Facial rejuvenation surgery in the 60s [deep plane facelift revision] - A case of improving nasolabial folds, the midface, and jowls

Hello, I’m Lee Han-jung, board-certified plastic surgeon and CEO of A Top Plastic Surgery Clinic.

When consulting for facial rejuvenation surgery, the goal patients want is a natural lifting result.

There should be a lifting effect, but the face should not look awkward when making expressions or speaking, and the impression should not change to look harsh.

It may feel like a difficult and demanding surgery, but from the perspective of patients seeking midlife facial surgery,

it is a very important point, so A Top Plastic Surgery Clinic always focuses on surgery to deliver highly satisfying results.

Today, I’d like to introduce a deep plane facelift case for a woman in her 60s who wanted a natural lifting result.

At A Top Plastic Surgery Clinic, we call it jowls lifting.

In particular, I will explain in detail the nasolabial fold improvement procedure, midface lifting, and jowls improvement effects.

🔍1. A case of a woman in her 60s who needed revision surgery after a previous SMAS lift

Ms. Park, 63, had undergone a standard SMAS lift 10 years ago,

and although she was satisfied at the time, she came to the clinic recently because facial sagging had become severe again over the past few years.

"When I had surgery before, it definitely improved, but after 5 or 6 years, it started sagging again.

Especially my cheeks and jawline feel like they’ve collapsed. But this time, I don’t want it to feel 'pulled.'

Some of my friends looked awkward after surgery... I want anti-aging that looks natural and appropriate for my age."

Ms. Park’s biggest concern was a facelift that would be effective without making it obvious that she had had surgery.

In particular, she needed improvement in cheek sagging, deepened nasolabial folds, and the jawline and neck line.

🔍2. Characteristics of facial aging in the 60s and analysis: Why is a deep plane facelift (jowls lifting) needed?

After analyzing Ms. Park’s face, the following anti-aging surgery was considered necessary.

Gravity-related sagging of the deep tissue (SMAS): Beyond simple skin laxity, the SMAS (Superficial Musculoaponeurotic System) layer had shifted downward overall.

Relaxation of retaining ligaments: As the ligaments supporting the facial soft tissue loosened, sagging in the midface progressed significantly. As a result, the front cheek appears hollow and the nasolabial folds deepen.

Changes in fat volume: As people age, fat decreases in the upper part of the face (forehead, temples) and increases in the lower part (cheeks, under the chin). This makes the cheekbones appear more prominent and the jawline look collapsed and boxy.

Skeletal changes: The structural support of the face had decreased due to age-related remodeling of the facial bones.

Effects of the previous surgery: As the effect of the SMAS lift performed 10 years ago diminished, revision lifting became necessary.

In particular, since she had already undergone a facelift, we determined that a simple lift would have limitations.

So for this case, a deep plane approach was more suitable.

📷3. Customized treatment plan for the 60s: The importance of natural expressions and surgical results

Considering Ms. Park’s condition and needs, a Deep Plane Facelift was determined to be the most appropriate.

The reasons for choosing this method are as follows:

Natural lifting result: Deep plane lifting raises the skin and SMAS together, so it leaves less of an artificial "pulled" look.

Long-lasting lifting effect: Because it corrects deeper layers, the effect lasts longer than with a regular lift (average 8–10 years).

Midface lifting effect: The deep plane approach is especially effective for improving the midface (cheeks, nasolabial folds).

Suitable for revision lifting: It is particularly effective for patients who have previously undergone a facelift.

Deep plane facelift procedure

Customized surgical plan: The patient’s face was photographed from multiple angles, and 3D CT analysis was used to determine the exact lifting vector and amount.

Safe anesthesia: Sedation anesthesia was performed for a comfortable surgery.

Incision design: Incisions were designed to be naturally concealed along the front and back of the ears. In particular, the plan took the previous surgical scar into consideration.

Deep plane dissection technique: Unlike a standard lift, dissection was performed along the deeper plane beneath the SMAS layer. During this process, important anatomical structures (such as facial nerves) were carefully preserved.

Midface contour repositioning: The face’s key fixation points were repositioned and securely fixed. In particular, for nasolabial fold improvement surgery, the deep fat layer was repositioned upward.

Natural skin adjustment: An appropriate amount of skin was removed, with careful adjustment to avoid excessive pulling.

Scar-minimizing closure: Multilayer closure was performed to minimize scarring.

The total surgery time was about 4 hours, and the patient was discharged after recovery from surgery.

📷4. Recovery period and progress after jowls lifting surgery

Early recovery (1–2 weeks)

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

Ms. Park reported the most discomfort during the first week, but it gradually improved.

"The first week was really hard. My face was so swollen that I wondered, 'Why did I do this?'

But the doctor reassured me that this was the expected course, so I was able to endure it."

The stitches were removed on day 7, and from the second week she was able to wear light makeup and gradually resume social activities.

Mid-term recovery (1–3 months)

At 1 month, the swelling had decreased by about 70–80%, and the facial contours began to become clearer.

In particular, the cheek position had lifted, and the jawline and neck line showed noticeable improvement.

"After about a month, every time I looked in the mirror, I could see a different face. The nasolabial folds improved a lot, and the jawline became clearer.

What surprised me was that it didn’t really look like I had surgery."

By 3 months, most of the swelling had subsided, and the natural anti-aging effect had begun to take shape.

✨5. Final result: Deep plane lifting effect (after 6 months)

When the final result was evaluated 6 months after the facial rejuvenation surgery, the following improvements were observed:

Midface lifting effect: The sagging cheeks lifted naturally, creating a younger and more vibrant impression.

Nasolabial fold improvement: The deep nasolabial folds were significantly reduced.

Jawline and neck line improvement: The previously blurred boundary between the jaw and neck became clearer, creating a sharper impression.

Facial sagging correction effect: The entire face improved in harmony without any one area looking overly pulled.

Most importantly, Ms. Park achieved the "natural lifting" she wanted.

"When I met my friends, they all said my skin looked better and asked what kind of care I’d been getting lately.

No one directly asked, 'Did you have surgery?' That was exactly what I wanted.

I look 10 years younger, but there’s absolutely no unnatural pulled feeling."

👑6. How to maintain natural results after lifting surgery

Before surgery - 3 months after surgery

Ms. Park was advised on the following care methods to help maintain the results for a long time:

Sun protection: Use sunscreen with SPF 50 or higher every day

Skin elasticity care: Use retinol-based products and antioxidant serums

Regular light procedures: Non-surgical maintenance such as Botox or fillers every 6 months

Lifestyle improvements: Quit smoking, stay properly hydrated, and maintain healthy eating habits

Regular checkups: Review the condition once a year and consult about additional care if needed

🍁7. How to improve facial aging in the 60s through midlife surgery: The value of deep plane jowls lifting

Before surgery - 3 months after surgery

Ms. Park’s case shows how effective deep plane jowls lifting can be for patients in their 60s.

It is especially suitable for patients who want natural results.

Patients over 60 show not only simple skin laxity but also complex aging changes, so a more comprehensive approach is needed.

Deep plane lifting can correct aging changes in multiple layers at once, including the skin, SMAS, fat layer, and ligaments, making it an ideal facial rejuvenation procedure.

Most importantly, I believe the key is a customized approach that matches the patient’s expectations and anatomical condition.

For those like Ms. Park who want "natural improvement," a deep plane approach focused on repositioning the deep tissues may be more appropriate than a simple lift that only pulls the skin.

Through this careful approach, patients in their 60s and older can regain a younger and more vibrant appearance, and even more importantly, their confidence and quality of life can improve.

"Before surgery, I avoided taking photos, but now I enjoy taking pictures with my grandchildren. I’m no longer afraid of getting older.

I’m really grateful that I can live actively with a naturally improved appearance."

Frequently Asked Questions (FAQ)

Q: How is a deep plane jowls lift different from a regular lift?

A: Deep plane lifting dissects down to the deeper plane beneath the SMAS layer, providing a more natural lifting effect. A standard SMAS lift works at a more superficial layer, so it can sometimes leave a "pulled" feeling.

Q: How long is the recovery period after jowls lifting surgery?

A: For a deep plane jowls lift, initial recovery takes about 2 weeks, and return to social activities is usually possible after 10–14 days. Full recovery and final results continue to improve for up to 6 months.

Q: When should revision lifting be considered?

A: Revision surgery can be considered when more than a year has passed after a previous lift or when the effect has diminished and sagging becomes noticeable again.

Q: What should I check when choosing a doctor for natural jowls lift results?

A: Make sure the doctor is a specialist in facelift surgery and carefully review previous cases and before-and-after photos. In particular, it is important to choose a doctor with extensive experience in deep plane lifting.

Q: Are there other methods besides deep plane surgery for improving facial aging in the 60s?

A: In addition to deep plane jowls lifting, neck lifting, lower blepharoplasty, and fat grafting can also be combined for age-related improvement in the 60s. Depending on each person’s aging condition, a customized combination approach may be needed for facial rejuvenation surgery.

Note: This case is based on a real patient’s experience, but some details have been modified to protect personal information.