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

Thanks Sensible253192 for your question! The surgeon's main goal in a typical, skin-only facelift is to redrape and remove extra skin. Because the underlying support structure (the SMAS and deeper tissues) isn't addressed, the skin may relax and sag again quite fast, even though this may initially provide the appearance of tighter skin. Comparable to tightening a slack clothing without modifying the underlying structure, the fabric may appear taut for a time before sagging once more.
The SMAS (Superficial Musculoaponeurotic System), a layer of tissue covering the facial muscles, is released and repositioned during a deep plane facelift. The surgeon can accomplish a longer-lasting and more natural-looking lift by targeting this deeper layer. After that, the skin is redraped over this enhanced foundation, which relieves tension and lessens the chance of premature skin relaxation.
The lifespan of any facelift, whether deep plane or skin-only, depends on a number of variables, including as skin elasticity, lifestyle, and heredity. After a facelift, it's normal to worry about possible side effects including hemorrhage, stiffness, and hardness. Although the incidence and severity of these adverse effects might vary based on the type of facelift and personal circumstances, they are absolutely feasible. Deep plane facelifts include greater manipulation of deeper tissues and blood vessels, which increases the risk of hematoma.
While skin-only facelifts have a lower risk, it's not entirely eliminated. Following any facelift, hardness and stiffness are often expected as the tissues settle and heal. However, if there is a lot of strain on the skin, which is more likely to happen with skin-only facelifts if the underlying support isn't addressed, excessive tightness and persistent hardness may result.
Although your worries are legitimate, getting a skin-only facelift just to stay away from these hazards might not be the best course of action. Weighing the possible advantages and disadvantages of each procedure is crucial, as is having a full conversation about them with a skilled board certified plastic surgeon. They can evaluate your particular situation and suggest the best course of action to meet your objectives while lowering risks.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian

Skin tends to relax more quickly after a skin-only facelift because the deeper structural layers of the face—particularly the SMAS (superficial musculoaponeurotic system)—are not addressed. In a skin-only facelift, the lift relies solely on the skin, which is elastic and less capable of holding long-term tension, especially in individuals with sun damage or reduced collagen. This often leads to earlier recurrence of sagging, particularly around the jawline and midface. In contrast, a deep plane facelift repositions the SMAS and deeper tissues, redistributing volume higher on the face and reducing strain on the skin itself. By lifting at a deeper level, the skin is better supported, resulting in more natural, longer-lasting results and less post-operative relaxation.

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.