Is a deep plane facelift a high SMAS face lift where the ligaments are released?

Question

Does deep plane facelift lift the muscles underneath the SMAS and the high smas face includes a release of specific ligaments? Recently had a consultation with the doctor stating that he does a HI SMAS deep plane facelift and he told me that it makes it a deep plane facelift due to the ligaments that are released. So is a deep plane facelift a high SMAS face lift where the ligaments are released or is it deep plane facelift where the musculature underneath the SMAS is moved?

Frank P. Fechner, MD · Answer

You are asking a technical question which is commonly discussed at conferences among facelift experts. In essence, when the surgeon dissects beneath the SMAS layer s/he is able to release ligaments which in other facelift techniques limit the confluent repositioning of the facial tissues. Both, the deep plane and the high SMAS face lift procedures do this and are allow the surgeon to more effectively improve the overall facial contour. A high SMAS lift requires more surgical dissection - but this is a minor difference. Additional advantage of the deep plane facelift is that the skin maintains a robust blood supply leading to decrease in complication.

Brian M. Harmych, MD, FACS · Answer

These are two different approaches to facelift surgery and the results are typically not comparable when the deep plane is performed by an experiences surgeon. A high SMAS facelift is not a deep plane facelift. However, it is true that the facial retaining ligaments may ALSO be released in tradition SMAS surgery. However, the mobilization of the muscle, fascia and fat pads of the face and neck are not mobilized nearly as much with a tradition SMAS, or high SMAS facelift, and the results of high SMAS fall short of those typically achieved with true deep plane facelift.

Dallas Buchanan, MD · Answer

Thank you for your questions. This is a very advanced question and something that is debated and discussed at national meetings by experts in the field. I would encourage you to discuss this with your plastic surgeon and maybe do not worry so much about the details and more about the outcome and results. Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Matthew Bridges, MD, FACS · Answer

Deep plane essentially means dissecting beneath the SMAS layer.  Sometimes surgeons release ligaments in this process, but the cutting of ligaments does not define deep plane.  Some advice : don't get too caught up in the specific maneuvers the surgeon might use for a facelift.  Make your decision based on results.  There are many ways to skin a cat, especially with face-lifting.  Focus on results the surgeon has achieved, not so much in how those results were achieved.  Otherwise, you'll drive yourself nuts overanalyzing all the different facelift maneuvers.  Also, there are no facelift techniques that involve dissection deep to the facial nerve (except subperiosteal, which is beyond the scope of this discussion).  I think one of the previous doctors misspoke.

Ronald J. Edelson, MD · Answer

There are many different interpretations of a deep facelift and many different ways surgeons work on the SMAS. I think most surgeons do some muscle tightening work including the SMAS but there is no evidence that one is better or longer lasting than another.

William Portuese, MD · Answer

There is lots of anatomical technical nuances to your question that are going to be more confusing. A Deep plane facelift involves dissection below the facial nerve, which puts the nerve at risk for injury.  in our practice, we perform a high-SMAS  facelift which is performed above the facial nerve branches. Choose your surgeon based on excellent results, not which technique they perform. Study your prospective  surgeon's facelift photo gallery and make sure that it is extensive with Natural results that you like.

Is a deep plane facelift a high SMAS face lift where the ligaments are released?

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