Facelift Revision in Her 60s [Deep Plane Facelift] – Focused on Improving Nasolabial Folds, Midface Sagging & Jowls

Hello, this is Dr. Han Jeong, Lee, board-certified plastic surgeon and Chief Director of ATOP Plastic Surgery!

When patients come in for mid- to late-life facelift consultations, their most common request is to achieve a natural-looking lift. They want visible improvement, but without unnatural facial expressions or a harsh appearance—especially when speaking or smiling.

This type of surgery may seem complex or delicate, but for patients undergoing facelift procedures in their 50s and 60s, these details are incredibly important. At ATOP Plastic Surgery, we’re fully committed to delivering satisfying results through detailed, customized surgical approaches.

Today, I’d like to share the case of a female patient in her 60s who underwent a deep plane facelift revision, specifically aiming for a natural, refreshed result.

At ATOP, we often refer to this as a “jowl lift”, and in this case, we focused on improving:

• Deep nasolabial folds

• Midface sagging

• Jowl definition

  
  

Let’s take a closer look at how we approached each of these concerns in detail.

🔍 1. Case of a Woman in Her 60s Needing Revision Surgery After Prior SMAS Facelift

Ms. Park (63) had undergone a traditional SMAS facelift about 10 years ago. At the time, she was satisfied with the results, but in recent years, she noticed a return of significant facial sagging and visited our clinic for a consultation.

“The first surgery definitely helped, but about 5–6 years later, everything started to sag again. Especially my cheeks and jawline—it feels like everything collapsed. This time, I don’t want that ‘pulled too tight’ look. I’ve seen some of my friends look unnatural after surgery, so I just want a natural anti-aging result that suits my age.”

Her main concern was achieving an effective facelift without looking like she had surgery. She wanted natural-looking improvement—particularly in the cheeks, deep nasolabial folds, jawline, and neck area, which had all started to visibly sag again.

🔍 2. Aging Patterns in the 60s and Why a Deep Plane Facelift (Jowl Lift) Was Necessary

After analyzing Ms. Park’s facial condition, we identified several key signs of aging that required surgical correction:

1. SMAS Layer Sagging: It wasn’t just the skin that had sagged — the SMAS (Superficial Musculoaponeurotic System), a deep connective tissue layer, had also descended due to gravity, contributing to the overall drooping of the face.

2. Ligament Laxity: The retaining ligaments that support facial soft tissue had stretched over time, causing midface sagging, which in turn led to hollowed cheeks and deeper nasolabial folds.

3. Fat Volume Redistribution: As is common with aging, Ms. Park showed a loss of fat in the upper face (forehead, temples) and fat accumulation in the lower face (cheeks and under the chin). This imbalance made her cheekbones appear more prominent and the jawline appear wider and less defined, creating a boxier facial shape.

4. Skeletal Remodeling: Bone structure also changes with age, and Ms. Park showed signs of underlying skeletal volume loss, which reduced overall facial support.

5. Diminished Results from Previous Surgery: The effects of her SMAS facelift from 10 years ago had gradually faded, and simple lifting was no longer sufficient.

Given all these factors—especially her history of prior surgery—a standard facelift was unlikely to deliver optimal results. Instead, a deep plane facelift approach was chosen, offering more comprehensive correction by addressing the deeper structural layers of the face.

📷 3. Customized Surgical Plan for a Patient

in Her 60s: Prioritizing Natural Expression and

Long-Lasting Results

After assessing Ms. Park’s facial condition and aesthetic goals, we determined that a

Deep Plane Facelift would be the most suitable option.

Here’s why we selected this technique:

• Natural-looking results: The deep plane facelift lifts both the skin and the SMAS layer together, reducing the risk of an overly “pulled” or artificial appearance.

  
  

• Longer-lasting effect: Because it corrects deeper structural layers, the results typically last longer than conventional facelifts—on average 8 to 10 years.

  
  

• Midface enhancement: This technique is especially effective in improving the midface, including sagging cheeks and deep nasolabial folds.

  
  

• Ideal for revision cases: It is particularly suitable for patients who have had a previous facelift, offering more comprehensive correction and natural improvement.

Deep Plane Facelift Surgical Procedure

✔️ Personalized Surgical Planning: We began by capturing photos of the patient from multiple angles and performing a 3D CT scan analysis to determine the optimal lift vectors and tissue adjustment volumes.

✔️ Safe Anesthesia: For a comfortable and safe experience, the procedure was performed under twilight sedation (IV sedation).

✔️ Incision Design: Incisions were carefully placed along the natural creases in front of and behind the ears, ensuring they remain discreet. Special consideration was given to the patient’s previous facelift scars during planning.

✔️ Deep Plane Dissection Technique: Unlike traditional facelift techniques, we dissected beneath the SMAS layer, allowing for a more comprehensive lift. Throughout the process, we carefully preserved critical anatomical structures, including the facial nerves.

✔️ Midface Volume Repositioning: Key facial retaining points were repositioned and securely fixed. For nasolabial fold correction, deep fat compartments were lifted upward to restore youthful contour and volume.

✔️ Natural Skin Re-draping: Excess skin was precisely removed and adjusted to avoid an overly pulled look, maintaining natural facial expression.

✔️ Minimized Scarring with Multilayered Closure: To reduce visible scarring, we used multi-layer suturing techniques, promoting smoother healing.

The total surgery time was approximately 4 hours, and the patient was discharged on the same day after a stable recovery.

📷 4. Recovery Timeline After Jowl Lift Surgery

📝 Initial Recovery (Weeks 1–2)

As expected, there was some swelling and bruising immediately after surgery, along with temporary discomfort.

During the first week, Ms. Park experienced the most difficulty, but her symptoms gradually improved over time.

“That first week was really tough. My face was so swollen I questioned why I even did it. But the doctor reassured me that this was all part of the normal healing process, which helped me get through it.”

On Day 7, the sutures were removed, and by Week 2, she was able to apply light makeup and slowly return to her regular social activities.

📝 Mid-Stage Recovery (1–3 Months)

By the 1-month mark, about 70–80% of the swelling had subsided, and her facial contours began to take on a more defined shape.

Most noticeably, the cheeks appeared lifted, and the jawline and neckline showed visible improvement.

“Around one month after surgery, I started to notice real changes every time I looked in the mirror. My nasolabial folds had faded significantly, and my jawline looked much sharper. The amazing part was—it didn’t feel like I had surgery at all.”

By the 3-month mark, the swelling had mostly resolved, and the natural anti-aging effects of the facelift were becoming fully apparent.

At the 6-month follow-up, the final results of the midface rejuvenation surgery showed significant improvements:

✔️ Midface lifting effect: The sagging cheeks were gently elevated, giving her a fresher, more youthful appearance.

✔️ Nasolabial fold reduction: The once-deep folds had noticeably softened, contributing to a softer overall expression.

✔️Jawline and neckline definition: The previously blurred contour between the jaw and neck became sharper and more refined, enhancing the lower face profile.

✔️ Balanced facial rejuvenation: Rather than one area appearing overly tightened, the entire face improved harmoniously—without any unnatural tension.

Most importantly, Ms. Park achieved the natural-looking result she had hoped for.

“When I met with friends, they said things like ‘Your skin looks great!’ or ‘What skincare have you been doing lately?’ But not a single person asked me if I had surgery—and that’s exactly what I wanted. I look about 10 years younger, but there’s none of that tight, pulled look you sometimes see.”

👑 Tips for Maintaining a Natural Look After Your Lift

Pre-op – 3 Months Post-op

Ms. Park was advised on the following care tips to help maintain her surgical results long-term:

🌞 Sun Protection: Use sunscreen with SPF 50 or higher daily to protect against UV damage.

🧴 Skin Elasticity Maintenance: Incorporate retinol-based products and antioxidant serums into her skincare routine.

💉 Regular Light Treatments: Undergo non-surgical maintenance treatments like Botox or fillers every 6 months.

🥗 Healthy Lifestyle Habits: Avoid smoking, stay well-hydrated, and maintain a balanced diet.

📅 Regular Check-ups: Schedule annual follow-ups to monitor her condition and discuss any additional care if needed.

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🍁 7. How Deep Plane Jowl Lifting Can Transform Facial Aging in Your 60s

Pre-op – 3 Months Post-op

Ms. Park’s case clearly demonstrates how effective a Deep Plane Jowl Lift can be for patients in their 60s. It is especially well-suited for those seeking natural-looking results.

Patients over 60 often experience complex aging changes that go beyond simple skin sagging, requiring a more comprehensive surgical approach.

The deep plane facelift addresses aging across multiple layers — including the skin, SMAS, fat compartments, and ligaments — making it an ideal solution for midlife facial rejuvenation.

Most importantly, a customized approach tailored to the patient’s expectations and anatomical condition is key.

For patients like Ms. Park who desire subtle, natural improvement, a simple skin lift is often insufficient. Instead, a deep plane technique that focuses on repositioning the deeper tissues offers better outcomes.

With such a meticulous approach, patients in their 60s and beyond can regain a youthful and vibrant appearance — and more importantly, restore their confidence and quality of life.

“Before surgery, I avoided taking photos, but now I enjoy taking pictures with my grandchildren. I no longer fear aging. I’m so grateful to live actively with a naturally refreshed look.”

💬 Frequently Asked Questions (FAQ)

Q: How is a Deep Plane Jowl Lift different from a traditional facelift?

A: The deep plane facelift involves lifting the tissue beneath the SMAS layer, resulting in a more natural and longer-lasting outcome. In contrast, traditional SMAS facelifts work on more superficial layers, which can sometimes lead to a “pulled” or artificial look.

Q: What is the recovery time after a Deep Plane Jowl Lift?

A: Initial recovery takes about 2 weeks, with most patients returning to daily activities 10–14 days post-op. Swelling continues to improve over time, with final results typically visible by 6 months.

Q: When should I consider a revision facelift?

A: A revision may be considered if it's been over a year since your last facelift, and noticeable sagging has returned or the initial results have diminished.

Q: What should I look for when choosing a surgeon for natural facelift results?

A: Ensure the surgeon is board-certified and specialized in facial lifting procedures.

Review before-and-after cases, and specifically check if they have extensive experience with deep plane facelifts.

Q: Are there other options besides the deep plane lift for aging correction in your 60s?A: Yes. Depending on individual aging patterns, procedures such as neck lift, lower eyelid surgery (lower blepharoplasty), and fat grafting can be combined. For patients in their 60s, customized combination approaches are often the most effective.

Note: This case was based on a real patient experience. Some details have been modified to protect patient privacy.