Some individuals feel their facelift results did not adequately treat the signs of facial aging that concerned them. Inadequate treatment of the neck with a facelift can result in persistent, severe, hanging skin and muscle. The neck can be better addressed specifically with the extended deep plane facelift. Facelift techniques that are not deep plane techniques do not lift the cheeks, which can make the face appear unnatural when the jawline is partially addressed but the cheeks are not. Many surgeons add large volumes of fat to the face to mask the lack of a cheek lift. However, as previously discussed, this can distort the natural appearance of the cheeks by leaving the drooping volume in an unnatural position while adding more volume where the natural volume should be located.

Other individuals experience poor cosmetic results making their face appear distorted and unnatural. Individuals who undergo facelift techniques that are not deep plane are at a significantly increased risk of multiple abnormalities. First, they are at an increased risk of poor healing and abnormal scarring at the incision sites due to the presence of significant tension on the skin. Second, they are at an increased risk of a pixie ear deformity, which is the adherence of the earlobe to the side of the face, which then stretches out down the side of the face as the incisions heal. Third, they are at an increased risk of appearing “windswept” or abnormally stretched horizontally, which can result in an unnatural purse string appearance with tethering at the jawline and a widened mouth.