Is It Possible to Have a Deep Plane Proceedure Performed After a Simple Suspension Type (SMAS) Was Done?

Doctor Answers 5

Deep plane facelift after SMAS suspension is possible but difficult

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This is a great question. The layers of the face dissected are what determine the efficacy of a facelift. The downward descent of the underlying structures of the face such as the SMAS is what contributes to the aging changes seen.  

Quite simply, a facelift is an operation of release and resuspension


A SMAS suspension tightens the SMAS but it does not usually release the SMAS and resuspend it in a favorable position.. A deep-plane facelift is usually performed by an expert facelift surgeon. This involves dissection underneath the SMAS which allows for release of this structure and resuspending it in a natural vector. The best results are usually vertical vector facelifts.  


Deep-plane facelifts should be performed by a board-certified facial plastic surgeon or plastic surgeon who is comfortable with this advanced technique. Any revision facelift is more difficult then the first time around but it is definitely still possible.

Best of luck, 

Sachin Parikh, MD 

Bay Area Facial Plastic Surgeon

Deep face lift vs SMAS facelift

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A deep plane facelift can be performed after a SMAS plication. Not many people use this technique, and I am not sure why you are specifically interested in this one.

Deep Plane vs. SMAS Facelift

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             It is possible, but I would not recommend it.  Several studies have reviewed facelift results, and skin only facelifts, SMAS plication, SMASectomy facelifts, and deep plane facelifts all produce similar results.  The rate of facial nerve injury is much higher in deep plane lifts.  Very few people perform the deep plane lift at this point.  If you find someone who performs it, make sure that he or she has done it at least 50 times and ask about rate of facial nerve injury.

Old Operative Report?

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 This is often a tough question without reviewing your original FaceLift operative report. May I suggest you attempt to obtain it from your original surgeon or the facility (hospital) where you had the procedure done.

 FaceLifts today often combine procedures like SMAS or Deep Plane and Fat Grafting. Consider taking this report with you to your cosmetic consult where your concerns could be addressed. Best,


Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon

Secondary facelifts

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The issue you will face here is potential damage to the facial nerve branches that make your facial muscles move.  Previous surgery can potentially increase that risk especially if the next surgery is one where the nerves are intentionally near the operative field.  Staying superfical would be safer and in the right hands works every bit as well or even better than a deep plane lift.  All the patients on my web site are SMAS lifts, not deep plane lifts.

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.