Why does skin relax more in a skin only facelift versus a deep plane facelift?

A skin-only mid-facelift typically provides results that last a shorter time compared to deeper facelift techniques. On average, the improvements may last 1 to 3 years because the skin alone does not have enough structural support to maintain long-term lifting. Since skin naturally loses elasticity over time, relying only on tightening it can lead to a faster relaxation of results, sometimes creating an unnatural or pulled appearance.
In contrast, a deep plane facelift addresses not only the skin but also the underlying SMAS layer, repositioning tissues to a more youthful position. By restoring each layer to its proper place, this technique creates a more natural, long-lasting result, typically lasting around 10 years or more, depending on individual factors such as skin quality, aging process, and weight stability.
If concerns about hematomas or tightness are the reason for considering a skin-only approach, it’s important to note that modern deep plane facelifts are designed to minimize excessive tightness and tension on the skin, reducing the risk of an unnatural look or complications. Choosing the right technique for you should be based on both your aesthetic goals and long-term satisfaction.

Skin is designed to permit stretch. Pulling on skin only does not work in facelift surgery. We have known this for a long time ever since the original skin only procedures by Passot. We also saw the problems with placing tension on the skin in Sam Hamra's deep plane rhytidectomy that was originally described. The "deep plane" procedure today is actually an excellent procedure because it places the tension on the more robust, deeper tissues and skin follows along (because the skin is not delaminated off the deeper structures). Long story short, the "deep plane" procedures pull on more robust, stronger, less elastic structures compared to skin. I would go see an American Board of Plastic Surgery certified surgery who has experience in facial rejuvenation. This ensures that your surgeon has done proper accredited real plastic surgery training.