Often earlier than expected, sometimes already in the mid-forties, patients notice that the changes in the mirror are no longer about skin quality. The jawline softens into jowls, the folds beside the mouth deepen, the neck loses its angle, the outer brow drifts downward, and the eyes begin to look tired regardless of sleep.
The case below shows how a deep plane facelift plan is actually built, decision by decision, from one patient’s anatomy.
This is a representative case, composed from real patients in our Istanbul practice. Identifying details have been changed; the surgical reasoning, techniques and recovery protocol are exactly as we apply them.
The Patient
A 47-year-old woman came to us after several years of non-surgical treatments. Her weight was stable and she was a non-smoker in good general health.
Her concerns: jowls that blurred her jawline, deep nasolabial folds, a neck that had lost its definition, and eyes that made her look tired in every photograph, with heavy upper lids and visible bags below.
On examination, the descent was structural. The deep supporting layer of the face, the SMAS, and the ligaments anchoring it had loosened, letting the midface and jowls slide downward. The platysma muscle in the neck had separated at the midline, producing visible bands. The outer third of the brow had dropped, adding to the hooded look of the upper lids. The upper eyelids showed genuine excess skin; the lower lids showed fat bulging through a weakened septum, the anatomy behind under-eye bags. Volume loss at the temples and midface completed the picture.
Why Fillers and Threads Were Not the Answer
This is the most common request we hear at this age, and the most common misunderstanding we correct: “Can we do more filler, or a thread lift, so there is no surgery?”
For the right patient, non-surgical treatments are excellent. That is why we use them in our practice. But they have limits, and this patient was well beyond them.
Filler adds volume; it does not lift tissue that has descended. Chasing sagging with filler eventually produces a heavy, overfilled face that looks different but not younger. Filler under the eyes can camouflage mild hollowing; it cannot remove bulging fat, and in a patient like this it often makes the area look puffier. Thread lifts can reposition mild laxity for a limited time; they cannot hold jowls and a loose neck in place for years, and no thread on the market can.
One more distinction matters here, because patients often hear the terms used interchangeably. SMAS is a layer of the face; deep plane is a technique. In a standard SMAS facelift, the surgeon tightens that layer with sutures while lifting the skin separately. In a deep plane facelift, the dissection goes beneath the SMAS, releases the ligaments that tether it, and moves skin and deep layer together as one unit. The result is a more natural, longer-lasting lift with less tension on the skin, which is exactly what an advanced case like this one needs.
Skin-only or minimal techniques would have flattened her wrinkles slightly and left her with the same jowls, the same neck, the same tired eyes, and money spent on a disappointment. The plan must address the deep layer, the neck, the brow and the eyelids together with appropriate tools.
The Surgical Plan: One Session, Six Procedures
Before the steps, an important distinction. The deep plane facelift and neck lift are the main procedures of nearly every facial rejuvenation of this kind in our practice, because jowls and a loose neck are what aging most consistently produces. The remaining steps were chosen for this patient’s specific needs; in another patient they might be replaced by different procedures, or not be needed at all.
1. Deep plane facelift
Through incisions hidden along the hairline and around the ear, the dissection was carried under the SMAS. The retaining ligaments were released and the midface and jowls were repositioned vertically, where they sat years ago. Because the lift happens in the deep layer, the skin is redraped without tension, which protects both the scar quality and the natural expression.
2. Deep neck lift with platysmaplasty
Through a small incision hidden under the chin, the separated edges of the platysma muscle were stitched back together at the midline and the deeper structures blunting the neck angle were addressed. This is what restores a clean line between jaw and neck; pulling skin sideways alone cannot do it.
3. Temporal lift
Through a short incision concealed in the hair above the temple, the outer third of the brow was released and repositioned upward. This step is small but decisive around the eyes: it opens the hooded outer corner, softens crow’s feet, and means less skin needs to be removed from the upper lids. Without it, an upper blepharoplasty alone often chases a problem that partly belongs to the brow.
4. Upper blepharoplasty
With the brow now sitting in its correct position, the true excess skin of the upper lids was measured and removed through an incision concealed in the natural eyelid crease. The goal was a rested, open look, not a surprised one, so the resection was conservative and symmetric.
5. Lower blepharoplasty
The bulging fat of the lower lids was addressed through an incision hidden just below the lash line. Rather than simply removing the fat, which can leave a hollow, skeletonized look, it was repositioned over the bony rim to smooth the transition between eyelid and cheek, and a conservative strip of excess skin was removed.
6. Fat transfer to the midface and temples
Aging is not only descent; it is also deflation. A small amount of fat was harvested, purified and placed in the temples and midface to restore the soft fullness of a younger face. In another patient this step might not be needed at all; here it completed the result.
Why One Session Instead of Separate Surgeries?
One anesthesia, one hospital stay, one recovery period, one trip to Istanbul. For international patients this is not just convenience; it is the difference between one week away from home and several separate trips. Combined facial surgery is not suitable for everyone: it requires good general health, normal pre-operative tests and realistic expectations. But for suitable patients it is safe and efficient in experienced hands, and the procedures support each other: the temporal lift reduces how much the blepharoplasty must do, and the facelift and neck lift are designed as one continuous contour. This patient’s operation took around six hours.
Recovery: The First Week in Istanbul
She stayed one night in hospital with her head elevated and cold compresses applied around the eyes. The small drains behind the ears were removed the next morning before discharge. Swelling and bruising, mostly around the eyes and jawline, peaked around day three and then began to fade. Sutures around the ears, in the temples and in the eyelid creases were removed between days five and seven. Her final check-up was on day six, and she flew home on day seven with a written aftercare plan.
At home: sleeping with the head elevated for two weeks, no heavy lifting or bending for three weeks, desk work from around day ten with light camouflage make-up if desired, contact lenses from week two, gym from week four to six. Most patients are comfortable in social settings from the end of week two.
You can also plan your own timeline with the recovery planner at the bottom of this page.
The Result
By week three, she looked like herself after a long holiday: a defined jawline, a clean neck angle, an open outer brow, and rested eyes without bags. The final result of a deep plane facelift is judged between six and twelve months, as the deep tissues settle and the scars mature into fine lines hidden by the ear, the hairline and the lash line. What made the outcome work was not any single procedure but the proportions between them, which is exactly why facial rejuvenation should never be sold as a fixed package. You can read more about the deep plane facelift procedure we offer.
Is a facelift in Turkey safe?
Safety depends on patient selection, planning and infrastructure: full pre-operative testing, surgery in a fully equipped hospital, an experienced anesthesia team, and honest suitability criteria. Our practice operates with Turkish Ministry of Health health tourism authorization, and combined cases are only offered to patients who meet the criteria.
How many days do I need in Istanbul?
Seven days covers even combined facial cases: arrival, surgery, one hospital night, drain and suture removal, and a final check-up before flying home.
Deep plane or SMAS facelift? Which one do I need?
It depends on the degree of descent and your anatomy, not on age alone. Milder laxity can respond well to a SMAS technique. More advanced jowling, midface descent and neck laxity, which some patients develop as early as their mid-forties, are better served by a deep plane approach, because it repositions the deep layer itself rather than tightening over it.
Do I need a temporal lift with my blepharoplasty?
Not always, but the outer brow should always be assessed first. If the brow has descended, removing upper eyelid skin alone treats the symptom and can pull the brow even lower. When the hooding comes partly from the brow, a temporal lift and a conservative blepharoplasty together give a more natural and longer-lasting result than an aggressive blepharoplasty alone.
When will I see the final result?
You will look presentable within two to three weeks, most swelling settles by month three, and the final result is evaluated at six to twelve months.
If you are considering a facelift and want to know which combination fits your face, send us your photos for an assessment or reach us directly: +90 544 772 07 72 (call or WhatsApp).
This article is for general information and reflects the surgical approach and aftercare protocol of Dr Mustafa Aydınol’s practice in Istanbul. It does not replace an individual medical consultation.
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Recovery does not end when you fly home
How well you look after yourself after you leave matters as much as the surgery itself. Most of the problems we see are preventable ones - massage that was skipped, compression given up too early. Your part of the plan continues at home.
Especially after liposuction. The sessions in Istanbul are only the start; continuing two to three times a week at home lowers the risk of fluid build-up and firmness. A simple handheld device works if a clinic is too costly.
Overnight above all, for at least six to eight weeks. The comfort of leaving it off is never worth a result that is harder to undo. With implants, support matters until healing settles.
If your recovery is not going the way you expected, reach out early rather than waiting. A small issue caught in time is easily managed; left alone, it grows. We would always rather hear from you.
When to seek help straight away
Recovery has its ups and downs, and some swelling, bruising and discomfort are all normal. But a few signs need urgent attention. If any of these happen - especially in the first weeks, when you may still be travelling - do not wait:
- Sudden shortness of breath or chest pain
- Pain, swelling, warmth or redness in one calf or leg
- A fever, chills, or feeling generally unwell
- Fast-increasing pain, swelling or bruising
- Heavy or bright-red bleeding, or fluid soaking through dressings
- A wound that opens, or looks red, hot and increasingly sore
Sudden breathlessness or chest pain is an emergency - call your local emergency number first, then tell us. For anything else on this list, contact us straight away; we would always rather hear from you early.
Talk it through on WhatsApp
Every recovery is different - your technique, your health, your travel dates, and whether you are combining procedures. Send us your plan on WhatsApp and Dr. Aydinol's team will go through your timeline with you.
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These timings reflect how we plan a straightforward recovery and are guidance rather than a promise; your own plan is confirmed with you in person, and your travel date at your final check-up before you leave. If anything about your recovery ever feels wrong, contact us first - that is what the direct line is for.
