Multiplanar Facelift & Fusion Facelift in Beverly Hills | Dr. Daniel Golshani

To understand why a multiplanar approach matters, it helps to understand what single-plane surgery can and cannot achieve.

The earliest facelifts worked only at the level of the skin. They tightened the surface but left the underlying architecture unchanged, which is why the results looked tight, lasted briefly, and announced themselves unmistakably as surgery. The development of the SMAS facelift in the 1970s represented a genuine generational improvement: by addressing the fibromuscular layer beneath the skin, surgeons could achieve lift that was more durable and more natural than anything skin tightening alone could produce.

The deep plane facelift, as described and developed through the 1990s, pushed further still, releasing the retaining ligaments beneath the SMAS and repositioning the entire composite flap of skin and SMAS together as a single unit. This approach produced results that, for patients with significant facial descent, were categorically better than anything above-SMAS techniques could achieve, particularly in the midface and nasolabial zone.

But each of these approaches, even the deep plane, works in a single primary anatomical plane and repositions the tissues it engages as a single composite unit. The advantage of that approach is its power and completeness within the zone it addresses. The limitation is that it moves all the engaged layers in the same direction by the same vector. In patients whose aging has produced different degrees of descent in different zones, or who need different vectors of repositioning for the skin, the SMAS, and the deeper facial fat, a single composite approach cannot independently address each component.

This is where the multiplanar technique provides a genuinely different capability.

The Multiplanar Facelift: What It Is and What It Does Differently

The multiplanar facelift is a surgical approach in which the skin and the SMAS are addressed as separate, independently mobilized layers rather than as a single composite unit. By releasing the skin from the underlying SMAS and releasing the SMAS from the deeper facial structures independently, Dr. Golshani can reposition each layer in the direction and to the degree that the patient’s specific anatomy actually requires, rather than being constrained to a single vector applied to the whole.

In practical terms, this means the following:

Independent control of multiple tissue layers. The facial skin, the SMAS of the upper and lower face, the platysma of the neck, and the deeper facial soft tissue can each be repositioned in the direction that corrects their specific descent. The lower facial SMAS can be repositioned differently from the upper facial SMAS. The skin can be re-draped in its optimal direction independently of the SMAS vector below it. The neck platysma can be addressed in the direction that corrects its specific laxity without being constrained by the direction of the facial tissue repositioning above it.

Maximum customization for individual anatomy. No two faces age identically. The degree of descent differs between the midface and the lower face. The skin quality and elasticity differ between the cheek and the neck. The amount of volume loss differs between the temples and the perioral area. A multiplanar approach allows the surgical plan to address each zone with the precision its specific degree of aging requires, rather than applying a uniform correction to a face whose aging is anything but uniform.

Retained vascular integrity. Because the skin and the SMAS are released from each other rather than elevated as a single thick composite flap, the blood supply to each layer is maintained through its own vascular connections rather than depending entirely on the perfusion of a single thick composite unit. This can reduce the risk of skin-related complications in patients with compromised skin quality or in revision cases where prior surgery has altered the vascular anatomy.

Ability to address asymmetry. Facial asymmetry, whether structural or the product of asymmetric aging, is one of the most challenging aspects of facelift surgery. A multiplanar approach allows Dr. Golshani to make independent adjustments to different zones on different sides of the face in a way that a single-composite approach does not easily permit.

The multiplanar facelift is not a repudiation of the deep plane technique. Dr. Golshani performs the deep plane facelift and considers it the most powerful approach for patients with significant composite facial descent. What the multiplanar approach provides is an additional dimension of customization for patients whose anatomy calls for it: a way to address the face not as a single anatomical unit to be repositioned uniformly, but as a collection of distinct tissue layers that can each be corrected precisely and independently.

The Fusion Facelift: When Surgery and Regenerative Medicine Work Together

The fusion facelift is Dr. Golshani’s comprehensive approach to facial rejuvenation that integrates surgical correction, regenerative volume restoration, and targeted surface improvement into a single, coordinated plan performed in one surgical session.

It is built on a fundamental insight: facial aging is not one problem. It is three problems happening simultaneously.

Structural descent. The SMAS, the malar fat pad, the platysma, and the skin have all descended from their anatomically youthful positions. This is a structural problem and it requires a structural surgical solution: a facelift, whether deep plane, multiplanar, or a combination, that repositions the descended tissue back where it belongs.

Volume deflation. The facial fat compartments have reduced in volume. The temples have hollowed. The periorbital area has thinned. The midface has flattened. The perioral region has lost the soft tissue support that once prevented fine lines from forming. This is a volume problem and it requires a volume solution: autologous fat grafting, specifically the G-Stem technique, to restore the lost volume with the patient’s own tissue and the regenerative benefit of concentrated adipose-derived stem cells.

Surface degradation. The skin has lost its quality, texture, and luminosity. Fine lines have formed. Pigmentation has appeared. The overall surface of the skin reads as aged independent of the structural and volumetric changes happening beneath it. This is a surface problem and it requires a surface solution: laser resurfacing, chemical peels, or targeted skin quality treatments that address the epidermis and dermis directly.

A facelift alone corrects the structure but leaves the volume and the surface untouched. A fat grafting procedure alone restores volume but does not address descent or skin quality. Laser resurfacing alone improves the surface but cannot correct structural aging or volume loss. Each is a powerful procedure in its own right. But performed together, in a coordinated plan where the surgical, regenerative, and surface components are designed to complement each other, the result is categorically more complete than any single approach can achieve.

This is the fusion facelift.

How the G-Stem Lift Integrates with the Fusion Facelift

The volumetric component of the fusion facelift is Dr. Golshani’s proprietary G-Stem Lift, his signature fat processing technique that concentrates the regenerative adipose-derived stem cells within the harvested fat before it is transferred to the face.

Standard fat grafting restores volume. The G-Stem Lift does something additional. The concentrated stem cell component contributes to tissue regeneration and skin quality improvement in the areas treated, producing improvements in skin resilience, texture, and luminosity that go beyond what volume replacement alone achieves. When this is performed in the same session as a surgical facelift, the regenerative activity of the grafted fat complements the structural repositioning of the lift, and the two together produce a face that looks not just more lifted, but more alive.

Fat is placed in the specific zones where volume loss has occurred alongside the structural descent being corrected: the temples, the periorbital area, the lateral midface, the perioral region, and the jawline. Each zone receives precisely calibrated micro-aliquots of processed fat, layered for maximal contact with the surrounding tissue and blood supply.

The result is a face where the structure has been repositioned, the volume has been restored, and the quality of the tissue itself has been improved at a cellular level.

The Role of Laser Resurfacing in the Fusion Plan

The surface component of the fusion facelift is addressed through laser resurfacing performed either in the same session as the surgical procedure or in a coordinated second stage, depending on the degree of surface aging present and the specific laser approach selected.

Laser resurfacing improves skin quality, texture, tone, and the fine lines and surface irregularities that no structural surgical procedure targets directly. The combination of a structurally correct, volumetrically restored face with genuinely improved skin quality is what produces a result that reads as comprehensively younger rather than simply lifted.

The specific laser approach, ablative, fractional ablative, or non-ablative, is selected based on the patient’s skin type, the degree of surface aging, and the overall treatment plan. Dr. Golshani coordinates this component of the fusion facelift with the surgical and regenerative components so that the recovery timelines and the healing of each element support rather than conflict with each other.

Who the Multiplanar and Fusion Facelift Are For

These are not entry-level procedures. They are the appropriate choice for specific patients whose anatomy, stage of aging, and goals call for the level of customization and comprehensiveness that these approaches provide.

The multiplanar facelift is best suited to patients with asymmetric aging patterns, patients who have experienced prior facelift surgery and present with altered anatomy that a single composite approach cannot easily navigate, patients whose skin and SMAS have aged at different rates and require independent correction, and patients in whom the maximum degree of customization in the repositioning vectors is important to achieving the natural result they are looking for.

The fusion facelift is best suited to patients who understand that their facial aging encompasses all three dimensions of the problem, structure, volume, and surface, and who want a comprehensive result from a single coordinated plan rather than addressing each component separately over time. It is also well suited to patients who have maintained their faces with fillers and Botox and want to move to a more definitive, durable, and holistic solution.

Both are suited to patients who have done their research, who understand what they are asking for, and who are looking for a surgeon whose depth of technical capability matches the sophistication of the plan they need.

The Multiplanar and Fusion Facelift as Part of a Complete Facial Plan

Neither procedure operates in isolation. Both are most powerful when planned in the context of the full face:

• Neck Lift with Corset Platysmaplasty to address the neck and submental region as an integrated component of the lower facial correction
• Cheek Lift and Midface Lift using the FAME technique or subperiosteal approach to address the midface zone when the malar fat pads require direct repositioning beyond what the facelift component achieves
• Blepharoplasty to address the periorbital frame when upper or lower lid aging accompanies the facial descent
• Endoscopic Brow Lift to restore the upper face and lateral brow arc as the final component of a full facial rejuvenation
• Buccal Fat Excision and Repositioning in patients where lower cheek fullness is a concern alongside the structural aging being corrected
• Botox and Dermal Fillers as long-term maintenance tools that complement and extend the surgical result

The philosophy that guides every plan built around the multiplanar and fusion facelift is the same one that guides every procedure at this practice. The goal is a face where every zone reflects the same person at the same moment in time. Where no single area announces itself as having been treated while adjacent zones remain unchanged. Where the result is complete, harmonious, and entirely invisible as surgery.

The Standard Applied to the Most Complex Cases

The multiplanar facelift and the fusion facelift are technically demanding procedures. They require a surgeon who understands the anatomy of multiple tissue planes, who can work independently across those planes without compromising the vascular integrity of any layer, who can integrate regenerative fat grafting with precision into a surgical field that has already been significantly mobilized, and who can coordinate all of these components into a single plan that heals coherently and produces a result that looks like none of it happened.

This is the level at which Dr. Golshani practices. His commitment, in every procedure regardless of its complexity, is to a result that is invisible as surgery, correct as anatomy, and natural as the patient’s own face.