John A. Standefer, MD, FACS, Fresh Image Cosmetic Surgery Center

Cosmetic Surgeon

About the Expert

Dr. John A. Standefer has 36 years of experience and is dual board certified with the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. He has successfully performed over 10,000 facial procedures. His astounding success is a composite of extensive small nuances that are only acquired with the experience of thousands of face
and neck procedures.



Do you find that patients today are doing more homework before inquiring about a facelift?

Yes, they’re studying the different types of facelifts available. Patients are interacting on facelift groups on Facebook. They come in knowing all the buzzwords. And though they may not understand exactly what they mean, it gives us a starting point to discuss the treatments I recommend. 

My goal with any facelift is that the patient’s new appearance never looks overdone, over stretched, or unnatural. We can start with what they know, discuss their goals and concerns, and talk about what’s best for them and why. 

What’s the difference between a SMAS facelift and the deep plane facelift?

Before the 1970s, a facelift was done by simply lifting the skin of the face, pulling it back, trimming it, then suturing it back in place. It was a skin only facelift. Unfortunately, the nature of skin is that it stretches back out over time, so patients weren’t getting long lasting results.

In the 70’s though, the superficial musculoaponeurotic system (SMAS) facelift came on the scene. The SMAS facelift enabled skin to be elevated and the second layer down to be tightened in a posterior and superior direction. Patients loved it because they got longer lasting results. Unfortunately, no matter how tight the SMAS was tightened, the skin eventually stretched and jowls reappeared. Then came the deep plane facelift, which allows the surgeon to reposition the SMAS vertically attaching it to the strong tissues on the cheekbone (zygoma). The deep plane facelift is the most advanced and longest lasting facelift available today. This has become our standard lift.

Which facelift do you perform most often?

I perform the deep plane facelift most often combined with some fine tuning techniques to the neck. The deep plane basically lifts the whole face by repositioning deeper tissue layers resulting in accentuated cheekbones, jawline, and neck and happy patients. It also leaves little or no trace of a facelift having occurred.

Is the recovery the same?

Functionally, there’s not much difference. But realistically, it may add a week or two to your recovery. For most patients, activities should be limited for two weeks. We remove sutures seven days after surgery and any residual swelling or bruising can be camouflaged with makeup or your hairstyle. Full recovery takes 10 to 30 days. Patients have varying experiences with bruising and swelling, so total recovery time depends on your body’s healing process.

Will the deep plane facelift last longer?

The short answer is yes. Because you get more movement of the tissue, you get better results that don’t just appear to last longer but actually do. No facelift stops the clock. It just turns back the clock. If you had an identical twin sister, you had it done and she didn’t, you will always look younger. 

What kind of maintenance should I expect? 

You may want to have laser resurfacing and broadband light advanced (BBL) photofacial before or after your facelift to lessen brown spots and rosacea. Living in Texas, it’s hard to avoid the sun, so just about anybody is a candidate for periodic laser resurfacing.

Living Magazine - Ask the Expert


(214) 540-0371

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