Deep Plane Face Lift
Both techniques lift the deeper facial tissues. Endoscopic access uses smaller incisions and a more vertical lift; traditional open access uses a more lateral pull and allows more excess skin removal.
END-of-Aging Facelift with Neck Lift and Endoscopic Brow LiftAddressing Jowls and Tissue Descent at 50Before and After
At 50 years old, this patient was beginning to notice the structural signs of facial aging through the midface, jawline, jowls, and lower face. To address these changes, Beverly Hills plastic surgeon Dr. Suzanne Trott performed her END of Aging Facelift, a fully endoscopic deep plane facelift, together with a neck lift and deep plane endoscopic brow lift. The combined procedure was designed to create a strong structural lift without a traditional facelift scar in front of the ear. END stands for Endoscopic, No scar in front of the ear, Deep plane. Rather than simply tightening the skin, the END of Aging Facelift works at the deeper structural level of the face. Using an endoscope for visualization, Dr. Trott releases and repositions descended facial tissues within the deep plane through small, strategically placed incisions hidden within the hairline. This allows for a powerful vertical and posterior lift while avoiding an incision in front of the ear. The goal is not to make the face look tight or fundamentally different. It is to restore facial anatomy by repositioning tissue that has descended with age, creating a more defined jawline, improving jowls, and restoring a more youthful position to the midface and lower face. What makes this case especially interesting is that these results are only three months after surgery. Three months is still considered relatively early in the facelift healing process. Swelling continues to resolve, tissues continue to soften and settle, and facial contours can become increasingly refined over the months that follow. What you are seeing here is not necessarily the final result. For appropriately selected patients, Dr. Trott’s END of Aging Facelift offers an alternative approach to facial rejuvenation for those interested in the benefits of a deep plane facelift performed endoscopically without the traditional scar in front of the ear. Dr. Suzanne Trott is a double board-certified plastic surgeon in Beverly Hills whose approach to facial rejuvenation focuses on precision, structural restoration, and natural-looking results rather than changing the character of the face. END of Aging: Endoscopic. No scar in front of the ear. Deep plane.
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Deep Plane Facelift, Neck Lift, Endoscopic Mid Facelift, Buccal Fat Removal & Endoscopic Brow LiftEarly Jowls, a Fresher Contour in Her Early 40sBefore and After
This patient in her early 40s is shown after a deep plane facelift and neck lift combined with an endoscopic mid facelift, endoscopic brow lift, and buccal fat removal. The before images show early descent along the jawline, mild jowl formation, and a slight heaviness in the lower cheek that was beginning to blur the jaw contour. In the after views, the jawline is more clearly defined from the chin to the mandibular angle, while the patient's cheek volume and characteristic facial shape remain recognizable. The buccal fat removal narrowed the lower cheek just enough to sharpen the transition between the cheek and the jaw, without creating a hollow or aged look. The brow has been lifted subtly, opening the upper face and brightening the eye area. The neck contour is tighter and the submental fullness is reduced. Because the lift was performed in the deep plane, the skin was not pulled tight; instead, the deeper tissues were repositioned and the skin followed. The result reads as a fresher, more sculpted version of the same face.
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Endoscopic Brow Lift, Deep Plane Facelift and Neck Lift with Facial Fat Transfer and Fractional CO2 Laser ResurfacingA More Defined Jawline, the Same ExpressionBefore and After
This patient is shown after an endoscopic brow lift combined with a deep plane facelift and neck lift, with facial fat transfer and fractional CO2 laser resurfacing of the face, neck, and décolletage. In the after images, the jawline is more clearly defined from the chin to the mandibular angle, and the transition from the face to the neck is sharper. The midface retains its volume, but the cheek tissue sits higher, softening the fold between the nose and mouth. The brow has been elevated through small hidden incisions, opening the upper eyelid and brightening the eye area while preserving a natural brow arch. The neck contour is smoother, with less fullness beneath the chin and a more defined cervicomental angle. Expression is preserved; the lateral brow, the corners of the mouth, and the periorbital region all move naturally. Fat transfer restored volume where the face had thinned, so the lift repositions tissue rather than simply tightening over a deflated frame. Fractional CO2 laser resurfacing was then performed on the face, neck, and décolletage to refine skin texture and quality: a change no lifting procedure can produce on its own. The deep plane technique allowed the cheeks, jawline, and neck to be lifted together by repositioning the deeper support layers rather than tightening the skin. From the front, oblique, and profile views, the result is a more rested, structured version of the same face.
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Deep Plane Facelift with Facial Fat Grafting, Lower Blepharoplasty and Fractional CO2 Laser ResurfacingRestoring Lift and Lost Fullness at 61Before and After
For this 61-year-old patient, Beverly Hills plastic surgeon Suzanne A. Trott, M.D., F.A.C.S. combined an upper, mid and lower facelift with transconjunctival lower blepharoplasty to remove lower eyelid fat, microfat grafting to the nasolabial folds, marionette lines, jaw, temples and under eyes, and fractional CO2 laser resurfacing of the skin. Each procedure has a specific responsibility. The facelift addresses tissue position and facial contours. Microfat grafting, a form of facial fat transfer, uses the patient’s own fat to replenish selected areas of volume loss. Together, they address both the descent and the depletion associated with aging. The fractional CO2 laser resurfacing addresses the skin itself, improving its texture and quality: changes no lifting procedure can achieve on its own. Fat grafting was mapped to specific areas rather than spread evenly. Small amounts went into the nasolabial folds and the marionette lines, where deepening creases pull the lower face down. The jaw and the temples were treated for lost definition and the hollowing at the side of the head, and the under eyes were filled to take the shadow out from beneath the lower eyelid. The lower eyelid work does two things at once. Fat is removed through an incision placed inside the lower eyelid, so no scar shows on the outside skin. Fat grafting is then placed into the under eyes to correct the hollowness that makes someone look tired. Taking the puffiness down and filling the hollow in the same operation is what makes the eye area look rested rather than operated on. With these facelift before-and-after photographs side by side, look beyond the outline of the face. Examine the lower eyelids, the cheeks and the relationship between fullness and definition. That is the thinking behind Dr. Trott’s approach to this case. The planning extends beyond how much to lift. It considers where fullness belongs and how the individual corrections will work together. The procedures are separate. The face is not.
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Deep Plane Facelift and Neck Lift with Upper Blepharoplasty and CO2 Laser ResurfacingKeeping His Masculine Look at 73Before and After
With men, I pay close attention to what gives their face its character. You can improve the jawline, neck, and eyelids, but you have to understand how those changes will affect the whole face. His concern was specific, and it’s one I hear often from men: he didn’t want to lose the masculine appearance he’d carried his whole life. That concern shaped the plan. For this 73-year-old patient, I performed a deep plane lower facelift and neck lift, upper blepharoplasty, and fractionated CO₂ laser resurfacing of the face and neck. The lift addressed the sagging along his jawline and neck. The upper eyelid surgery removed excess skin that was making his eyes look heavy. The CO₂ laser addressed skin texture and fine lines. Look at his eyes and the shape of his face. He still has the features and expression you recognize. There’s more definition along his jaw, his neck looks tighter, and his eyes look more rested. That’s what I like about this result. You see the improvement, but you still see him.
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Endoscopic Brow Lift, Deep Plane Facelift and Neck Lift with CO2 Laser ResurfacingWhy the Neck Came First at 60Before and After
Her facelift was not where we started. Her neck was. She was unhappy with the lack of definition beneath her chin, so I first performed submental plication to address that concern. Her facelift came years later, at 60. That distinction matters: this was a treatment plan that evolved over time, not a collection of procedures performed in one sitting. The later treatment included an endoscopic brow lift, mid and lower facelift, neck lift, and CO₂ laser resurfacing of the lower eyelids. I considered the brow, cheeks, jawline and neck together, while giving the lower eyelid skin its own treatment. Repositioning tissue and refining skin texture are different assignments. A thoughtful facial rejuvenation plan recognizes where each approach belongs rather than asking a facelift to do everything. She is thrilled with how natural her results look. When I review her facelift and neck lift before and after photographs, I look beyond any single feature. I consider how the brow, face and neck relate to one another, not simply how much tightening was achieved. Her neck brought her to my Beverly Hills practice, but her care did not stop at that first concern. We addressed what mattered to her then and revisited her needs years later. The plan followed the patient, not the other way around.
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Deep Plane Facelift and Neck LiftBothered by Jowls, Worried About Scars at 55Before and After
Her concern wasn’t a single wrinkle. It was the way her cheeks had descended, deepening the folds beside her nose and the lines below the corners of her mouth. Those changes were making her lower face look heavier. For this 55-year-old patient, I combined a deep plane facelift and neck lift. Repositioning the descended cheek tissues helped soften her nasolabial folds and marionette lines while restoring definition along her jawline. The neck lift refined the contour beneath her chin. The relationship between those areas matters. Elevating the cheeks changes how the lower face looks. Defining the jawline brings that improvement into focus. As a woman of color, she was particularly concerned about visible scarring. We discussed that carefully during planning, and I concealed the incision along the ear within the tragus, the small cartilage flap at the ear opening. That placement helps keep the scar discreet, although every incision leaves a scar and healing varies. These before-and-after images show her progress so far. As swelling settles and the tissues and scars mature, her result will continue to evolve, with further refinement expected over the coming months.
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Secondary Lower Facelift and Neck LiftA Refreshed Jawline, Still Hers at 50Before and After
At 50 years old, this patient underwent a secondary lower facelift and neck lift after having a previous face and neck lift performed by another surgeon nearly 10 years earlier. Performed comfortably in-office under local anesthesia, her updated “uptick” refreshed the jawline and neck while maintaining a natural, elegant appearance that still looks like her. These before-and-after photos, shown six months post-op, highlight smoother contours through the lower face, improved neck definition, and subtle rejuvenation without looking pulled or overdone. Secondary facelift procedures require a highly specialized understanding of facial anatomy, scar tissue, and prior surgical alterations in order to safely restore youthful structure and support while preserving facial identity.
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Case 75234
Deep Plane Facelift and Neck LiftFrom a Heavy Lower Face to a Softer Contour at 54Before and After
At 54 years old, this patient wanted improvement in her neck, jawline, jowling, and the heavy appearance through her lower face. She also struggled with deep acne scarring along the lower cheeks that had not responded to previous laser treatments, including fractionated CO2 resurfacing. Just two months after her lower facelift and neck lift, her results already show a dramatically more defined jawline, smoother neck contour, and a softer, more heart-shaped facial appearance rather than a bottom-heavy one. Her incisions were carefully hidden around the ears and inside the tragus, making them nearly imperceptible even early in healing. With minimal bruising and swelling, she was able to return to normal activities within about a week after surgery.
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Case 79318
Facelift and Neck LiftLess Heaviness, More Definition in Her 60sBefore and After
Less heaviness along the lower face, a clearer jawline and a smoother neck bring her own features back into focus. In her 60s, this woman's facelift and neck lift with Suzanne A. Trott, M.D., F.A.C.S., in Beverly Hills create a more rested contour while preserving her recognizable facial character. Explore five before and after views of her cheek, jawline and neck changes.
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Case 106043
Endoscopic Brow Lift, Deep Plane Facelift and Neck LiftA Natural, Rested Look at 60Before and After
Before and after photos of a brow lift, facelift and neck lift performed by Dr. Suzanne Trott in Beverly Hills. Case 104513
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Case 104513