Facelifts: deep plane / smasectomy

Do deep plane facelifts allow for as much excess smas / fat and skin removal as smas to reshape the face? Or does deep plane facelifting work mainly on repositioning things?

Doctor Answers 6

Deep Plane/Smasectomy

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Thanks for the question.  Deep plane facelifts allow for a greater degree of repositioning than the SMAS suturing techniques.  I would focus on the facelift technique's ability to reposition your facial tissues rather than remove SMAS and fat, as volume removal is only good when it cannot be repositioned to a more favorable position.  As the face ages, it generally loses volume (not uniformly), and any tissue removal may need to be addressed with volume restoration in the form of fat grafting or fillers at a later date.

Best Wishes,

Summit Kundaria, MD

Charlotte, NC

Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Deep plane is SMAS

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It is honestly less about how much SMAS/skin is removed and more about repositioning the deeper tissues back to where they were and letting the skin redrape over the new contour.  It is surprising how little skin and SMAS actually need to be removed to get the look you desire!  Subcutaneous facelifts (skin only) rely more on taking more skin out as the vehicle to lift the deeper structures and therefore do not last as long or have as strong as an effect.  It really depends on what your particular face needs.  Your facelift surgeon, certified by the American Board of Plastic Surgery, should help explain your unique needs.  Hope that helps.

Dr. Z

Deep plane versus SMAS

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Thank you for your question. This is quite complicated so it's going to be difficult to answer on a forum such as this. Every facelift technique is slightly different and every surgeon has stylistic differences and how they perform the same technique. Therefore a deep plane facelift in one surgeons hands is usually different from the deep plane in another.  While there are anatomical reasons why a deep plane facelift may be better for soft tissue resuspension, the result will largely depend on the specific surgeon and his technique.

Both a deep plane facelift and a SMAS facelift can reshape the face, and reposition volume. Which is better depends on the patient and the specific execution.  

Sorry for such a "non-answer" but it's not as easy as saying one technique is better for removing more skin - they can both be equal, or one can be better depending on the patient and the operator.

Best Wishes,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Christopher C. Chang, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Not all the same

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Not all deep plane facelift are the same. In my practice and my opinion the HIgh SMAS deep plane facelift allows for the best of both worlds. We can reposition structures (as most deep lifts do) but we can also excise or remove SMAS which is very useful for patients who have heavy faces.

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 46 reviews

Facelifts: deep plane / smasectomy

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Deep plane facelifts and smasectomy procedures are certainly different.  The amount of SMAS removal is not really the most important issues.  The degree of movement using mobilization of the SMAS followed by lifting (in the proper direction) is what really gives you the final results. 

One of the most important parts about a deep plane or extended-SMAS flap technique is that the SMAS layer is undermined and fully mobilized to shift up and back as unit.  Often the SMAS layer is then overlapped and secured in position.  In some areas like the upper lateral cheek this can be very helpful in bringing natural volume back to the area.  If needed, the overlapping SMAS can actually be excised.

Lateral SMASectomy involves excising a strip of SMAS and tightening the edges onto themselves.  Good results can be obtained, but a deep plane technique will allow for a more complete mobilization of the deeper layers in the natural direction.

Comparing the amount of skin removal between the two techniques is too complicated to try to simplify in a brief answer here.  

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon

Deep plane vs lateral smasectomy

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the answer to this is more complicated than you can imagine.  You can have a very advanced lateral smasectomy do much more than a limited deep plane or vice versa.    The most movement you can get naturally is by extended deep plane lifts in general.   They vary significantly from surgeon to surgeon and you should base your decision mainly on what changes you see in photos rather than what the surgeon chooses to call the technique.  Mine is called auralyft, which is a gimmick of a name I use to simplify saying vertical vector modified and extended deep plane lift. In the end only the photos matter. 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

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.