There is so much confusion, even amongst the surgical community, about definitions for the various techniques employed for facelifting procedures. In general, a deep plane facelift means lifting very little (3-5 cm) skin flap and then elevating beneath the thick connective tissue (SMAS) to reposition the tissues. By modified, he may mean he lifts a longer skin flap, doing less elevation in the subSMAS plane or some combination of these. Technically therefore, their is no "standard definition" of a "modified deep plane facelift". All these answers are speculating what your surgeon was telling you and you should clarify this question with your surgeon.

1

The majority of board-certified plastic surgeon perform some type of facelift referred to as a SMAS facelift which allows the surgeon to manipulate the skin in both the face and the neck and manipulate the structure called the SMAS which is continuous with the platysma muscle in the neck and therefore a facelift and a necklift can simultaneously be performed using this popular technique. A deep plane facelift is performed over the periosteum of the facial structures and can be effective in the hands of experience and skilled surgeons in this procedure. Overall there is a higher incidence of nerve damage with this procedure. A modified deep plane facelift is somewhere between the SMAS and the periosteum. There are many variations of this technique and it is important to thoroughly discuss this with your surgeon. Make sure he has extensive experience with this technique. Consultation with a board-certified plastic surgeon is imperative.

The word modified usually means "slightly less invasive" but to be sure I would ask your surgeon just that question in terms you can understand. It is most important to pick the most qualified surgeon rather than the procedure. Here are some tips on how to pick the most experienced (see link):

http://drnichter.com/find-best-plastic-surgeon-dr-right/

It is very important that your surgeon explains this to you specifically. This is not a question anyone else can answer. This misunderstanding must be made clear prior to any intervention.

You should ask your surgeon. Modified usually means a minor deviation from the typical way that the procedure is done, whether that is the location or length of the incision, the extent of the dissection, or how the tissues are suspended. The majority of the time it is a minor alteration and represents a nuanced change that the surgeon has introduced to the procedure that may fit your situation better. But, just ask you surgeon, can't hurt...

Surgeons called "modified" procedures to any small or big changes to the basic procedure. Sometimes can be a slight change in direction, one additional stitch here and there. You need to ask your surgeon what basic technique is using and what modifications to that technique he/she is referring to.

Modified can mean almost anything from a small to a significant variation of the deep plane facelift. The deep plane facelift has more nerve injuries associated with it then the more common SMAS face lift, with almost similar results. I would recommend a second opinion before signing up for this surgery.

It is important to understand facial anatomy and how a procedure is performed when considering facelift. From outer to inner levels there is the skin, the subcutaneous fat, the Submuscular Aponeurotic System (SMAS), the facial nerves, the facial muscles, the periosteum (covering tissue of bone) and then bone. The deep plane facelift was developed with the thinking that elevating the tissues in the deepest plane (sub-periosteal) would elevate the sagging overlying tissues enbloc with less dependence on the skin to hold tissues in place. This is a relatively difficult procedure with risks to facial nerve injury so many have modified the technique. It would be important to know what this modification is why it's being consider in your case.

In my opinion, the level of dissection for facelift should remain at the SMAS and no deeper. This layer is a fibrous tissue that can hold sutures in elevating the deeper tissue and take pressure of the skin for an optimal result. The SMAS layer is contiguous with the platysmal muscle. This is a wide muscle under the skin of the neck. Elevating the SMAS layer elevates the platysmal muscle and gives elevating support for the neck as well.

A note about "skin only" and mini facelifts: When the skin is used soley to elevate tissue in a facelift it will stretch over time. The results look good for about 6 to 12 weeks and then the skin stretches under the forces of the underlying tissues. Patient will often be surprised to see the jowls, marionette folds, and loose neck they were trying to correct months after their procedure.

Be sure you surgeon is Certified by the American Board of Plastic Surgery and can describe what he-she plans for your case with how the tissues will be held into place. If they are going deep to the SMAS, get another opinion.