Everything you need to feel informed, supported, and confident — before, during, and after your Deep Plane Facelift procedure.
"The goal of facial rejuvenation is not to create a new face — it is to reveal the one that time has gradually concealed."
— Dr. Andre Panossian
A guide to your recovery.
A personal message from your surgeon.
Dear Patient,
Choosing to undergo facial rejuvenation is a deeply personal decision. It is rarely about vanity. More often, it reflects a quiet frustration — the feeling that the face looking back at you no longer represents the vitality, energy, and identity you carry inside.
I understand that, and I respect it.
Over the course of my career in both reconstructive and aesthetic surgery, I have had the privilege of restoring faces in every sense of the word — from returning smiles to children born without facial movement, to helping adults reclaim the natural appearance that time has gradually altered. This dual perspective — the precision of reconstruction combined with the artistry of aesthetic surgery — informs every procedure I perform.
The Deep Plane Facelift was developed from this philosophy. It is not a one-size-fits-all facelift. It is a methodical, anatomically guided approach designed to restore your facial architecture from its foundation — not by pulling or tightening the surface, but by repositioning the deeper structures that define your natural contours.
The result is not a "done" look. The result is you — refreshed, rested, and recognizable.
As you prepare for this experience, I want you to know that surgery is only one chapter of the journey. The preparation, the healing, and the long-term care all play essential roles in achieving the outcome you deserve. This guide is designed to walk you through each of those phases with clarity and confidence.
You may feel a mixture of anticipation and apprehension right now. That is entirely normal. My team and I are here to ensure you feel informed, cared for, and supported at every stage.
You are in experienced hands.
With warmth and care,
Dr. Andre Panossian, M.D. Board-Certified Plastic SurgeonKnowing what is being done — and why — is one of the most powerful ways to approach your surgery with confidence.
Facial aging is not simply about wrinkles or loose skin. It is a structural event.
Over the years, the deeper layers of the face — the fascia, the supporting ligaments, the fat compartments — gradually descend, deflate, and shift from their original positions. These changes produce the visible signs we associate with aging:
The Deep Plane Facelift addresses these changes at their source — not at the surface.
Unlike traditional facelift techniques that rely on pulling the skin tighter, the Deep Plane Facelift works beneath the superficial muscular aponeurotic system (SMAS) to release and reposition the fundamental structures of the face.
By operating in this deeper anatomical layer, we are able to:
The face ages as an integrated unit, and the most natural results come from treating it that way. The Deep Plane Facelift addresses continuity from:
This unified approach produces a result that is harmonious and balanced — not a face that appears "done" in one area and untouched in another.
Because the correction occurs at the level of the deep structural tissues rather than just the skin surface, the results are:
Aging does not stop after surgery. However, it continues from a significantly more youthful foundation — and tends to progress more gradually over time.
The Deep Plane Facelift is not about changing who you are. It is about restoring the natural architecture of your face — so that the person in the mirror matches the person you feel like inside.
Comprehensive facial rejuvenation often involves addressing multiple dimensions of aging in a single surgical session.
Each component of the Deep Plane Facelift targets a specific aspect of facial aging. When combined, they produce a cohesive, natural result that no single procedure could achieve alone.
The centerpiece of your rejuvenation.
The Deep Plane Facelift addresses the foundational structural changes that occur with aging — the descent of the midface, the softening of the jawline, the development of jowls, and the laxity of the neck.
Working beneath the SMAS layer, the deeper fascial and muscular tissues are carefully released from their attachments and repositioned vertically — back toward their original, more youthful location.
This approach:
The neck is addressed as an integral component of the Deep Plane Facelift.
Through platysmal muscle tightening and, when indicated, direct sculpting of the submental region, we restore:
The result is a smooth, youthful neckline that transitions naturally into the jawline — without the telltale signs of surgical intervention.
Aging involves both descent and deflation. Fat transfer restores the volume that has been lost over time.
Using your own purified fat, we selectively restore fullness in areas such as:
Fat is placed conservatively and precisely. The goal is to restore natural contour — not to create artificial fullness.
Excess skin and tissue of the upper eyelids can create a heavy, fatigued appearance that obscures the natural eyelid crease.
Upper blepharoplasty addresses:
The result is a more open, refreshed eye — while preserving the natural shape and character of your eyelid.
Lower eyelid surgery targets:
When fat redistribution is indicated, it is typically performed through a transconjunctival approach (from inside the eyelid), avoiding any visible external incision.
The goal is a smooth, seamless transition from the lower eyelid to the cheek — without hollowing or overcorrection.
With age, the distance between the nose and the upper lip gradually lengthens, which contributes to a less youthful appearance.
A lip lift:
This is achieved without adding volume — it is a structural refinement that complements the overall rejuvenation.
While surgery restores the deeper structure, laser resurfacing addresses the quality of the skin itself.
Laser treatment can improve:
This complements the structural improvements from surgery by refining the surface — producing a result that is both structurally restored and visibly rejuvenated.
Each procedure targets a different dimension of aging. Together, they create a result that is balanced, natural, and aligned with your individual anatomy and goals.
Understanding what surgery can accomplish — and what falls outside its reach — is essential to a satisfying outcome.
There are two reliable outcomes that the Deep Plane Facelift is designed to deliver.
The combination of deep structural repositioning, volume restoration, and complementary procedures produces a visible improvement in the shape and definition of your face.
The degree of transformation depends on your starting point:
Regardless of where you begin, there will be meaningful, visible improvement.
This is the most important goal — and the most difficult to consistently achieve.
The objective is that you will look refreshed, rested, and rejuvenated — without looking like you have had surgery.
This distinction is what separates refined surgical technique from outdated approaches.
It is important to understand that surgery addresses structure — not skin quality.
If you have:
These characteristics may still be present to some degree after surgery. We reposition deeper tissues, but the intrinsic quality of the skin is influenced by genetics, sun history, and lifestyle. Laser resurfacing can meaningfully improve skin quality, but it cannot reverse decades of cumulative damage entirely.
I cannot promise perfection.
Every face has natural asymmetries, and surgery — while precise — works within the boundaries of your individual anatomy. I cannot guarantee that every line, fold, or subtle irregularity will be completely eliminated.
What I can promise is this: a thoughtful, meticulous approach that maximizes improvement while preserving what makes your face yours.
The need for revision surgery is uncommon. We do not routinely perform touch-ups or secondary procedures unless there is a genuine concern that warrants intervention, such as:
In many cases, attempting to "perfect" minor details can introduce more complexity than it resolves. Patience with the healing process is often the most effective intervention.
Surgery is both precise and predictable — but it is not absolute.
Once a procedure is complete, the final result is shaped by something no surgeon controls: your body's individual healing response.
Even when identical techniques are applied, outcomes can vary based on:
In the great majority of cases, results are excellent. However, it is important to understand that no outcome can be guaranteed with mathematical precision.
Patients who are best suited for this procedure understand both the power of what surgery can achieve and the limits of what it cannot.
If you are seeking:
Then the Deep Plane Facelift is well aligned with your goals.
Healing is not immediate, and it is not always linear. Swelling, tissue settling, and minor irregularities continue to resolve over weeks to months — and in some cases, up to a year or more. Early concerns are most often resolved by time and patience, not by intervention.
Thoughtful preparation reduces risk, optimizes healing, and creates the safest possible conditions for your procedure.
Two factors matter most in surgical preparation: minimizing bleeding risk and controlling blood pressure. Everything in this section is designed around those principles.
Nicotine severely compromises blood flow to the skin and significantly impairs wound healing. All nicotine products must be completely avoided for a minimum of 2 months before and after surgery, including:
This is a firm requirement, not a suggestion. Even small amounts of nicotine can jeopardize your healing and compromise your result.
Certain medications and supplements thin the blood and must be discontinued at least 2 weeks before surgery, unless otherwise instructed:
If you are unsure about any medication or supplement you are taking, please ask our team before discontinuing anything.
We recommend beginning Arnica and Bromelain several days before surgery and continuing through the early recovery period.
These supplements are commonly used to help:
While individual responses vary, clinical evidence supports their potential to assist the body's natural healing process.
Alcohol affects both bleeding risk and blood pressure stability.
Avoid alcohol for at least:
Elevated blood pressure is one of the most significant risk factors for post-operative bleeding (hematoma), particularly in the early recovery period.
To help maintain stable blood pressure before surgery:
In the weeks leading up to your procedure:
The majority of complications in facial surgery are related to bleeding or impaired healing. The steps above are not arbitrary — they directly address those risks.
Preparation is part of the procedure. By following these guidelines carefully, you are actively contributing to a safer surgery, a smoother recovery, and an optimal result.
This section ensures that everything is organized and in place before your procedure, so your surgical day is smooth, safe, and free of unnecessary stress.
By the time you arrive, your only responsibility should be to relax and feel prepared.
For your safety, you will receive specific instructions regarding eating and drinking before surgery. In general:
This includes all food, liquids, gum, and candy unless otherwise instructed. These guidelines are essential to reduce the risk of complications related to sedation or anesthesia.
You may be directed to take specific medications the morning of surgery with a small sip of water. This will be confirmed during your preoperative visit. If you have medication allergies or are undergoing general anesthesia, your instructions may differ.
For your safety, you must arrange:
If needed, a professional caregiving service can be coordinated. This is a required part of your surgical plan, not optional.
Depending on your schedule and travel arrangements, your preoperative visit will take place either:
During this visit, we will:
Certain procedures are best evaluated in person, including:
It is very common for patients — especially those traveling — to initially plan for the Deep Plane Facelift and facial fat transfer, and then add complementary procedures after the in-person assessment.
Especially for patients traveling from out of town, preparation is important:
Preparation eliminates stress. When everything is arranged in advance, your only role after surgery is: rest, recover, and allow the process to unfold.
Understanding what to expect — step by step — removes uncertainty and allows you to approach each phase of recovery with confidence.
While every patient is unique, the overall trajectory of recovery is remarkably consistent.
On the day of your procedure, our focus is on creating a calm, controlled, and comfortable experience.
Surgery is typically performed under local anesthesia with IV sedation, which keeps you relaxed and comfortable while avoiding many of the risks associated with general anesthesia.
When you arrive:
Following your procedure, you will spend a brief period in recovery before being discharged the same day to your home, hotel, or recovery accommodation.
At this stage, your priorities are simple: rest, hydration, and allowing your body to begin its healing process.
This is the most intensive phase of early recovery. It is entirely normal to experience:
Pain is typically minimal. Most patients manage comfortably with Tylenol alone, although prescription medication is available if needed.
During this time:
Swelling typically reaches its peak between days 3 and 6. This is often the most challenging phase — both physically and emotionally.
You may notice:
This is completely expected, entirely temporary, and does not reflect your final result. What you are seeing is the peak of the healing response — not the outcome of your surgery.
Around days 6 to 7, most patients experience a noticeable shift. Swelling begins to decrease meaningfully, and for the first time, you start to see glimpses of where things are heading.
This is an important psychological milestone — the point where most patients begin to feel encouraged and optimistic.
During the first week:
By the end of the first week, you will begin to see meaningful improvement and feel increasingly comfortable.
By the end of the first 2 to 4 weeks, the majority of the more conspicuous swelling has resolved.
At this stage:
Some residual swelling commonly persists — most noticeably in the upper cheeks, along the jawline, and beneath the chin. This subtle swelling continues to improve gradually over time.
Healing continues well beyond the first month. Over the following weeks and months:
Final settling can take 6 to 12 months — and in some cases, particularly in the neck and incision areas, up to a year or longer.
What you see in the early days is not your result — it is the process of getting there. Each stage has a purpose. Trust the progression.
While recovery unfolds gradually, there are consistent patterns that help you interpret what you are seeing and experiencing.
Swelling is the most prominent feature of early recovery and follows a predictable course:
Residual swelling — most commonly in the upper cheeks, along the jawline, and beneath the chin — is subtle and continues to improve gradually over the following months.
Bruising is typically mild to moderate and follows a consistent pattern:
Some patients experience minimal bruising; others may have more. Individual variation is normal.
It is normal to experience:
These sensations are part of normal healing and improve gradually. Numbness may take several months to fully resolve — and in some areas, particularly around the ears, can take up to a year.
Temporary asymmetry is common and expected during recovery.
This occurs because:
As healing progresses and swelling resolves, symmetry improves naturally.
Incisions go through predictable phases:
Patience during this process is important. The final appearance of incisions continues to improve well beyond the first few months.
Recovery is not about evaluating your result day by day. It is about allowing the process to unfold. What you see early is temporary. What you are moving toward is lasting.
Understanding where incisions are placed — and how they heal — is an important part of preparing for your procedure.
The Deep Plane Facelift uses a carefully planned incision pattern that allows for the removal of excess skin after the deeper structures have been repositioned.
The incision typically:
When fullness beneath the chin requires direct treatment, a small incision may also be placed within the natural submental crease (under the chin).
A critical goal of incision design is to:
Because the deeper structures are lifted and secured first, there is minimal tension placed on the skin closure. This is essential — tension on the skin is what typically leads to:
In the majority of cases, scars heal as a fine line, typically 1–2 mm in width.
Scars may heal slightly lighter or darker depending on:
In rare cases, scars may become more prominent, including the development of hypertrophic or keloid scarring.
Sun exposure during the first year after surgery can significantly impact how scars heal and mature.
Protecting your incisions from the sun is essential. Diligent sun protection helps:
Incisions are designed to be well concealed, tension-free, and respectful of your natural anatomy. With proper care and the passage of time, they typically become subtle and unobtrusive.
While much of this guide focuses on the physical aspects of healing, the emotional dimension of recovery is equally real — and equally important to understand.
This is a topic that is not discussed enough, but every patient navigates some version of it.
In the first several days — particularly between days 2 and 6 — it is very common to feel:
This is not only common — it is expected.
You are seeing the peak of your body's inflammatory response to surgery — not the outcome of the procedure. The two are very different things.
Facial surgery is unique among all surgical procedures because the area that is healing is the area you see every time you look in a mirror.
Even entirely normal healing changes — swelling, tightness, temporary asymmetry, discoloration — can feel more alarming than they actually are simply because they are so visible.
Knowing this in advance allows you to interpret what you are seeing with greater accuracy and less anxiety.
Around days 6 to 7, most patients experience a meaningful shift:
This is an important psychological turning point in recovery — the moment when most patients transition from uncertainty to quiet optimism.
You should always feel comfortable reaching out to our team with any concern — no matter how small it may seem.
In most cases, what you will hear from us is reassurance — because the vast majority of what patients experience during recovery is entirely normal and expected.
Time is the single most important factor in the healing process.
Every patient moves through this emotional landscape. As the swelling resolves and everything settles into place, what emerges is precisely what the procedure was designed to achieve — a natural, restored, recognizable version of you.
Facial rejuvenation is best understood through two components: structure and skin. Your surgery restored the first. What you do afterward determines the second.
Through the Deep Plane Facelift, the deeper structures of your face were carefully repositioned and secured. Because this was performed using a true deep plane dissection with vertical vector elevation, the structural correction is foundational, durable, and long-lasting.
Aging does not stop after surgery — but it continues from a significantly more youthful starting point. You will continue to age, but more gradually and more gracefully than you otherwise would have.
At the same time, the skin itself continues to age through a separate process:
Unlike structural aging, this is something you can actively influence every day.
UV exposure is the single most significant driver of skin aging. Protecting your skin from the sun is essential to preserving your results and preventing:
Wear broad-spectrum SPF 30+ daily — even on overcast days, even when you are indoors near windows.
A consistent, evidence-based skincare regimen built around proven active ingredients — retinoids, antioxidants, peptides, growth factors — helps:
This is not about elaborate multi-step routines. It is about consistent, targeted care with effective products. Our team can recommend a regimen tailored to your skin.
One of the most valuable advantages you now have is clarity. After restoring facial structure surgically, there is no need for:
Small, selective adjuncts — such as neurotoxin (Botox/Dysport) for dynamic lines or microneedling for skin quality — may be beneficial over time, but these are supportive measures, not the foundation of your results.
Think of your surgery as a structural reset. From this point forward:
You have already completed the most significant step. Maintaining your results does not require complexity — only consistency. Healthy skin, cared for over time, is what allows you to continue looking natural, refreshed, and unmistakably yourself.
Most patients feel comfortable in social situations within 2 to 3 weeks, as the majority of visible swelling and bruising has resolved by that point. Subtle swelling — particularly in the cheeks and neck — may persist longer and continues to improve gradually.
You will notice meaningful improvement within the first few weeks. However, refinement continues over time:
Pain is typically minimal. Most patients are comfortable with Tylenol alone, though prescription medication is available if needed. You are more likely to experience tightness, swelling, and a sensation of pressure rather than significant pain.
Temporary asymmetry is completely normal. Swelling does not resolve evenly, and different areas of the face heal at different rates. As swelling diminishes, symmetry improves naturally.
Incisions go through predictable phases:
The goal of the Deep Plane Facelift is not to make you look different — it is to restore your natural appearance. The most common feedback patients receive is: "You look great" or "You look so well-rested" — not that they had surgery.
The structural improvements from your procedure are designed to be long-lasting. You will continue to age naturally, but from a more youthful foundation — and at a more gradual pace. Your results will remain impactful throughout your lifetime.
In most cases, no. After surgically restoring facial structure, routine filler use is typically unnecessary. Small, selective treatments — such as neurotoxin for dynamic wrinkles — may be used when appropriate, but they are supplementary, not foundational.
The most important factor is skincare. Daily sun protection and consistent use of medical-grade skincare help maintain skin quality, tone, and youthful appearance over time.
Please contact our office if you experience:
If something does not feel right, we would always rather hear from you.
Most questions that arise during recovery are not signs of a problem — they are signs of normal healing. Understanding what to expect allows you to move through the process with confidence.
Your recovery will be smoothest when you follow these guidelines carefully. Most instructions are straightforward — but consistency is essential.
This is the most critical window of early healing. Your focus should be simple: rest, elevation, and minimizing strain.
Cold compresses can be helpful during the first 48 hours to reduce swelling:
Do not drive during the early recovery period, particularly:
Take all medications exactly as directed.
You will begin a course of antibiotics before surgery and continue for several days after.
Maintaining stable blood pressure is one of the most important factors in preventing post-operative bleeding.
For the first several weeks, avoid:
Light walking is encouraged early — it promotes circulation and recovery — but keep all activity gentle.
Both must be strictly avoided during recovery:
Nicotine (smoking, vaping, patches, gum, secondhand exposure):
Alcohol:
You will receive specific instructions for cleaning and caring for your incisions:
If used:
Showering is typically allowed within a few days after surgery.
Please call immediately if you experience:
If something does not feel right, we would always rather hear from you.
Recovery is a controlled, step-by-step process. There is nothing complicated about it — but the details matter. By protecting against bleeding, elevated blood pressure, and impaired healing, you are giving yourself the best opportunity for a smooth recovery and an optimal result.
Organizing the right supplies ahead of time will make your recovery significantly more comfortable and free from unnecessary stress.
During early recovery, it is best to minimize close contact with pets. This helps reduce the risk of:
Preparation removes stress. When everything is organized ahead of time, your only responsibility after surgery is: rest, recover, and trust the process.
If you are helping care for a patient after surgery, your role is straightforward — but genuinely important.
Your presence provides support, reassurance, and helps ensure a smooth recovery during the most intensive early phase.
This is when your support matters most. During this time, the patient will:
Most importantly: create a calm, steady, and reassuring environment.
While the first few days are the most intensive, patients benefit from having support for up to one week.
Recovery can feel isolating, and having a trusted friend, family member, or professional caregiver present can make a meaningful difference.
You may notice:
These are all expected parts of the healing process.
Please contact our office if you notice:
If you are unsure, it is always appropriate to call.
It is very common for patients to feel uncertain in the early days — especially between days 3 and 5, when swelling is at its peak.
You can help by reminding them:
The goal during this phase is not to do more — it is to do less:
Your role is not to manage every detail — but to provide steady, calm presence during the early stages of recovery. When things feel uncertain, the most helpful reminder is: trust the process — healing unfolds in stages.
Your recovery is a guided process, and our team is available to support you at every stage.
If you have questions or concerns at any point — before, during, or after surgery — please do not hesitate to reach out.
Andre Panossian, MD
Plastic & Reconstructive Surgery
Pasadena Office:
39 Congress Street, Suite 402
Pasadena, CA 91105
Phone: (626) 765-6885
Email: info@drpanossian.com
Hours: Monday–Friday · 9:00 AM – 5:00 PM (Pacific)
If you need assistance outside of regular office hours, please call our main office line and follow the after-hours prompts to reach the on-call team.
For true medical emergencies, call 911 or go to the nearest emergency room immediately.
Please call our office if you experience:
If you are unsure whether something is normal, it is always appropriate to reach out. We would rather hear from you than have you worry in silence.
The vast majority of recovery follows a predictable and normal course. When questions arise, they are usually a natural part of the healing process. But we are always here to guide you, reassure you, and ensure everything is progressing as expected.
You are not navigating this alone.
Bring these pages to your follow-up visits. Use them to track your recovery and write down anything you would like to discuss.
Track your medications during the first two weeks of recovery. Check off each dose as you take it.
| Medication & Dose | D1 | D2 | D3 | D4 | D5 | D6 | D7 | D8 | D9 | D10 | D11 | D12 | D13 | D14 |
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| Day | Hours of Sleep | Pain Level | Notes |
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| Date | Time | Visit |
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Write your notes and questions here…