Deep Plane Facelift & Filler Removal: A Doctor’s Story

Beyond the Over-Filled Face: A Clinical Restoration in Istanbul

In the modern era of aesthetic medicine, we are witnessing a new clinical phenomenon: the "over-filled" face. It is a challenge that requires more than just a standard lift; it requires a surgical rescue.

Recently, a colleague—a medical doctor practicing in London, originally from Iran—contacted my clinic in Istanbul. Despite her medical background and access to the best practitioners in the UK, she found herself struggling with the long-term consequences of repeated injectable treatments. Her story is a testament to why facial rejuvenation must eventually move from the syringe to the scalpel.

The Challenge: Filler Fatigue and Tissue Distortion

For many years, the patient had undergone multiple injections of Hyaluronic Acid and Calcium Hydroxyapatite. While these treatments are effective when used sparingly, chronic over-filling leads to what we call "filler fatigue."

When I examined her in my Istanbul clinic, the clinical findings were significant:

• Mobile Filler Masses: She had palpable, moving masses of filler throughout her cheeks.

• Tissue Expansion: The sheer volume of the filler had expanded her skin over time. When palpated, the skin felt "airy"—as if the underlying support structures had been replaced by empty spaces and migrated product.

• Secondary Sagging: Instead of lifting the face, the weight of the filler had actually accelerated the sagging of her midface and jowls.

• Eyelid Malposition: She presented with "scleral show," where the lower eyelid drops, exposing the white of the eye and creating a tired, unnatural appearance.

The Surgical Strategy: More Than a Facelift

As a double board-certified plastic surgeon, I knew that a simple skin-only facelift would fail this patient. We needed to physically remove the foreign material and rebuild the facial architecture from the deep layers up.

1. Surgical Filler Removal

The first priority was the physical removal of the accumulated fillers. Unlike Hyaluronic Acid, which can sometimes be dissolved, Calcium Hydroxyapatite and older, integrated fillers often require meticulous surgical excision to restore the natural contours of the face.

2. The Deep Plane Facelift & Neck Lift

To address the severe sagging caused by years of tissue expansion, I performed a Deep Plane Facelift. By operating beneath the SMAS layer and releasing the tension on the deep ligaments, we can reposition the entire facial structure vertically. This is the gold standard for patients coming from the USA and UK who demand a natural look without the "wind-swept" appearance of traditional lifts.

3. Correcting the Periorbital Area

To fix the scleral show and rejuvenate the eyes, we combined an upper and lower blepharoplasty with a canthopexy to reinforce the lower eyelid position. A midfacelift and temporal browlift were also performed to harmonize the upper and middle thirds of the face.

4. Autologous Fat Injection

After removing the "artificial" volume of the fillers, the face needed "biological" volume. I used the patient’s own fat to restore a youthful fullness to specific areas, ensuring a soft, living result that moves naturally when she speaks or smiles.

The Recovery and Results

The patient’s recovery was a journey of shedding the "heavy" look of fillers and rediscovering her original features. In her post-operative photos and testimonial video, you can see the transition from an over-filled, distorted profile to a sharp, elegant, and medically sound result.

The "airy" feeling under her skin has been replaced by the firm, healthy tension of repositioned deep tissues. The scleral show is gone, and her eyes now have a refreshed, almond shape.

Why Doctors Choose Dr. CBS in Istanbul

As a member of ISAPS with international training—including a fellowship with the legendary Dr. Raul Gonzalez in Brazil—my approach is rooted in anatomy, not marketing.

Patients from the USA, UK, Canada, and Australia often travel to my clinic because they are looking for a surgeon who speaks their language—both literally and professionally. I believe in a "cool" style of communication: I provide the facts, the anatomy, and the surgical reality.

If you are experiencing "filler fatigue" or are looking for a comprehensive facial rejuvenation, it is time to stop adding volume and start restoring structure.

Key Procedures Performed:

• Deep Plane Facelift: Vertical repositioning of deep tissues.

• Surgical Filler Removal: Clearing the face of migrating masses.

• Canthopexy & Blepharoplasty: Correcting eyelid sagging and scleral show.

• Facial Fat Grafting: Restoring biological volume.

• Neck Lift & Brow Lift: Complete facial harmony.

Are you ready to restore your natural anatomy?
Contact Dr Cem Berkay Sinaci.