Deep Plane Facelift Question. Why Do Some Doctors Do a Deep Plane Face-Lift vs A SMAS?

Why do some doctors do a deep plane face-lift vs a SMAS. From looking at pictures, it looks to me as if the deep plane works best for the jowl and neck area. Most pictures that I see after a Smas, I can still see residual looseness under the neck.

Doctor Answers (29)

SMAS facelift should tighten the jawline as well as a deep plane lift


Thank you for your question.  A properly performed SMAS facelift should provide as good a result as a deep plane facelift throughout the face including the jawline and neck.

In the SMAS facelift the neck muscle the platysma is tightened in the neck and along the jawline as well as the mid and upper face.

I seriously recommend that all patients considering facelift surgery choose their surgeon based on the surgeon's experience  and reputation as a facelift surgeon and let the surgeon decide the best technique to achieve the best result and your face.

The deep plane facelift can achieve excellent results in the hands of an experienced plastic surgeon however deep plane facelift does increase the risk of nerve injury which is why many experienced plastic surgeons choose not to use this technique.

Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Deep plane versus SMAS facelifts


The deep plane facelift is more technically demanding and has more inherent risk of facial nerve damage than a SMAS lift does. That being said, a surgeon experienced in the deep plane technique will likely have very few complications. The deep plane technique is potentially more useful for a very heavy face, requiring more aggressive suspension of the underlying tissue. The increased depth of dissection also typically increases the post-operative swelling. I would heed a common and valid theme on this board and find a surgeon who you are comfortable with and trust his or her judgement regarding the technique that he or she chooses.

Todd C. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Deep Plane Facelift Question. Why Do Some Doctors Do a Deep Plane Face-Lift vs A SMAS?


 It's a matter of preference.  I have performed facelifts for over 25 years and in my opinion achieving a natural, beautiful result from a facelift relies more on the ability to understand and follow the aesthetics of facial beauty than it does with the tissue layer that's dissected.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

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Training and Surgeon's experience will determine which Facelift you will be offered


Deep Plane Facelifts and SMAS Facelifts will give the exact same results in the "average patient". By "average patient" and for sake of discussion, let's say this means a female patient who is 55 years old with mild to moderate jowls and decent but not great skin tone and quality. When done properly a SMAS facelift will give you the same results that a Deep Plane Facelift will with quicker recovery and lower cost.

Now, let's take a female patient who is 45 years old with mild jowls and pretty good skin tone and quality. A Deep Plane Facelift may be a bit aggressive for her while a well executed SMAS Facelift will get her excellent excellent results with long lasting benefits.

Finally we have a 65 year old female patient with moderate to severe jowls and poor skin quality and tone. For her a Deep Plane Facelift will provide overall better results since the dissection is deeper and allows for heavier / looser tissues to be lifted up. A SMAS lift will certainly provide nice results as well but will not be easy to execute unless the surgeon knows who to get the most impact out of a SMAS facelift (and the fact is most surgeons know exactly how to do this!).

All facelift techniques can improve the neck but if neck problems are more than mild a dedicated neck procedure like a neck lift will be needed with both a Deep Plane Facelift or a SMAS Facelift.

The technique individual surgeons will choose will be based on their training level, depth of experience, overall comfort with each of the procedures and their ability to make sound judgement as to which procedure will offer the best outcome for each individual patient's needs.

Lastly it should be mentioned that some surgeons will only offer one procedure over the other to all patients because it offers the most financial benefit to them - sad but this can be reality.

Keep asking questions & do your research and all will be well,

Dr. J

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Deep plane facelift vs a SMAS lift


Dear Loveseasons,

  • I perform deep plane facelifts because, in my hands, I think it gets my clients better results
  • The difference is the amount and level of dissection, both are safe in experienced hands
  • You are very astute to look at the jowl area before and after, as that portion is often missed or unimproved after facelifting
  • If you find a surgeon with great before and after pics, it does not matter which technique is used, as long as you get the result you want

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Face Lift techniques, is one better than another?


There are many facelift techniques including deep plane, SMAS, composite, MACS, full and mini. Each of these techniques have unique benefits and risks and will all obtain excellent results in well trained and experienced hands. The best surgeons will carefully evaluate the patient's anatomy and desires in order to choose the technique which will reliably achieve the best results in a safe manner. Ask your surgeon to explain the technique they think will work best for your particular goals.

Andrew Goldberg, MD
Fairfax Plastic Surgeon
4.5 out of 5 stars 4 reviews

SMAS vs Deep Plane lifts


Good question. I do both. Ithink it depends on the issues that the patient has with their face. I generally think that the deep plane lifts are a bit more powerful, which can require additional procedures, like a midface lift and browlift, in order to keep the face looking natural. The SMAS type lifts can be varied a bit more but have some limitations. That's just my opinion and you'll get as many opinions as surgeons who choose to answer the question. There is not really any right or wrong. It's the "art", not the "science".

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 30 reviews

Deep Plane Facelift Question. Why Do Some Doctors Do a Deep Plane Face-Lift vs A SMAS?


Dear Seasons,

Thank you for your question.  Both SMAS and Deep planes are good techniques.  However, more important than the technique itself, is the surgeon.  The Techniques will have different results with different surgeons.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 29 reviews

Deep Plane vs. SMAS Facelift


Both the deep plane facelift and SMAS facelift are excellent. They are simply different techniques with the same goal.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Face lift techniques



Thank you for the question.  There are a handful of different face lift techniques.  The more extensive techniques are often better suited for patients with more aging issues.  When properly selected, the right technique, performed by the right surgeon, on the right patient will accomplish the best result.  I would define what you would like to accomplish and then seek consultation and options to achieve your result regardless of the technique.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 98 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.