Extended Deep Plane Facelift: How the TriMax Version Shapes the Face

By Adam Bryce Weinfeld, MD · Board-certified plastic surgeon · Austin, Texas · Updated November 2, 2026

What is an extended deep plane facelift?

It’s a facelift that releases the ligaments deep in the facial tissues, then suspends and repositions those tissues higher up, toward the outer, upper portions of the face, anchoring them to deeper, strong tissues to lift them.

The extended deep plane facelift is a perfectly fine facelift. In fact, my facelift, the TriMax deep plane facelift, is an extended deep plane facelift. But I noticed that in extended deep plane facelift patients, sometimes important features go untouched. That had been my observation, and that’s why I developed the TriMax version: to take over where the extended deep plane facelift leaves off.

If you’re comparing techniques more broadly, I explain deep plane vs. high SMAS facelifts, whether a deep plane facelift moves the facial muscles, and whether a deep plane facelift is right for you. My deep plane facelift page covers the procedure itself.

What is the TriMax deep plane facelift?

It’s my version of the extended deep plane facelift, where my goal is to optimize an important aesthetic triangle. For a very long time I’ve been observing faces, and I noted that there’s an important aesthetic triangle in the face: the malar-genial-gonial triangle. Those areas of emphasis, and the lines that go between them, make an important aesthetic triangle.

I’m trying to maximize that triangle in my deep plane facelift. TriMax: triangle maximizing.

TriMax is part of my Light Touch TriMax Three-Dimensional Deep Plane Facelift, where Light Touch refers to preserving the anatomy of the ear and a tension-free closure.

What is the malar-genial-gonial triangle?

It’s a triangle with three points. There’s the malar eminence: that’s the cheek, essentially. There’s the gonial angle, at the back of the jaw. And there’s the genial area, which is the front of the jaw, the chin.

The lines that connect them are important to pay attention to as well:

• Between the malar eminence and the genial region, we have the nasolabial fold and the nasolabial crease.
• From the chin back to the gonial region, we come across the jowl. It’s the jawline, really important in a face and neck lift.
• Between the malar eminence and the gonial angle, the line is a little more vague, but we often like to see a subtle hollow in that region.

And we shouldn’t forget the center. The center of the triangle is an important part of the face too, and we need to maximize it as well.

I go deeper into this framework in how I think about the central face in every facelift. Here’s how each part of the triangle can be addressed:

How does a TriMax facelift enhance the cheek, chin and jaw angle?

By tailoring what each point of the triangle needs. When I’m doing the TriMax deep plane facelift, I aim to maximize that triangle, and that can be different things for different locations in different patients.

The cheek (malar eminence)

For many patients, it means my standard approach: my five special sutures, to elevate, support and recruit soft tissue back onto the malar bone, the cheekbone. But when I detect that’s not going to be enough augmentation or repositioning of tissue in that area, especially in women, I do fat grafting to create a little more volume and a little more support.

I walk through the sutures one by one in my suspension suture sequence for the deep plane facelift. My suspension starts with the cheek, not the neck. The one exception is a midline platysmaplasty, a tightening of the neck muscle in the middle of the neck.

The chin (genial region)

The chin, in some patients, is actually too big, and we can reduce it by contouring the bone. That’s an important way of enhancing femininity in a woman who might not have felt as if she looked feminine from the very beginning.

When the chin is a little deficient, maybe 1 to 2 millimeters, I’ll do fat grafting, because that achieves everything I need it to. But if the chin is more deficient than that, and the neck lift alone isn’t going to create the definition I need in the chin and the jawline, I’ll either do a chin implant (I prefer porous polyethylene implants) or even a genioplasty, where I gently cut the bone, push it forward and hold it in place with a plate.

More on chin augmentation, your chin augmentation options and jawline surgery options.

The jaw angle (gonial angle)

The gonial angle often needs a little enhancement. I can bring that about with a folded-over SMAS and platysma flap (the SMAS is the deep layer lifted in a facelift; the platysma is the thin muscle of the neck), which adds a little volume in that area. I can also fat graft right onto the gonial angle, which can be extremely effective, in addition to the fat grafting I do along the body of the mandible when more neck definition is required.

Then I do a special suture: either the mastoid crevasse suture described by Dr. Ben Talei in Los Angeles, or my version of it, the stair-step suture. It harnesses the mastoid fascia, the firm tissue over the bone behind the ear, supporting not only the platysma and the SMAS to define the gonial angle, but also the earlobe, which helps prevent a pixie ear (an earlobe pulled down onto the cheek). I explain the ear side of this in hidden scars and ear anatomy in the deep plane facelift.

How are heavy nasolabial folds and jowls treated during a facelift?

With micro-liposuction as an insurance policy, plus subcision and fat grafting where the crease needs it. These lines between the points are where the power of the TriMax deep plane facelift really shines.

Heavy nasolabial folds

Those of us who do a lot of facelifts know that it can be really difficult to address someone with a heavy nasolabial fold. They can be hard. The way I like to tackle that, to create a little bit of an insurance policy, is to do micro-liposuction directly in the fold. That helps deflate it. Sometimes I can remove as much as 1 to 3 cc of fat. That’s a lot.

But I don’t stop there. I’ll also do some subcision, a dissection underneath the deep dermal attachments of the nasolabial crease, and inject some of the fat into the crease itself. We’re decreasing the fold and raising the crease, creating a smoother transition from the cheek to the lip.

Jowls

The line from the chin to the gonial angle, along the jawline, is disrupted by the jowl. A deep plane facelift lifts and supports that jowl right off the jawline. But we all know there can be a little recurrence, and some patients have big, heavy jowls that we know are more likely to recur.

So in most of my patients, I also do micro-liposuction to that area, and sometimes I can remove as much as 3 to 5 cc of fat from the lower part of the jowl. Can you imagine what an insurance policy that is against a recurrence of the jowl? It can be really potent, and I love to do it.

What does buccal fat pad suspension do in a facelift?

It fills the upper cheek and creates a natural hollow in the mid-cheek, which maximizes the center of the triangle. We talked about the three points and the lines that connect them, but the center is an important part of the face. That’s where the buccal fat pad, a deep fat pad in the cheek, comes into play.

Many people will either leave it alone or reduce it. Sometimes I leave it alone, and sometimes I’ll reduce it.

But here’s a pro tip. In patients who have a little fullness in the mid-lower cheek and lack a little definition and fullness in the upper cheek, I love to release the buccal fat pad and suspend it, resupporting it at the malar eminence. I suture it down to some of the tissues in that area, then drape the deep plane tissue over it. It creates a beautiful little hollow in the mid-cheek that extends up to the line between the malar eminence and the gonial angle, and it enhances the cheek in a very natural way.

Who isn’t a candidate for buccal fat pad suspension?

People who have really full upper cheeks and full central cheeks. Those may be better candidates for buccal fat pad reduction. It’s also not for someone who doesn’t have a lot of lower face fullness, because they don’t have a big buccal fat pad. You wouldn’t want to remove it and make them look hollow.

Why is the TriMax deep plane facelift called shape surgery?

Because it’s designed to enhance shape, not just to lift. What I love about the TriMax deep plane facelift is that it goes beyond an extended deep plane facelift. It truly enters the realm of Shape Surgery. We’re focusing on shapes in the face. We’re not just lifting and supporting, and we’re not just repositioning. We’re truly shaping an important aesthetic triangle in the face.

Most facelifts are designed to create a natural lifted result. This procedure isn’t designed exclusively for that. It’s designed to enhance shape, to actually make you look more like you. That’s always the goal of facelifts in my hands, and I love providing this as an option to my patients. You can read more about my facelift approach in Austin.

What does a facelift result look like 1 year later?

Here’s the patient from the video, 1 year after surgery. She had a deep plane facelift, a hybrid deep plane neck lift, an endoscopic brow lift, an upper blepharoplasty and fat grafting (the brow lift and blepharoplasty together are what I call a hidden scar upper facelift). Her photos are taken with her hair back to show the ear anatomy.

Frequently asked questions

Does the TriMax approach make facelift recovery longer?

No. The TriMax facelift really does not increase recovery at all. Patients may have a small amount of additional bruising along the jawline or in the nasolabial fold, and sometimes a little firmness in that area for about a month, but nothing that can actually be seen. It’s more of a sensation to the finger.

How long do TriMax deep plane facelift results last?

Results generally last about 15 years, though every face keeps aging. In my view, which can’t be medically proven, a facelift not only treats aging but may slow it, because sutures hold the deep tissues rather than relying only on the natural ligaments. Micro-liposuction of a heavy jowl adds an insurance policy against the jowl coming back.

How much fat is removed from the nasolabial fold or the jowl?

In a heavy nasolabial fold, micro-liposuction directly in the fold sometimes removes as much as 1 to 3 cc of fat. That’s a lot. From the lower part of the jowl, I can sometimes remove as much as 3 to 5 cc. Some of the fat goes back into the nasolabial crease as a graft, so we decrease the fold and raise the crease.

Does every patient get every part of the TriMax facelift?

Not all of them in every facelift. I use some of these strategies in almost every facelift, most of them in most of my facelifts, and some of them in almost all. Maximizing the triangle can be different things for different locations in different patients. For many patients, it means my standard approach with five special sutures to support the cheek. Sometimes I leave the buccal fat pad alone.

For what to expect with bruising after facial surgery in general, see bruising after a facelift or rhinoplasty.

This article is for education only and is not medical advice. Individual results vary. Patient photos are shown with permission and are unretouched. Diagrams are illustrations. Written by Dr. Adam Weinfeld from his video; edited and formatted with AI assistance.