Short Scar Deep Plane Facelift: When Less Is More

Patient Overview

• Patient: Feradov

• Age: 53

• Gender: Female

• Procedures: Short scar deep plane lower face and neck lift, upper blepharoplasty

• After photos taken at: 1 month post-op

• Origin: United States

• Location: Istanbul, Turkey

The Procedure That Was Cancelled — And Why That Matters

Feradov's case begins with a decision not to operate. During virtual consultation from the United States, the initial plan included a full deep plane facelift with a browlift and upper blepharoplasty. When Feradov arrived in Istanbul for her face-to-face consultation, Dr. Cem Berkay Sinaci, a fellow of the European Board of Plastic Reconstructive and Aesthetic Surgery (FEBOPRAS) and member of ISAPS and ASPS, re-evaluated her anatomy under clinical examination conditions — assessing her brow position, skin elasticity, and the dynamic relationship between her brow and upper eyelids with direct observation rather than through a screen.

The conclusion was clear: Feradov's brow position was acceptable. The heaviness she perceived around her eyes was primarily due to upper eyelid skin excess rather than brow descent. Adding a browlift would have over-corrected, potentially creating an elevated or surprised brow position that did not match her natural facial proportions. The browlift was cancelled, and the surgical plan was refined to a short scar deep plane lower face and neck lift with upper blepharoplasty alone.

This decision illustrates a principle that defines responsible surgical planning: the best operation is sometimes the one you do not perform. A surgeon who recommends fewer procedures after examining the patient in person — even when the patient has already agreed to more — is demonstrating a commitment to the result rather than the revenue. For a detailed discussion of how facelift planning affects long-term outcomes, read: Facelift Longevity: The Realities.

Short Scar Minimal Access Deep Plane Technique

The short scar approach used for Feradov's facelift concentrates the incision around the front of the ear and into the temporal hairline, avoiding the longer scar that extends behind the ear and into the occipital hairline in a traditional facelift. This reduced incision footprint is possible when the degree of skin excess — particularly in the posterior and inferior neck — does not require the additional access that a full-length incision provides.

For Feradov at 53, the ageing changes were concentrated in the lower face and anterior neck — jowling along the mandibular border, loss of jawline definition, and early cervical laxity. The posterior neck skin was not significantly redundant, making the short scar approach appropriate. The deep plane dissection beneath the SMAS layer was performed through this more limited access, releasing the retaining ligaments and repositioning the descended jowl and lower facial tissue exactly as a full-length incision would allow in the targeted zones.

The advantage for the patient is a reduced scar burden without compromising the quality of the deep tissue correction. Not every patient is a candidate — more advanced laxity, particularly in the posterior neck, may necessitate the additional access of a traditional incision. Having trained in advanced facial rejuvenation through fellowship with Raul Gonzalez in Brazil and cadaver dissection courses in Bangkok, Dr. Sinaci selects the incision design that each individual anatomy requires rather than applying a single approach universally.

The Deep Plane Difference in the Lower Face

The deep plane technique works beneath the superficial musculoaponeurotic system, elevating the SMAS along with the overlying fat and skin as a single composite flap. For the lower face specifically, this means the jowl fat pad — which has descended below the mandibular border with gravity and ligament loosening — is physically repositioned back to its original location above the jawline. The result is a defined mandibular contour achieved through tissue repositioning rather than skin tension.

This distinction has practical implications for the longevity of the result. Skin stretches over time — it is one of the fundamental properties that causes facial ageing in the first place. A facelift that relies on skin tension for its correction is inherently fighting against biology. The deep plane approach, by anchoring the lift to the more structurally robust SMAS layer, creates a result that is not dependent on the skin maintaining tension. The skin simply redrapes over the corrected deeper framework, sits without strain, and ages from this new position at the normal biological rate.

Upper Blepharoplasty: The Right Procedure for the Right Problem

With the browlift appropriately cancelled, Feradov's upper eyelid concern was addressed through blepharoplasty alone. The excess skin that was creating a hooded appearance was removed through an incision within the natural eyelid crease. Because the brow was in an acceptable position, the amount of skin removed could be precisely calibrated to the true eyelid redundancy — without the confounding variable of brow-related tissue displacement that would have required a different calculation.

Non-dissolvable sutures were used for the closure, removed at four to six days. These generate minimal inflammatory reaction in the thin eyelid skin, producing a finer scar line than dissolvable alternatives. At one month, the incision is already settling into a fine mark within the crease, well on its way to becoming imperceptible.

Reading the One-Month Result

Feradov's before and after photographs at one month show a result in the late-early phase of maturation. The structural correction is fully apparent — the jawline is defined, the jowling is corrected, the neck contour is improved, and the upper eyelids are open and refreshed. These changes are permanent and represent the foundation of the final result.

What will continue to evolve over the next two to four months is the refinement around the edges. Residual firmness along the jawline and in front of the ears will soften as the deep tissue healing completes. Any subtle swelling that is perceptible to the patient but not obvious in photographs will resolve. The scars will continue to fade from their current early maturation phase. By four to five months, the result will be fully settled.

When Virtual and In-Person Consultations Differ

Feradov's experience highlights why in-person examination remains essential in facial surgery planning, even in an era of high-quality video consultations. The virtual consultation established the general direction — facial rejuvenation addressing the lower face, neck, and eyes — and allowed Dr. Sinaci to form an initial assessment. But the specific surgical plan was finalised only after hands-on clinical examination in Istanbul.

Brow position, in particular, is difficult to assess accurately through a screen. Lighting, camera angle, and the patient's unconscious tendency to raise their brows slightly when being observed can all create a misleading impression of brow ptosis. Direct examination, including assessment of brow position at rest, the relationship between the brow and the superior orbital rim, and the pinch test of upper eyelid skin, provided the information needed to make the correct decision — that a blepharoplasty alone would achieve the desired eye area improvement without the risks and recovery of unnecessary brow surgery.

American Patients Choosing Personalised Facial Surgery in Istanbul

For international patients considering facial rejuvenation in Turkey, Feradov's case offers a reassuring message: the surgical plan is not fixed at the point of booking. A responsible surgeon will re-evaluate the plan at the in-person consultation and modify it — including reducing the scope of surgery — if the clinical assessment indicates that a less extensive approach will produce the optimal result. This patient-first philosophy, combined with board-certified expertise and accredited surgical facilities, is what distinguishes a thoughtful practice from one that simply performs whatever the patient has been quoted.