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

The Deep Plane and SMAS facelifts are both very effective procedures.  Both operations dissect deep to the SMAS fascia to mobilize the face. The main difference is that in the SMAS facelift is more of a two-layer dissection (skin and SMAS separately) and the deep plane operation is more of a "composite" procedure (skin and SMAS together).  There are advantages of each technique and some surgeons, such as myself, vary the type of facelift they perform depending on the patient's anatomy.  In both procedures the surgeon must release the retaining ligaments of the face to achieve a natural appearance that is not "pulled" or "swept back". 

A deep pane facelift is a technique that some surgeons like to use. However, it's becoming less likely because a deep pane facelift involves a longer recovery period and there's usually a lot of swelling involved.

A deep plane lift repositions structures in a natural fashion by lifting the skin and SMAS (muscles) in one layer.  By lifting in one layer, particularly in patients with thin skins, a so-called "joker line" can usually be avoided (the muscle layer showing through as a line under the skin).  The blood supply is also better, so that there is little risk of losing part of the skin with the skin flap under tension.  The cheek structures, muscles, and ligaments retaining the face and cheek area are also treated, so that a natural look is easy to achieve without the patient looking "lifted".

There are many ways to achieve a good result with a facelift.  Some doctors will tell you that their way is the only way.  When I see a facelift consult I look to see what the problems are that bother them and then address those specific problems. Not everyone needs everything that the surgeon knows how to do.  Express your concerns to every plastic surgeon you see so they can tell you what would be best for you.

he SMAS technique is the most common surgical approach to a facelift.
However, most plastic surgeons use different surgical methods so that they can
customize the a facelift surgery in response to a patient’s anatomy and desired
outcome. In a SMAS procedure, the
skin is
separated from the underlying muscle tissues, the muscles are
repositioned and
tightened, and the skin is redraped. In the deep
plane technique, the skin and the underlying tissues are treated as one
continuous unit. Proponents of the deep plane technique prefer the
method
because it tends to lead to faster healing and better rejuvenation
results.
However, the deep plane technique is more intricate and, due to its
deeper
dissection, there is a higher risk of nerve damage. I personally use
different techniques with each patient as often the surgery requires to
an individual patient's needs. Some patients will benefit more from deep
plane technique, other from a SMAS technique. The best way to forward is to see a facelift surgeon for a consultation to discuss the best treatment options for you.

Both of the terms can be applied to a great number of techniques, there is no one and the same method called Deep plane lift and there is no very definite technique called SMAS. If try to describe in few words the difference between them, the Deep plane is the technique, which involves tightening the deeper structures of the face and more frequently used for the candidate with moderate to severe signs of aging. It can provide overall better results, as this technique allows the surgeon to lift the looser tissues up. Besides, it is more complicated technically and has more inherent risk of facial nerve damage.In a SMAS technique we more have a neck and jaw as an object of lift, than a face and cheek. A dramatic improvement in the neck and jowls can be achieved with experienced surgeon with less injuries, less recovery time and less cost.That is why I think choosing the board certified plastic surgeon surgeon you can trust and whose decision you can rely on, should be prior to choosing surgical method. I wish you best of the luck!

Hi LoveseansThank you for your question. It should always be possible to treat the jowls satisfactory with a  SMAS lift or tightening. With regards to the neck, combining liposuction and tightening of SMAS/platysma should successfully improve and rejuvenate the angle between the lower jaw and the neck. (cervicomental angle)I hope that helps but do some research and maybe talk to a surgeon specifically to get more information about you personally.

I have preformed both types of face-lifts and would agree as stated by other physicians that it really is the Dr. preference on what type of technique they use during the surgery.  Some of this may also depend on the extent of improvement that needs to be made, patients desired outcome, and other factors.Deeper plane face-lifts can be higher risk with nerve damage and longer recovery for patients but are still preformed safely by trained surgeons.  I would suggest finding a qualified physician and discussing your concerns and expectations and have them go over your options to find the best surgery plan for you. Looseness under the neck would be directly reflected if they included a (neck lift) with the lower face lift.  This involves surgically tightening the actual neck muscle itself.  I would say the majority of my lower face lift patients all need this as well.  Placement of the incisions can also vary result sometimes as well.

Ultimately one can achieve good results with different facelift surgical techniques.   Addressing the deeper layer of the face called the smas and platysma muscle are essential components of a good long lasting surgical result.   In certain cases the skin and Smas layers  are lifted together which is called a deep plane lift.   In other situations two layers are lifted separately known as a smas lift.   Your surgeon can discuss shich technique they are most comfortable performing in your situation.  

Both deep plane and SMAS facelifts can achieve goodresults. Surgeon’s experience plays a great role in achieving goodoutcomes. I have performed over 2500 facelifts using various techniques. For the past 7 years I have been performingSMAS facelift with local anesthesia and twilight sedation for all type of faceand neck laxities achieving a natural, and beautiful results. I tighten themuscle or SMAS in two layers for long lasting results.