Dr. BORSUK - The Modern Facelift Master in Canada
All facelifts are performed in a Canadian-accredited surgical centre in Westmount
The surgeries are performed under twilight sedation under the care of an Anesthesiologist and a respiratory therapist. (Not General Anesthesia !)
What Is a Deep Plane Facelift?
The deep plane facelift is one of Dr. Borsuk’s specialties. It is an advanced surgical technique that targets the deeper structures of the face — primarily the SMAS (superficial musculo-aponeurotic system) and the malar fat pad — rather than just tightening skin. Unlike traditional facelifts that pull the skin or superficially reposition the SMAS, the deep plane approach releases and repositions the deeper ligaments and tissues as a single unit.
Anatomy Refresher
- SMAS: A fibrous-muscular layer that connects facial muscles to the skin. Manipulating it affects facial expression zones (cheeks, jowls, etc.)
- Malar Fat Pad: Sits in the midface, contributes to youthful cheek contour.
- Retaining Ligaments: Secure soft tissues in place; these are released in the deep plane technique to allow more natural repositioning.
Ideal Candidates
- Patients in their 40s to 60s with:
- Midface sagging
- Deep nasolabial folds
- Jowls and neck laxity
- Not ideal for extreme laxity or medically complex patients without adjustments.
Surgical Details
- Incisions: Typically hidden around the ear and sometimes under the chin.
- Dissection: Beneath the SMAS, extending under the malar fat pad.
- Duration: 3–5 hours, depending on the extent.
- Anesthesia: Usually general, though sedation is possible in select cases.
- Recovery: 14–28 days for most social downtime.
Pros
- More natural-looking, lifted result
- Longer-lasting
- Better midface and nasolabial fold improvement
- Less tension on skin — improved healing and scarring
Cons / Considerations
- Technically demanding — it requires an experienced surgeon who specializes in face-lift procedures.
- Longer operative time
- Risk profile: same general facelift risks (hematoma, nerve injury, infection), though no higher incidence when done properly
Bottom Line
The deep plane facelift isn’t just a trend — it’s a sophisticated evolution in facial surgery that, when performed by a skilled surgeon, offers natural, long-lasting rejuvenation. It’s especially powerful for addressing the midface and lower face in a way that looks refreshed rather than “done.”
Here’s a comparative breakdown of the deep plane, sub-SMAS, composite, and short-scar (Latin) facelift techniques:
Key Surgical Distinctions
Deep Plane
- Targets ligaments: zygomatic, masseteric
- Best for: Deep nasolabial folds, heavy jowls, midface ptosis
- Risk: Higher risk of facial nerve exposure — but not necessarily injury if done correctly
Sub-SMAS
- Plication vs. Imbrication: Some surgeons fold (plicate) SMAS; others resect (imbricate) and suture
- Best for: Lower face and neck definition
- Less midface elevation unless extended
Composite
- Developed by: Dr. Sam Hamra
- Includes orbicularis oculi: Helps avoid lower eyelid hollowing but more technically demanding
- Best for: Patients with periorbital aging + midface ptosis
Short-Scar (Latin Lift)
- Also called: Mini-lift, MACS lift (Minimal Access Cranial Suspension)
- Quick recovery, limited improvement
- Best for: Early jowling, younger patients
Which One Is “Best”?
There’s no one-size-fits-all. It depends on:
- Patient age and anatomy
- Extent of laxity
- Desire for midface, neck, or periorbital improvement
- Tolerable downtime and scarring
- Surgeon’s experience and philosophy
Tailored Recommendation by Patient Profile and Clinical Setting
The Borsuk FaceLift
Facelifts counteract the signs of aging by tightening muscle, removing fat, and trimming excess skin, giving your face a fresher, youthful look. Dr. Daniel Borsuk emphasizes a natural appearance that attempts to restore the patient's face to their youth. His bespoke facelift approach is especially effective for rejuvenating the mid-to-lower face and neck, correcting sagging, deep creases under the eyes or between the nose and mouth, and loose skin and fat under the chin and jaw. Dr. Borsuk performs multiple types of bespoke facelift procedures:
SMAS Lift, Extended SMAS Lift, Signature Latin Lift, Mini Face Lift, Deep Plane Lift, and the minimally invasive Thread Lift.
Facelift Procedure
In most facelift procedures, incisions are made from within the hairline in the temples down in front of the ears, or in the ear, and back behind the earlobe to the lower scalp. The procedure takes about two to three hours.
Renowned Montreal plastic surgeon, Dr. Borsuk has developed his own techniques that maximize the natural refreshed look that his patients require. He performs all the techniques listed above and tailors them to each patient such as: lifting the skin, fat grafting and suctioning, soft tissue redistribution and augmentation, and muscle tightening. Sometimes metal clips are also used to hold incisions firmly closed on the scalp to prevent hair loss and improve scars, and bandages are often wrapped around the head to reduce bruising and swelling.
EyeBrow "Smokey Eyes" Lift - Thread Lift
Dr. Borsuk has developed a novel technique that can give the lateral eyebrow a gentle lift to give a more youthful appearance that many young patients desire. The technique can be done under local anesthesia and takes less than an hour to perform. There is minimal downtime of 1 - 2 days.
Forehead Lift (Open and Endoscopic)
Also known as a brow lift, a forehead lift is a surgical procedure performed to reduce signs of aging in the forehead area. It aims to remove or minimize deep horizontal creases across the forehead and bridge of the nose, and the frown lines between the eyebrows. It also lifts the eyebrows, making the eyes look more open.
Forehead Lift Procedure
The procedure usually takes about one to two hours to perform. Depending on the surgical technique used, one long incision or a series of small incisions are made. Tissue and muscle underneath the skin are moved or repositioned as necessary. At the end of the procedure, the incision(s) is closed with sutures, screws, adhesives, or surgical tape; a drain may be put in to collect excess blood and fluid. Post-surgery, the patient is moved to a recovery area for observation.
Recovery After Forehead Lift
A patient typically returns home on the day of the forehead lift surgery, although an overnight stay may be necessary for some. Swelling may be pronounced for the first day or two after surgery, although most swelling goes away within 2 weeks. To prevent post-operative bleeding, bending and heavy lifting should be avoided for a few days. It can take up to 6 months for swelling to fully subside and scars to fade.
Eyelid Surgery (Blepharoplasty)
Blepharoplasty is a procedure that improves the appearance of the eyelids by tightening muscles and tissue or removing excess fat and skin. The blepharoplasty procedure is performed under local anesthesia with sedation. General anesthesia may be used for anxious or nervous patients. Patients may choose to have this procedure on their upper or lower eyelids, or both. Depending on these choices, the procedure can take anywhere from 45 minutes to two hours.
Blepharoplasty Procedure
If the upper eyelid is being treated, an incision is made along the natural crease of the eyelid. Once the incision is made, your doctor may reposition fat deposits, tighten muscles and tissue or remove excess skin. For the lower eyelid, an incision is made just below the lash line in order for excess skin to be removed.
After the procedure is performed, the incisions are closed with sutures and usually wrapped in gauze to allow the area to heal.
Nose Surgery (Rhinoplasty)
Rhinoplasty, or nose surgery, can reshape, reduce or augment a person's nose to achieve facial harmony and boost self-confidence. It is usually an outpatient procedure that is performed under IV sedation or general anesthesia.
Rhinoplasty Procedure
Surgeons typically use one of two techniques when performing nasal surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, the surgeon gently lifts the soft tissues covering the nose. He or she sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum.
The entire procedure generally lasts for one to two hours.
Neck Lift
The neck is often one of the first areas of the body affected by the signs of aging, resulting in wrinkled, hanging skin that can make you look much older than you feel. A neck lift is a surgical procedure that sculpts and smoothes the neck for a younger, natural-looking appearance with no clear signs of surgical intervention.
Neck Lift Procedure
During a neck lift, liposuction may be used to remove fat, while additional procedures remove excess skin and tighten the neck muscles for a younger-looking appearance. Many patients choose to combine a neck lift with a facelift, forehead lift or eyelid surgery to maximize results.
Schedule a Cosmetic Surgery Consultation in Montreal
Dr. Borsuk specializes in facial cosmetic surgery and other plastic surgery procedures. To learn more or to schedule a consultation, please call our practice at 514-933-0495. Our practice serves Montreal, QC, and the nearby areas.
