From Colorado to Istanbul: Anita's Deep Plane Facelift
Anita, 53, flew from Colorado to Istanbul for a deep plane face and neck lift, brow lift, fat grafting and CO2 laser. Her day 24 results.
Patient: Anita | Age: 53 | From: Colorado, USA
Procedures: Deep Plane Face & Neck Lift · Endoscopic Brow Lift · Submental Platysmaplasty · Microfat + Nanofat SVF Fat Grafting · Fractional CO2 Laser Skin Resurfacing
Surgeon: Dr. Cem Berkay Sinaci (Dr. CBS) — Istanbul, Türkiye
Follow-up shown on this page: Day 24 post-op — video testimonial and before and after photographs, filmed in Istanbul
From Colorado to Istanbul: Anita's Deep Plane Facelift
Twenty-four days before this video was filmed, Anita flew from Colorado to Istanbul for a single-stage full face rejuvenation with Dr. CBS: an extended deep plane facelift with complete facial retaining ligament release, a deep neck lift with submental platysmaplasty, an endoscopic brow lift, combined microfat and nanofat SVF fat grafting, and fractional CO2 laser skin resurfacing — all in one operation, under one anaesthetic.
Most facelift before and after photographs you find online are taken at six months or a year, when everything has settled and the swelling is a memory. Anita's are not. The photographs and the testimonial on this page were recorded on day 24 — three and a half weeks after surgery, while healing is still actively under way. That is deliberate. "Deep plane facelift recovery day by day" and "what does a facelift look like at 3 weeks" are two of the most searched questions in facial surgery, and they are almost never answered honestly with real images. This is what an honest answer looks like.
Why Anita Travelled from Colorado to Istanbul for a Facelift
At 53, Anita described the problem the way most facelift patients do: the structure of her face had changed, and no amount of skincare, filler or effort was reaching it.
Jowls had formed on either side of a jawline that had been sharp into her forties. Her cheeks had flattened while the tissue that used to sit on them had slid downward, deepening her nasolabial folds. Her neck had lost its angle — platysmal bands showed whenever she turned her head, and there was fullness under the chin that had nothing to do with her weight. Her brows had dropped, pressing her upper eyelids down into a heavy hood, and the frown lines between them had become permanent. And her skin carried the signature of twenty-five years at altitude: Colorado sits high, the UV index is brutal, and the air is dry. Fine lines around her mouth, enlarged pores across her cheeks and uneven pigmentation had all arrived early.
"People kept telling me I looked tired or angry when I felt neither," Anita says. "That's what finally did it. It wasn't vanity. It was that my face had stopped saying what I was actually thinking."
She started, as almost every international patient does, with search. Deep plane facelift before and after. Deep plane facelift vs SMAS facelift. Best age for a facelift. How long does a deep plane facelift last. Deep plane facelift cost. Facelift in Turkey reviews. She consulted two surgeons in Denver and one in Scottsdale before she looked outside the United States at all.
"The American quotes ran from forty-five to eighty thousand dollars once the neck, the brow and the laser were added in," she says. "That's real money, but it wasn't the deciding factor. The deciding factor was that when I asked whether they release the retaining ligaments, I got two vague answers and one 'we don't really need to go that deep.' Dr. CBS drew the ligaments for me on a screen and explained exactly which ones he releases and why. That's a different conversation."
What closed it was the before and after gallery. "No windswept hairlines. No pulled mouth corners. Nobody with that shiny, wind-tunnel look. They looked like themselves — just the version from ten years earlier. That specific look is what I was shopping for, and it is genuinely hard to find."
The Online Consultation: Planning a One-Stage Face, Neck and Brow Lift
Anita's first consultation was a video call. Dr. CBS assesses a face in layers, and the surgical plan comes out of that assessment rather than from a menu of procedures.
"Four things age, and they age independently," Dr. CBS explains. "The skin envelope. The fat compartments. The SMAS and platysma muscle layer. And the bone and dental support underneath. A facelift only treats one of those four. If you tighten the muscle layer and ignore lost volume and skin quality, you get a tighter version of a tired face — which is exactly the result nobody wants and exactly the result that makes people say they can always tell."
For Anita, that assessment produced one combined operation rather than a staged series — which matters enormously for a patient flying from the Rocky Mountains, because it means one anaesthetic, one recovery and one trip:
Extended deep plane facelift — full facial retaining ligament release, repositioning the midface, jowls and jawline at the structural level
Deep neck lift with submental platysmaplasty — rebuilding the cervicomental angle from the muscle layer outward
Endoscopic brow lift — short incisions behind the hairline, no coronal scar, hairline not moved
Microfat and nanofat SVF fat grafting — volume restoration and skin regeneration, performed as two separate steps
Fractional CO2 laser skin resurfacing — for the altitude sun damage, perioral fine lines and pore quality that surgery cannot touch
Notably, Anita did not have eyelid surgery. She had expected to need an upper blepharoplasty and had budgeted for it.
"Her hooding was brow descent, not eyelid skin," Dr. CBS says. "If I had removed upper eyelid skin from that face, I would have fixed the hood and created a hollow, over-operated eye ten years from now. Lift the brow to where it belongs first and the eyelid frequently needs nothing at all. Deciding what not to do is half of facial surgery."
"He took a procedure off my plan and off my invoice," Anita says. "That had never happened to me in a consultation before."
Inside the Surgery: An Extended Deep Plane Facelift with Full Ligament Release
The extended deep plane facelift is the operation that defines Dr. CBS's practice, and what separates it from every older technique is what happens to the facial retaining ligaments.
The face is tethered to the skull and jaw by fibrous ligaments — the zygomatic ligaments over the cheekbone, the masseteric cutaneous ligaments along the masseter, and the mandibular ligament at the jawline. With age the soft tissue slides down while those anchors stay put. That is exactly why folds and jowls form where they do: the nasolabial fold and the jowl are not random, they form at ligament boundaries.
"In Anita's operation I released every one of those retaining ligaments — zygomatic, masseteric cutaneous and mandibular," Dr. CBS says. "That is what the word extended means in extended deep plane facelift. Until those ligaments are released, the tissue physically cannot move. If you pull without releasing, you are not lifting a face — you are stretching skin over a face that is still falling. That is where the operated look comes from, and it is also why those results relapse so quickly."
Once released, the SMAS and the overlying skin are elevated together as a single composite flap. They are never separated from one another. That one technical decision preserves the skin's blood supply — which is what makes same-session CO2 laser resurfacing safe — and it is what gives a properly executed deep plane result its soft, unstretched quality.
The flap is then repositioned along two deliberate vectors, and this is where a jawline is won or lost.
"In the face I lift vertically, straight up against gravity, because that is the direction the tissue fell," Dr. CBS explains. "In the neck the vector changes: there I lift more horizontally, backwards toward and behind the ear. Those two vectors together are what give a sharp, snatched jawline without a windswept face. A single direction of pull cannot do both jobs — you either get a defined jaw and a distorted face, or a natural face and a jawline that is still soft."
This is the real difference between a deep plane facelift and a traditional SMAS facelift, a mini facelift or a skin-only facelift, where skin is lifted separately from the muscle layer and the retaining ligaments are left intact. It is also why deep plane results last considerably longer.
The Deep Neck Lift and Submental Platysmaplasty: How Anita Got a Snatched Neck
"The neck was the part I hated in photographs," Anita says. "Front-facing I was fine. The second anyone took a picture from the side, I saw my mother."
A neck like Anita's cannot be corrected by pulling from the sides. The bands, the blunted angle and the fullness under the chin all sit in the midline, beneath the skin, and they have to be treated there. So the lateral neck lift was combined with deep neck work through a small incision hidden under the chin.
Subplatysmal fat reduction — the fat that sits beneath the platysma muscle, which liposuction can never reach, and which is the single most common reason a neck stays full after a lesser procedure or after chin liposuction alone
Submental platysmaplasty — the two platysma muscle edges released and sutured together in the midline, creating a continuous internal corset from chin to thyroid cartilage that abolishes the visible bands
Digastric muscle tightening and deep structure assessment — the anatomy under the platysma evaluated and treated under direct vision, because a bulky deep structure left alone will show through even a perfectly tightened neck
Horizontal posterior vector — the neck flap redraped backwards behind the ear, which is what converts a merely tightened neck into a defined cervicomental angle
"A tight skin envelope over an untreated deep neck gives you a smooth neck with no shape, and patients notice that within a year," Dr. CBS says. "When you reduce subplatysmal fat, tighten the digastric muscles and close the platysma in the midline, you are rebuilding the cervicomental angle architecturally. That is a permanent structural change, not a temporary tightening. It is the difference between a neck that looks pulled and a neck that looks sculpted."
Endoscopic Brow Lift: Opening Hooded Eyes Without a Scar and Without the Surprised Look
Two fears stop people from having a brow lift: a long scar across the top of the head, and the permanently startled expression everyone has seen on somebody. The endoscopic technique exists to answer both.
"An endoscopic brow lift is done through a few short incisions hidden behind the hairline, with a camera," Dr. CBS says. "There is no coronal scar across the scalp, and — this matters for anyone with a high forehead — the hairline is not moved backwards. The forehead is released, the brow is repositioned to its natural height, and the muscles that pull the brow down and cause the frown lines between the eyes are addressed at the same time."
Two points in Anita's case are worth spelling out, because both are common search questions.
The brow lift came before any consideration of eyelid surgery — and replaced it. "The order is not optional," Dr. CBS says. "If you do an upper blepharoplasty first and lift the brow afterwards, you have already removed skin that the brow lift would have raised out of the way, and the eye ends up hollow and skeletonised. Brow first, always. In Anita's case, once the brow was where it belonged, there was no meaningful excess eyelid skin left to remove. She avoided an operation."
Height is not the goal; position is. "A brow lift that raises the brow too high, or lifts the inner brow more than the outer, is what produces the surprised face. What I am restoring is the position that face had at forty — slightly higher at the tail of the brow, essentially unchanged in the middle. Nobody should be able to identify a brow lift. They should only notice that the eyes are open."
Where a patient does have true excess eyelid skin with no fat herniation, Dr. CBS often treats it with CO2 laser rather than a knife — one of several situations where laser resurfacing can substitute for minor surgery entirely. Read more about brow lift surgery.
Microfat and Nanofat SVF: Two Types of Fat Grafting Doing Two Different Jobs
Facial fat grafting is usually described as one procedure. In Dr. CBS's hands it is two, performed together in the same session and in a fixed order, because microfat and nanofat do completely different things.
Fat was harvested gently from Anita's abdomen and processed into two distinct products.
Microfat first — for volume. Intact fat parcels containing living adipocytes, injected wherever structural volume had been lost: the temples, the midface and cheeks, the tear trough, along the jawline and around the mouth. This is what restores the fullness a face loses after fifty, using the patient's own living tissue rather than a gel that has to be topped up every year. Unlike dermal filler, grafted fat that survives is permanent.
Nanofat with SVF second — for skin quality. The same harvested fat, mechanically emulsified until no viable adipocytes remain, leaving the stromal vascular fraction: adipose-derived stem cells, growth factors and regenerative elements. Nanofat adds no volume at all. It is injected superficially into the dermis to improve skin thickness, texture, fine lines and dark under-eye circles.
"I always do microfat first for volume, then nanofat for skin rejuvenation, in every facial fat grafting case," Dr. CBS says. "They answer different questions. Microfat asks: where has this face lost volume? Nanofat asks: where has this skin lost quality? A patient living at altitude, like Anita, needs both. Lifting a deflated face without replacing volume is the classic route to a gaunt, pulled result — and replacing volume without treating the skin leaves a well-shaped face with tired skin sitting on it."
Fractional CO2 Laser Skin Resurfacing: Treating the Layer Surgery Cannot Reach
The last step of Anita's operation, still under the same anaesthetic, treated the skin itself. A facelift repositions structure; it does not change a single sun-damaged skin cell.
Colorado made this step more important than usual. Ultraviolet intensity rises roughly 4–5% for every 1,000 feet of elevation, so a life lived at altitude concentrates photoageing — fine perioral lines, enlarged pores, uneven pigmentation and thinned, crepey skin texture — in a face that may otherwise be structurally young.
Dr. CBS uses fractional CO2 laser rather than fully ablative resurfacing, specifically because it is the safer choice alongside a facelift. "Fractional means the laser treats microscopic columns of skin and leaves untreated skin between them, and that intact skin drives the healing," he explains. "On a freshly elevated flap, that margin of safety is not negotiable. I would not perform fully ablative resurfacing in this setting. Fractional CO2 I perform routinely, and it is the difference between a lifted face and a rejuvenated one."
The dose is individualised for every patient — by age, skin type and Fitzpatrick phototype, skin thickness, expectations, season and sun exposure. Anita's settings were deeper around the mouth and eyes, where etched lines concentrate, and lighter across the cheeks and forehead.
Three details matter to anyone considering this combination:
It is only safe because of the composite deep plane flap. Skin and SMAS stay attached, so skin perfusion is preserved. After a skin-only lift or a widely undermined SMAS lift, this is not reliably true.
It does not prolong facelift recovery. Cooling is performed in theatre before the patient wakes, so there is no burning sensation afterwards. Antibacterial and moisturising creams begin immediately; a topical steroid cream is used for a maximum of five days, and only in high-dose cases.
Sun protection afterwards is the critical piece of aftercare — it is what prevents post-inflammatory hyperpigmentation. For a patient returning to high-altitude Colorado sunshine, this was the single most emphasised instruction of her whole discharge.
More detail here: CO2 laser skin resurfacing after a facelift.
Recovery Day by Day: What Anita's First 24 Days Actually Looked Like
This is the section most people are really searching for. Here is the honest version, day by day, from a patient who was filmed on day 24 rather than at a flattering six months.
Days 1–3: One night in hospital, then rest at her hotel. Swelling peaked on day three, exactly as predicted. Anita described the sensation as tightness and pressure rather than pain — the consistent report after deep plane surgery, where tension sits in the SMAS layer rather than in the skin. The CO2-treated skin was pink and sensitive, not painful, and creams were applied from the first hours.
Days 4–7: The laser-treated skin completed its initial peel. Bruising began moving from purple toward yellow. The first sutures came out. "Day five was my low point," Anita says. "Swollen, yellow, hair a disaster, absolutely convinced I'd made a terrible mistake. Every single person told me that day would come. It still came."
Days 8–14: Remaining sutures removed, including the endoscopic brow lift incisions behind the hairline. Anita calls day twelve her turning point — the day the jawline and the neck contour appeared. She stayed in Istanbul a full 14 nights, which Dr. CBS requires for combined cases of this size.
Days 15–21: Back to normal daily activity, out and about in Istanbul, comfortable in public with makeup on. Residual swelling along the jawline and in the midface. Tightness and numbness in front of the ears — this accompanies every deep plane dissection and always resolves. Laser redness fading, still present.
Day 24 — the video and photographs on this page: Roughly 60–70% of the final result. The jawline is continuous, the neck angle is defined and the platysmal bands are gone. The brow sits open and level. There is still some midface fullness, a faint pink tone from the laser and a firmness under the skin that nobody but the patient can feel. "This is the version of me at three and a half weeks, not the polished version," Anita says. "I wanted people to see it at this stage, because this is the stage everyone is frightened of."
What still comes after day 24: at three months, around 80% of the final result, with the fat grafts settled at permanent volume and CO2 collagen remodelling actively under way. Between six and twelve months the result matures, the last firmness softens, the scars in front of and behind the ear fade to fine lines, and skin quality is still improving — because both the fractional CO2 laser and the nanofat SVF keep working on the dermis long after surgical swelling has gone.
Anita's Results at Day 24: A Deep Plane Facelift Before and After
Judged against her pre-operative photographs, the change at 24 days is structural rather than cosmetic. Her jawline is continuous, with no jowling on either side. Her neck has a genuine cervicomental angle, and the bands that appeared whenever she turned her head are gone. Her brows sit at their natural height, so her eyes are open without the hollowing an eyelid operation would have risked. Her cheeks and temples carry volume again — her own. And her skin, after twenty-five years of high-altitude sun, is already smoother in texture and more even in tone, with the pigment and pore change still improving.
"Twenty-four days," Anita says in the video. "Not six months, not a year. I still have swelling and I can see it. But I look like me — the me I remember. That was the whole point. Nobody has asked what I had done. Two people have asked whether I've been on holiday."
"And to anyone sitting where I was sitting six months ago, reading these pages at midnight: ask the surgeon whether he releases the retaining ligaments, and listen to the answer."
See more results in the before and after gallery, or read what other international patients have written in our patient reviews.
Expert Perspective: Why Dr. CBS Operated at 53 and Combined Everything in One Session
"Anita's case answers the question I am asked more than any other — what is the best age for a facelift," Dr. CBS says. "There is no number. I have declined to operate on patients of 62 and recommended surgery at 44. What I assess is tissue descent, ligament laxity, skin quality and neck anatomy, never the age on the passport. What is true is that a patient in her early fifties, operated with a deep plane technique, gets a longer and more natural run out of the result than a patient who waits until the descent is severe and then asks for the same operation."
"Combining procedures is only safe when the technique supports it. The composite deep plane flap preserves skin perfusion, which is what allows fractional CO2 laser in the same session. Complete retaining ligament release is what allows a tension-free closure, which is what protects the scars. The brow lift performed before any eyelid assessment is what saved her an eyelid operation. Each decision makes the next one possible. That is what a combined plan actually is — a sequence, not a package."
Travelling from the USA to Istanbul for Facelift Surgery: Practical Notes
Denver to Istanbul is roughly 13–16 hours with one connection, most commonly through a European hub or New York. Dr. CBS's guidance for patients making the trip:
Arrive two days before surgery — for in-person examination, blood work and recovery from the flight
Plan 14 nights in Istanbul minimum for a combined face, neck and brow case at this scale
Stop all fillers six months beforehand; stop smoking, vaping and every nicotine product entirely
Fly home in compression garments, walk the cabin hourly and hydrate continuously — long-haul flying is permitted from day 14–16
Bring high-factor sunscreen and a wide-brimmed hat. Post-CO2 skin is highly photosensitive, and returning to high-altitude sun makes strict sun protection the most important piece of aftercare a patient like Anita has
Follow-up continues by video at 1, 3, 6 and 12 months, and in person whenever a patient is back in Istanbul
Full logistics, hospital details and accommodation guidance are in our guide for international patients.
Frequently Asked Questions
What does a deep plane facelift look like at 3 weeks?
At three to four weeks — the stage shown in Anita's day-24 photographs and video — most patients are at roughly 60–70% of the final result. The jawline and neck contour are visibly defined, bruising has resolved, and the patient is comfortable in public with makeup. What remains is midface and jawline swelling, a firmness under the skin, some numbness in front of the ears and, after CO2 laser, a faint pink tone. All of these continue to improve for months.
How long does a deep plane facelift last?
Because the deep plane technique releases the facial retaining ligaments and repositions the SMAS rather than tightening skin, results typically last 10–15 years. Skin-only lifts and simple SMAS plication commonly relapse within 5–7 years. Ageing continues either way — but it continues from a corrected starting point.
What is the difference between a deep plane facelift and a SMAS facelift?
A SMAS facelift lifts skin and SMAS as two separate layers and generally does not release the retaining ligaments. A deep plane facelift releases the zygomatic, masseteric cutaneous and mandibular ligaments and moves skin and SMAS together as one composite unit — producing genuine repositioning, less skin tension, a sharper jawline and a longer-lasting, more natural result.
What is an extended deep plane facelift?
"Extended" refers to the completeness of the ligament release. Dr. CBS releases all of the facial retaining ligaments, which allows the midface, jowls and jawline to be repositioned as one unit rather than only the lower face being tightened.
Is 53 a good age for a facelift?
Yes. Suitability is determined by tissue descent, ligament laxity, neck anatomy and skin quality rather than by age. Patients in their early fifties are among the largest groups in facelift practice, and operating before descent becomes severe generally produces a more natural result that holds for longer.
Will a facelift fix jowls and give me a snatched jawline?
Jowls are repositioned tissue that has slid past the mandibular ligament, so they need ligament release and structural repositioning — not skin tightening and not filler. A defined, snatched jawline comes from the combination of a vertical facial vector, a horizontal posterior neck vector and treatment of the deep neck. All three are needed; any one alone gives a partial result.
Do I need a neck lift with my facelift?
In most patients over fifty, yes. The neck ages faster than the face and it is what other people notice first. A facelift lifts the neck from the sides; visible platysmal bands and fullness under the chin sit in the midline and require deep neck work with submental platysmaplasty to correct properly.
What is a submental platysmaplasty?
Through a small incision hidden under the chin, the two edges of the platysma muscle are released and sutured together in the midline, forming a continuous internal corset from chin to thyroid cartilage. It is the step that removes visible neck bands and, combined with subplatysmal fat reduction and digastric tightening, rebuilds the cervicomental angle.
Does an endoscopic brow lift leave a scar?
No visible one. The incisions are short and sit behind the hairline, and no strip of scalp is removed, so the hairline is not moved backwards. This is the main advantage over a classic coronal brow lift.
Will a brow lift make me look surprised?
Not when the brow is repositioned to its natural height rather than raised for the sake of height. The startled look comes from over-elevation, and particularly from lifting the inner brow more than the outer. The aim is a brow position that looks unremarkable to everyone except the patient.
Do I need a brow lift or an upper blepharoplasty for hooded eyes?
It depends on whether the hooding is brow descent or true eyelid skin excess. If the brow has dropped, lifting it often removes the need for eyelid surgery entirely — as it did for Anita. If both are present, the brow lift is performed first, because removing eyelid skin before lifting the brow leads to over-resection and a hollow eye.
Can CO2 laser be done at the same time as a facelift?
Fractional CO2 laser can, when the facelift is a deep plane composite flap that preserves skin perfusion. Dr. CBS uses fractional rather than fully ablative CO2 for exactly this reason. It does not prolong facelift recovery, and it treats sun damage, pigmentation and fine lines that surgery cannot touch.
Does CO2 laser hurt after a facelift?
No. Acute cooling is performed in the operating room before the patient wakes, so there is no burning sensation afterwards. Antibacterial and moisturising creams are applied immediately. A high dose produces fine scabbing for a couple of days; a low dose produces no scabbing and a reddish tone for a couple of weeks.
Do I still need fat grafting if I'm having a facelift?
Usually, yes. A facelift repositions tissue but does not replace lost volume or improve skin quality. Microfat restores volume; nanofat SVF improves the skin. Lifting a deflated face without replacing volume is one of the most common causes of a pulled, gaunt result.
Is it safe to combine a facelift, neck lift, brow lift, fat grafting and CO2 laser in one operation?
In an appropriately selected, medically fit patient, and with a composite deep plane flap that preserves the skin's blood supply, yes. Patient selection and technique determine safety, not the number of procedures. Every combined plan is confirmed after in-person examination and pre-operative testing.
How much does a deep plane facelift cost in Turkey compared with the USA?
Published 2026 figures put a comprehensive deep plane facelift with neck lift in the United States in the region of $35,000–$75,000 once the neck, brow and skin treatments are included, and Anita was quoted between $45,000 and $80,000 in Colorado and Arizona. Costs in Istanbul are substantially lower for the same combination of procedures. Dr. CBS quotes only after an online consultation, because the price follows the surgical plan and no two plans are the same. Cost should never be the first filter — technique, ligament release and the surgeon's before and after gallery should be.
How long do I need to stay in Istanbul after a facelift and neck lift?
Dr. CBS asks combined-surgery patients to stay 14 nights. Long-haul flights are permitted from day 14–16 with compression garments, hourly mobilisation and adequate hydration.
When do facelift results actually settle?
Roughly 60–70% at three to four weeks, around 80% at three months, and the true result between six and twelve months. Skin quality keeps improving into the second half of the first year, because both the CO2 laser and the nanofat SVF continue remodelling the dermis long after the swelling has resolved.
Conclusion: One Trip, One Operation, One Complete Result
Anita's journey from Colorado to Istanbul shows what a properly sequenced full face rejuvenation achieves when every layer of facial ageing is treated in a single well-planned operation. An extended deep plane facelift with complete retaining ligament release. A deep neck lift with submental platysmaplasty for a genuinely snatched neck. An endoscopic brow lift that opened her eyes without a scar and without an eyelid operation. Microfat and nanofat SVF fat grafting for volume and skin regeneration together. And fractional CO2 laser resurfacing for skin that twenty-five years of high-altitude sun had changed.
And it is documented at day 24 — swelling, pink skin and all — because that is the stage nobody shows and everybody wants to see.
More Patient Stories
Book Your Deep Plane Facelift Consultation
Dr. Cem Berkay Sinaci performs deep plane facelift, deep neck lift and endoscopic brow lift surgery in Istanbul for patients travelling from the United States, the UK, Europe and Australia. Learn more about Dr. CBS, browse the before and after gallery, read about CO2 laser skin resurfacing after a facelift, or book your online consultation today.
