Why Do I Look So Old/Deep Plane Lifts vs The Rest?- Scene Magazine July 2022

Why Do I Look So Old?

Defining the aging face seems deceptively simple yet it's true manifestations elude the best of us because we hang on to oversimplified, one dimensional catch phrases of wrinkles and volume loss. The grand design of our face starts with a deep bony skeleton and interwoven mesh of various types of soft tissue (fat, muscle, fascia and skin) all of which are tethered to the bone by cutaneous ligaments. Youth is defined by the shape and volume distribution of the face, the ideal being more fullness in the upper cheeks, hollows in the lower cheeks and a crisp jawline. With aging, the soft tissue falls, especially fat, reversing this facial proportion. As the volume falls, it creates the perceived volume loss of the upper face, and the bunching of this tissue around the mouth creates laugh lines and accordions the lips filling them with wrinkles.

Deep Plane Lifts vs The Rest?

Ascribing to the one dimensional analysis, we pull with mini-lifts and plump with fillers and fat. Why not just move the fallen volume? Hmmm.

Science purports tremendous innovative progress with shiny expensive energy machines and eloquently named products that just hollow out the areas that need fullness and overly plump others. Look around you - do you like what you see? We are slaves to a system of simple solutions for a quick buck, where we are selling the idea of beauty with smoke and mirrors rather than creating it.

To create beauty we evoke the grand design with the deep plane facelift. We release the deep tethers that foil the other facelift techniques and lift the deep tissue that had fallen to its youthful origin. This recreates the original proportions of facial volume. While the concept is simple the technique is intimidatingly complex. 

Mini-lifts do little more than pull, and the SMAS facelifts struggle with shifting volume, often augmented with fat injections to camoflauge the limitations. Non-surgical fillers and threads are great for subtle improvement, but create disasterous results when pushed to the max, an all too common theme in celebrity plastic surgery gone wrong. 

To realize our dreams is to face reality, embrace vanity and ignore hype. Choose wisely and enjoy life!

Top Doctors- SRQ Magazine November 2021

Sumeet Bhanot, M.D., F.A.C.S.

2021 Peer Review Honorees Top Doctors Medical Resource Guide

Honoree Plastic and Reconstructive Surgery

Dr. Sumeet Bhanot was born in Chandigarh, India while his father was on the battlefield. His father fell ill when he was eight causing an abrupt move to the U.S. for emergency medical care. This tumultuous early life is what has shaped him into the dedicated surgeon he has become. Dr. Bhanot is a double board certified Facial Plastic Surgeon who completed both medical school and a surgical residency at the prestigious Yale School of Medicine and Yale New Haven Hospital; he further honed his skills with a fellowship in facial plastic and reconstructive surgery. Dr. Bhanot has been serving the Sarasota area in his endless pursuit of excellence for the past eighteen years. 

Specialties

Surgery of the Aging Face

Deep Plane Facelift, Necklift, Eyelid Lift, Browlift

Cosmetic and Functional Rhinoplasty

Noninvasive Procedures: fillers, Botox, lasers, peels, etc.

Facial Reconstructive Surgery

What Procedure Best Encompasses Your Passion and Life’s Work in Addressing the Aging Face?

Throughout my career I have been striving to solve the conundrum of how to create a natural, refreshed, youthful appearance while being true to Mother Nature’s design and natural proportions. Early in my career, I performed the standard SMAS facelift which, while very satisfactory at addressing the neck and jowl, fails to reposition the mid facial volume. This left me feeling cornered and forced to consider camoflauging solutions such as fat injection or excessive fillers to hide the limitations of this technique, which results in the all too common cherub-like plumped faces. I resisted the pressure and evolved my technique to a Deep Plane Facelift; my patients and I have been very happy since.

My technique is a product of comprehensive study of the anatomy of aging. Aging is the shift of facial volume–not loss of volume. With the Deep Plane Facelift, the fallen malar fat pads are elevated and repositioned to their initial location restoring the volume proportions and youthful facial harmony. The facial volume is globally addressed in a vertical lift. Patients look decades younger and natural, with soft fullness in the upper face and less heaviness in the lower face. In the past I treated wrinkles; now I realize that true rejuvenation needs to address the root cause and not the superficial manifestations. The answer is not to compensate by overfilling or overly stretching the skin. My patients report that their family and friends did not realize they had a facelift, only that they look younger and fabulous, I invite you to look at the results and decide for yourself.

Top Doctors- Sarasota Magazine May 2021

The Deep Plane Facelift- Scene Magazine April 2021

The buzz over deep plane facelifts is growing louder due to a Real Housewife of NYC recently having one: What makes it special?

To understand this, we must first understand the architecture of the face. Anatomically, the face consists of a bony skeleton that provides structure to soft tissues made up of deep fat, fascia, and superficial skin penetrated by supporting cutaneous ligaments.

Aging is the disharmonious descent of the soft tissue elements relative to their ligamentous anchors. For example, the deep fat, which provides volume in the face, descends and settles in the lower cheek and jowl area. This shift hollows out the upper cheek and lower eyelid area and changes the shape of the face, leading to a heavy lower face and a gaunt upper face.

Because aging is a multidimensional problem involving volume shift, loose fascia, and sagging skin, a simple solution is unlikely to correct it. The most common fixes offered today are the nonsurgical facelift, the mini-lift, the traditional facelift, and the comprehensive deep plane facelift.

Typically, nonsurgical solutions fill the upper facial voids with volume. If this is done judiciously or on the young who have limited facial descent, the illusion helps. Unfortunately, this approach retains the lower heaviness while adding upper heaviness to match, and can result in a cherub-like, distorted appearance. The mini-lift,

another unidimensional approach, fails miserably because it just stretches the skin and leaves the bulk of aging untouched, creating a wind-swept appearance. The traditional facelift addresses the neck and jowl, however fails to reposition the mid facial volume. Some doctors remedy this with fat injection to hide the volume descent. I used to perform this facelift myself, but I was frustrated with the limitations of the results.

My philosophy now is to tackle the problem at the source with a very rare comprehensive deep plane facelift. In this approach, we release the anchors and reposition facial volume globally in a vertical lift. When the fascia is repositioned in the traditional facelift it is limited by the anchors. The deep plane not only improves the fascial repositiong by releasing the anchors, it adds the dimension of volume repositioning by moving the fat pads. This addresses the root cause by repositioning

all elements of soft tissue that descended with age. To the best of our ability, this restores the natural harmonious proportions of the youthful face, without the limitation of the other techniques.

In essence, patients actually look decades younger and yet natural, with soft fullness in the upper face and less heaviness in the lower face. This is simply because we are moving more of the facial structures and volume back to their original locations and not compensating by overfilling or overly stretching the skin. I invite you to look at the results yourself and you will notice that they require no explanation or qualifications; they just look right.

Many of my patients report that their family and friends did not realize they had a facelift, only that they look fabulous! The state of the art is not how easily, quickly, or cheaply a problem can be fixed. Rather it is a methodical, measured, artistically crafted, comprehensive technique that creates natural youthful beauty. The deep plane facelift is performed in the operating room with an anesthesiologist and light anesthesia just like the other facelifts with similar recovery, yet the results are dramatically different. We only live once. Choose wisely and enjoy life!

Doctors of Distinction- Scene Magazine January 2021

Dreams, Vanity, Hype and Reality- Scene Magazine October 2019

Medical Pioneers- SRQ Magazine August 2018

What makes Bhanot Facial Plastic Surgery different from others in the area?

BFPS strives to provide a unique boutique tailored personal experience. Our approach to facial rejuvenation is discerning; we don’t believe in stretched, pulled and plumped, nor do we condone quick fixes that just don’t work. Our rejuvenation approach and philosophy is to provide honest and well thought out solutions to address the root of the problem. At BFPS we disregard the quick easy procedures for comprehensive procedures that truly create a natural, rested, rejuvenated look that is seamless. We are the home of the deep plane facelift. Our patients look younger yet their friends and family are at a loss in deciphering what exact measures they took to look so good. 

How do you create an exceptional patient experience?

The best way to create an exceptional experience is to give patients what they want. Inquiries to our office are greeted by our exceptionally warm, courteous and knowledgeable staff who will answer all questions and provide concierge level service. Dr. Bhanot will personally perform the entire in office consultation for up to an hour to educate patients on the anatomy, physiology, recommended procedures and options. Together, Dr. Bhanot and the patient will formulate a plan for surgery. The surgery is performed in a nationally accredited surgery center with a board certified anesthesiologist. Surgery is followed by close follow-up with 3-4 appointments within the first 2 weeks alone. Our patients can rest assured that everyone in our office will know them and their concerns; they will remain valued members of our family for decades to come. 

What are the benefits in choosing Bhanot Facial Plastic Surgery?

The benefits of choosing Bhanot Facial Plastic Surgery are the extraordinary experience of one on one personalized attention as well as placing your care in the hands of a Yale educated and trained double board certified surgeon whom has earned the designation of being a Castle Connolly Top Doctor for seven consecutive years and running. Dr. Bhanot’s extensive experience in head and neck surgery has honed his skills and understanding in dealing with the complex anatomy of the head and neck; this has translated into successful procedures and an unparalleled understanding of the complexities involved in addressing the aging face. Dr. Bhanot is a perfectionist; he will not be satisfied until he feels he has done his absolute best for his patients. Service is personalized to the degree that BFPS does not employ physician extenders; absolutely all procedures including injectable fillers and Botox are performed by Dr. Bhanot himself. His warm bedside manner combined with exceptional medical knowledge and surgical skill has earned him many referrals from area physicians as well as past patients over the fifteen years he has been practicing in the Sarasota area. At BFPS the satisfaction of our patients is paramount.

The Deep Plane Facelift- Scene Magazine July 2018

Parts vs. the Whole- Scene Magazine May 2018

What is plump enough, tight enough, how much do you lift? Where do you focus your dollars? Consumers are wondering how to get the most bang for their buck. Is a satisfying result gained by walking into a surgeon’s office and saying, “Hey doc, what can you do for $500?” Do patients want honest results or a deal? These are the things that I ponder. I am a purist. My goal is to do what is right for the patient, not what works for my gain. Beauty is a composition of ordinary parts that together become extraordinary. There is too much general social opinion that creates artificial credibility. What we need is true expert opinion. 

Using a paintbrush does not make one an artist, as is true with wielding a needle. The answer is balancing perspective and proportions. Knowledge of complex anatomy, symmetry of the facial composition, how much to use, when to stop. Art takes vision, perspective, judgment, creativity, thought, knowledge and execution. My approach is comprehensive, individual and measured.

Patients often present with a pressured mindset to achieve their goal with minimal cost. As with “retail therapy”, they are hoping that addressing one feature will make them feel better. Simply fixing puffy eyes may not give them the total look they are seeking. Art isn’t divisible, it cannot be cut up and sold in pieces; the same is true for the face. We all know beauty when we see it yet is seems so elusive when we try to create it in pieces. 

Encountering what I call the fallacy of equivalent options: people feel that the results of surgical and non surgical approaches are the same and that all providers are created equal. Sometimes chasing small budget items ends up costing more than doing it right the first time and it doesn’t last. We consider smooth skin, plump cheeks and lips and tight neck lines victories individually, but we lose the war collectively. As in the children’s book The Emperor’s New Clothes we all know in our hearts that it doesn’t look right, just like everyone knew the Emperor was naked, but no one wants to say it. We all recognize natural beauty yet when we look around we see so many unnatural results. All providers are not created equal, perspective and vision play a large part in outcome. 

Ultimately it comes down to a collaborative partnership between the patient and the surgeon. The patient commissions the work while the the surgeon’s artistic vision creates the result. My approach to aging faces is to bring the restore harmony to face by recreating the youthful propotions of volume. I see past the wrinkles, hollows and bags and address the true concern of falling volume with the deep plane facelift. The answer is to address the problem and not the symptoms; it is truly that simple. Changes are dramatic yet the result is very subtle. People look 20 years younger and no one recognizes they have had a facelift. The results are beautiful and natural. Have respect for beauty and know that, as in life, anything that is worthwhile is never quick and easy.

Medical Pioneers- SRQ Magazine January 2018

What are some benefits of choosing BFPS?

The benefits of choosing Bhanot Facial Plastic Surgery is care in a small, intimate setting where personalized attention is paramount. Our practice is one in which staff are always available to answer your questions and concerns. They will know you when you call and they will be with you throughout your journey. Our patients are just part of our extended family. I personally perform all procedures and give each patient the benefit of my training, expertise, artistry and experience. 

What is the definition of good health?

Health is many times only thought to be physical, leaving the mental aspects neglected. It is no wonder our mental state affects our physical well being. I often hear, “When I look in the mirror I see my mother but I don’t feel that old in body and spirit.” This is one of the most common reasons patients will get facial plastic surgery. In these cases, surgery restores confidence. Feeling good about how we present ourselves to the world improves our outlook thus improving our overall health. Patients often start taking better care of themselves after cosmetic surgery, be it in the realm of weight loss or increasing social interactions and assuming a more active lifestyle as a result of increased self esteem and confidence.

What is your favorite part of your day?

My interaction with my patients is what drives me. The diversity of their life stories enrich me; it is very much a reciprocal relationship. I would like to share two recent stories.

A young girl presented for her reveal after a rhinoplasty. Upon unveiling her nose she was visibly shaken and began to cry, creating concern in both myself and her parents. Then she uttered those three little words that brought tears to my eyes – “ I love it”, made my day to see that such a simple act on my part brought such joy and happiness to someone’s life. 

I see a woman who spent her entire life selflessly caring for others, who finally gets the courage to do something meaningful for herself. Her reveal also brought tears of joy. Not only does she look 20 years younger, she feels empowered and liberated from finally doing something for herself. She looks younger, healthier and naturally rejuvenated. To see such responses to the fruits of my labor is priceless!

Plump Up the Volume?- Scene Magazine December 2017

In this age of social media it has become commonplace to witness the successes and pitfalls associated with the use of volume in the form of injectable dermal fillers and fat. The current trend of rounded faces can be seen everywhere you look which leaves me to ponder: Will the cherubic faces of the twenty-tens be ubiquitous to the Jennifer Aniston shag haircuts that were so popular in the nineteen-nineties? Now that we are able to alter our appearances so dramatically, the effects on our facial contours may become as changeable as with trends such as hair and fashion.

Does this look natural? Is this the ideal? Is this truly what we are after? When I see patients in consultation the answer is almost always a resounding “NO”! Why is this trend so popular? Is this a situation where the solution dictates the problem as opposed to the problem dictating the solution? Are we injecting volume because it is easy and readily available?

Aging is a complex process that involves all facets of the face: skin, fat, fascia, muscle and bone. It is the culmination of the downward vector pull of gravity on the interconnected anatomic weave of the facial structures. We first notice the loss of the cheek bones. In reality, it is the fat pad covering the cheek bones that descends downwards in a pendulum fashion from the upper cheek to the mouth. The fat gathers above the laugh lines, deepening these lines while the fat from the lower cheek descends vertically, effacing the jawline and creating the jowl. This creates a relative excess of volume in the area around the mouth and a paucity of volume in upper cheek. This creates disharmony in the facial volume distribution. 

How do we correct this problem? Well, as is always true in life – it depends on the severity. If someone is fairly young and these changes are minor, we can use volume to fill in the void of the upper cheeks and a small amount of fillers in the areas around the mouth to alleviate the hallmarks of early aging. If done judiciously, it creates a wonderful illusion of fullness and youth. We must remember that we are not lifting the volume that has fallen, we are just adding to the area to create this illusion.

In the case of more advanced aging the volume solution is not so simple; we are unable to compensate for the imbalance in the face. If we add a great deal of volume to the upper face to compensate for the descent of the fat pads, we inadvertently create an overly filled, round face. Our efforts, while sincere, are the genesis of the problem of the overly filled, plump face. In this case the solution is not “volume”. The solution is to raise these fallen fat pads to their original location using a very unique technique know as a “Deep Plane Facelift”, to restore a harmonious youthful, heart shaped face. This results in patients looking decades younger without anyone suspecting anything was done at all.

We are all born with a natural beauty, my priority is to restore it, not distort it! I use fillers in my practice to help postpone and augment a deep plane facelift – The key in surgery and in life is always to restore harmony!

Nip & Tuck- Beauty Notes- Scene Magazine July 2017

Which facelift looks normal, refreshed and natural, as opposed to pulled, stretched and plumped?

Facelifts come in many varieties. There are the mini-lifts that generally create a pulled appearance. The next level is the fascia facelifts that help reposition the fascia. The fascia is a layer of tissue within the cheek area that helps support areas of the face. These fascia facelifts provide decent support, longevity and look relatively natural, yet lack the ability to fully restore the aging face. There are some adjuvant techniques such as fat grafting that can fill in the shortcomings. So, is that all we have to offer? The answer is NO!

There is a rare type of facelift called the deep plane facelift. This lift not only supports fascia, but helps recontour the entire face, lift fat pads, restoring natural volume in areas where it has fallen, recreating the natural, youthful face that you once had (perhaps 20 years ago). By using only the natural tissue without overly stretching skin or overly plumping with fat or fillers, a deep plane facelift creates a very natural, rested and youthful appearance. This does not mean the other techniques are without merit, just not when performed to the extreme. This facelift provides a dramatic change in the appearance yet very subtle results. Our patients look refreshed, typically 15-20 years younger. Despite this their friends and family have no clue they even had a facelift. Now ask yourself, is that not the holy grail of facial rejuvenation? This facelift is extremely complex to perform and cannot be performed in one hour and is not offered as a drive-thru. We all know that in order to achieve our true goals we have to be diligent, methodical, focused, perseverant and have an unwavering mission to follow a true artistic vision to its pinnacle. 

How long can I expect the results of a facelift to last? 

Think of the deep plane facelift as a reset button. It will reset your appearance to approximately 15-20 years ago. From that point aging continues, although you will always look 15-20 years younger than your age.