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 (26)

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 26 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 3 reviews

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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 81 reviews

Deep Plane and SMAS lift why doctors do either or which one


A deep plane lift is a type of smas lift. The smas is just the layer of muscle that all of your facial muscles reside. You pull on the smas to lift the face. The deep plane just described going deep to the SMAS to release structures so the SMAS is able to move better. Based on doing more than 1300 face lifts, I don't think the deep plane is any better.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 29 reviews

Is deep better than superficial??


The "Deep" plane face lift, (below the facial muscles), procedure was introduced about 20 years ago as a better and more long lasting way to improve on the standard more superficial, (above the facial muscles -SMAS),  techniques which had been done for almost the previous 50 years. Operating below the facial muscles puts the nerves to the facial muscles at risk for injury. With the dissection more complicated, the time of the operation is longer, there will be more post operative swelling and recovery. When patients have undergone one procedure on one side and the other on the opposite side,  post operative evaluation by independent plastic surgeons fails to show any appreciable difference. Make sure your surgeon is vastly experienced in the "Deep" plane technique. 

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 23 reviews

To each his/her own


Facelifting is a very personal art.  With patients requesting less down time, less surgery is more common now.  In both procedures the SMAS is lifted, but in the deep plane the dissection of tissue goes all the way to the cheek lip grooves (nasolabial folds).  There can be more swelling.  Equal numbers of surgeons seem to feel each type is the best way in my experience.  I tend to do a large SMAS flap.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

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


                 There are so many techniques to tighten tissues even within a category like SMAS plication or SMASectomy or deep plane.   It is the execution of the maneuvers and the tailoring of the operation to the individual that produces the best result.  Find a plastic surgeon with ELITE credentials who performs hundreds of facelifts, facelift revisions, and facial procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 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 18 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

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.