What’s the difference from a SMAS facelift and a DEEP PLANE facelift and is 49 too young?

The most significant difference between my Deep Plane facelift approach and a SMAS facelift is that the Deep Plane will reliably correct the marionette frown. This is often the earliest sign of aging, typically showing up in the late 40's - early 50's and you are not at all too young for a Deep Plane Facelift. Rather than focusing on the name of the surgery during consultation you should discuss your expectations. A facelift should correct the neck, jawline, marionette frown and lift the cheek without the need for fillers and the surgeon should be able to demonstrate expected results in these areas with before and after photos of their work.

Hi
Thanks for the question. In my opinion a deep plane facelift is a good option for patients considering facelift at a younger age and 49 is not too young . Facelifts deal with structural laxity in the face that lead to some of the features that people dont like such as jowls , deep nasolabial folds and neck laxity.
In a SMAS plication the surgeon dissects between the skin/fat layer and an elastic layer called the SMAS. Working above the smas the surgeon uses sutures to lift the smas. In a deep plane facelift the surgeon works deep to the SMAS and releases ligaments which can tend to hold the SMAS fixed . With this release the smas can be repositioned without tension and the skin and smas remain attached and move as one block and so although a little more complex can give a very natural looking outcome. I tend to reserve a smas plication facelift for older patients who have coarse wrinkles in the face for which going in between the skin and smas can be useful.

Hi there.
Deep plane is an advanced and more invasive type of facelift. With this approach the surgeon is able to free up all the SMAS and platysma muscle from the deeper structures, allowing for a more effective, natural and longer lasting result.
The deep plane is more effective also in treating the marionette lines and nasolabial folds, as well as repositioning the cheek fat compartments higher on the midface.
During a SMAS facelift there is no extensive release from the deeper muscles and nerve, hence the above mentioned areas are not fully addressed.
The deep plane technique requires an in depth knowledge of the facial nerve anatomy, something that only experienced facial surgeons have in their repertoire. Having said that, there are very experienced surgeons out there performing SMAS lifts only, and have consistently great results and very happy patients.
At 49 you are at a good age for a facelift, if you have concerns with facial aging. Age is just a number at the end and some people will look good without surgery even at their late 50's. On the other hand some patients may show signs of premature aging and be candidates for facelift surgery at an earlier stage- late 30's/ early 40's.
Best wishes

Hi,Thank you for your question. The difference between a SMAS and Deep Plane facelift can be very confusing, even for young surgeons learning the procedures. One of the main reasons, is that surgeons often use different terminology to describe similar facelift procedures, so a SMAS or Deep Plane may look very different depending on the surgeon preforming the procedure. In general, the terminology is used to describe the plane of dissection in the face used in effort to have the desired lifting. Deep to the skin of the face there is the layer called the SMAS ( Superficial muscular aponeurotic system). This is a unified layer that contains the fatty tissue intertwined with the muscles of the face by connective tissue called fascia. This is a very important layer because sagging tissue is this layer form the jowls, the nasiolabial folds, and neck bands. These are all the areas addressed during a facelift. The SMAS layer can be elevated very safely by a skilled surgeon allowing for pure vertical lifting of these tissues for a nice rejuvenated appearance that does not look too tight or "wind blown" because the tissues are simply lifted up back where they belong. However, this requires some careful dissection and is often what is referred to as a deep plane facelift or extended deep plane. The nerves controlling the face are right underneath this layer, requiring extra care and skill, but it gives the most lasting and natural results. When only skin is elevated during the procedure and the skin simply pulled back in a more lateral direction while the SMAS is minimally elevated or just has sutures thrown through it without elevating it is called a SMAS facelift. This is done without the time and careful dissection required with a deep plane. This procedure can be done in the office with some good success, but much more limited in longterm results. I would need to see some photos to help guide further regarding choice. Hope that helps!
Matthew Tamplen MDTamplen Plastic Surgery

You must trust the surgeon who operates on you and look at multiple before and after photos. Dr. Orfaniotis is right in that surgeons call the same thing differently. Both procedures work well in the right hands. Discard the selling or marketing wording and look at the results. We go through periods where everyone talks about a short scar lift, S lift, lifestyle lift, etc. when all you need is a good, experienced surgeon. Results matter!

First it is not your age , it's how you age. You pursue surgery when the facial aging bothers you. There was a twins study years ago with ten year follow up which revealed that a deep plane did not provide longer lasting results at ten years.
A smas face lift will provide excellent results. The issue is how to address the smas : imbricaton, smasectomy, or high smas.
This must be individualized to the patient,