium time. Almost every major thought leader has moved away from SMAS.
@@samlammdThank you for the reply!
@@samlammd You forgot to mention the PRICE of the deep plane lift as opposed to the SMAS lift. The difference in price is big.
Do you noticed that people who have had ultherapy tend to have thinner tissues? Does it create problems when doing a deep plane face-lift?
@@staceyanderson8916 yes it can cause issues. So far I haven’t see a lot of ulthera patients but I highly discourage it for that reason.
That was very helpful to understand, thank you.
One day I may have the deep plane as I appreciate the principal of less pulling and working closer to the issue.
For the time being I practice facial massage using thumb and forefinger working the same spot simultaneously to break up any tension.( Inside and out.) This has prevented some problems by encouraging circulation and a smoother appearance.
The deep plane is ideal for when it becomes the desirable maintenance. :)
glad you enjoyed it and found it helpful
The deep plane is also more dangerous as it can cause permanent nerve damage!
Pray you find a skilled surgeon. It is very dangerous and could leave you paralyzed.
Excellent educational video thank you Doctor! I haven't found any other video on RUclips that fully explains the differences between High SMAS (not Classic SMAS) and the Deep Plane techniques.
Glad you gained benefit from it. :)
Hi Dr Sam, love your opinions and channel. What are your thoughts on buccal fat removal? I’m in early 30s and they’re starting to sag into bulldog cheeks, but confused due to all the conflicting perspectives from other doctors.
Yes, this is a tough one. If you are seeing progressive thinning of the face, then I would be very careful to do it. If you have always had a very full face, especially in ethnic individuals who remain quite full overtime then buccal fat removal can be undertaken. I’m always on the more conservative side because once you have removed that precious fat, you can’t put it back in because normal fat does not look like buccal fat, does not work like buccal fat, so it is some thing that it would be on a case by case basis.
From an outsider, I personally wouldn't remove any fat from my face. It happens in your forties on its own. I always had round cheeks, now they are quite defined...purely with age.
@@Corrans you are correct. However, many ethnic faces hold their fat much longer. You have to be very careful with white faces.
Thank you foto This explanation !!!! Very useful
if you are doing a secndary neck lift on a patient who had the giam pappa stitch plication suture in the first surgery,do you think it is difficult to remove the gortex cable or should it be left in? I would really like to remove it is possible. I am no a fan of this technique that was used on me in 2016.
I am planning on a lift . Are the ligaments reattached after you release them ? Thanks ☺
@@Babygirl16457 no, they don’t need to be. Once you elevate the tissues into the new position, they scar down to the new place acting like new ligaments.
@samlammd thanks for replying back. 🙂
How come some people ended up with more profound nasolabial folds after deep plane face lift?
Never seen that. Don’t know
Dr. Sam, can buccal fat pad be reached with SMAS techniques? How is it done? this is what I found:"After skin elevation and SMAS flap elevation, the fascia that surrounds the buccal fat pad is opened up to take out the buccal fat". Thanks for your help
Yes, I do it all the time. You have to be comfortable with the deep plane technique and the buccal fat is right there.
I'm looking around to do this but it's hard to know which are the skilled docs in Korea or Taiwan. Are there you know around asia pacific. It's pretty scary to see the botched jobs.
@@vern0018 sorry I don’t
What are your thoughts on deep plane neck combined with high SMAS facelift?
Yes, that’s good. I don’t think high SMAS vs low SMAS matters if you go to a good surgeon. There are arguments both ways.
Dr i am going to get s deep plane but hrs siggested there epuld be Pickering and so an endoscopy to lift the brow and bring the scat higher in the hair line. What are your thoughts as now this doesnt sound like deep plane
I don’t see that issue and I rarely do brow lifts.
Hi, I am a 48 year old man
About to undergo deep plane surgery including eyebrow lifting (not with the endoscopic method) incisions behind the hairline
The doctor tells me that I don't have to worry about hair loss because it is not going to damage the hair follicles. Is this even possible? Do I really need to worry about hair loss? I would love to receive an answer from you
Do you recommend undergoing this facelift surgery despite its risks?
I can’t speak of this since I do this but of course there’s always risk for hair loss if you are elevating those tissues. In most cases, it’s temporary. You can use my Folliflo spray from Amazon to help manage hair shedding.
Hi Doc, I’m only 37 and I’m planning to get a SMAS lift coz of my middle face n jowls r sagging already.. not sure how long it will last so… I’m thinking maybe after 15-20 years I can get a deep plane lift.. what’s ur thought bout this?
I do only deep plane even for 30 some year olds or isolated deep necks if the neck is the problem. I’m just not a fan of the SMAS. I don’t think it does enough in any age.
Really helpful. Appreciate it! how about mid aged male patients who needs to avoid ear/front scars? Do you think deep plane techniques with endoscope could help without removing any skin?
I’ve done 6 male facelifts last month with frontal ear incisions. I’m confident you won’t be able to find them when they heal.
@@samlammd Thank you for reply. What is the average age (roughly) of those men patients that you referred to?
@@FN_FN the ages were all over the place: late 30s, mid 40s, 50s, 60s, and 70s. I didn’t need to touch the sides in the 38 year old since the skin redraped and he didn’t need his jowls elevated.
How long does a deep plane last approximately?
Forever, minus further aging. The best way for me to phrase it is think if you have an identical, twin sister that in 10 years you should still look significantly younger than she does if you can control all variable like lifestyle, sun, exposure, stress, etc.
Does she have hypocalcemia? Looks like The Chvostek sign minutes 2:09, 2:41.
I don’t believe so
Do you reattach the ligaments after?
No no need to
@@samlammdcould you kindly expand?
@@Dusankoa the ligaments prevent an elevation of the tissues. Once the ligaments are released, and you elevate the tissues, the tissues reattach in a higher position so you don’t need to re-approximate any ligaments. The scar tissue is what is creating the adhesion in a higher position.
@@samlammd- so what happens to the ligaments? Does your body eventually dissolve them?
@@JustMe-px9qy once the ligaments are gone and you reposition the tissues higher then the tissues reaffix in a higher position.
❤ u doc
Not clear, Doc
Sorry
i think this cost over 85.000 but its ok for that i think
Please we want transelat this video to Arabic language
Thank you❤
WTF!!! Watch your language, young man!