Deutsch
Nederlands
Français
A 56-year-old female presented with concerns about recurrent lower facial aging, jowling, and volume descent following a prior facelift procedure performed 7 years earlier. The patient expressed dissatisfaction with the durability and naturalness of her previous results, noting an early return of heaviness in the lower face and marionette areas.
She was healthy, non-smoking, and maintained a stable weight. Her primary goal was a refreshed, natural look—particularly in the cheeks and jawline—without signs of over-tightening or artificial contours.
Clinical Findings
Physical examination revealed:
- Moderate jowling with descent of the lower cheek fat
- Residual marionette line hollowing
- Midface volume deflation
- Skin laxity and lateral tension from the previous facelift
- No platysmal banding or significant cervical skin redundancy
Given the absence of neck aging signs or patient complaints regarding neck contour, a revision deep plane facelift alone was deemed appropriate.
Surgical Approach
A revision deep plane facelift was planned to reposition descended midface tissues, address perioral sagging, and create natural vector lifting. The procedure included:
- Release of residual scarring and previous SMAS manipulation
- Vertical vector lifting via deep plane dissection to mobilize and elevate the cheek fat pads
- Structural rejuvenation with tension redistribution over a robust SMAS flap
- Conservative skin redraping with meticulous incision closure to camouflage scars
Neck lift or subplatysmal work was not indicated or performed.
Intraoperative Summary
- Anesthesia: General
- Duration: ~3.5 hours
- Procedure Highlights:
- Deep plane entry from the zygomatic arch to jawline
- Elevation and repositioning of midface soft tissues
- SMAS elevation and re-suspension without manipulation of neck structures
- Skin closure with minimal tension to support long-term natural results
Visual Outcome
Notable Changes:
- Harmonious facial contouring
- Lifted cheeks and lower face definition
- Preservation of facial expression and dynamic movement
Op. Dr. Erman Ak is an internationally experienced specialist known for facial, breast, and body contouring surgeries in the field of aesthetic surgery. With his natural result–oriented surgical philosophy, modern techniques, and artistic vision, he is among the leading names in aesthetic surgery in Türkiye. A graduate of Hacettepe University Faculty of Medicine, Dr. Ak completed his residency at the Istanbul University Çapa Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery.
During his training, he received advanced microsurgery education from Prof. Dr. Fu Chan Wei at the Taiwan Chang Gung Memorial Hospital and was awarded the European Aesthetic Plastic Surgery Qualification by the European Board of Plastic Surgery (EBOPRAS). He also conducted advanced studies on facial and breast aesthetics as an ISAPS fellow at the Villa Bella Clinic (Italy) with Prof. Dr. Giovanni and Chiara Botti.
Op. Dr. Erman Ak approaches aesthetic surgery as a personalized art, tailoring each patient’s treatment according to facial proportions, skin structure, and natural aesthetic harmony. His expertise includes deep-plane face and neck lift, lip lift, buccal fat removal (bichectomy), breast augmentation and lifting, abdominoplasty, liposuction, BBL, and mommy makeover. He currently provides safe, natural, and holistic aesthetic treatments using modern techniques in his private clinic in Istanbul.
