Are high SMAS, Deep Plane face lifts ,and vertical face lifts the same lifts using different names? (photo)

Question

I need a face lift . I read a bunch of stuff from the web. I read the best for me is high SMAS or vertical SMAS face lift because it does better work vertically to remove my deep folds and making my face more natural looking. Do i need a neck lift? too??

Philip Solomon, MD, FRCS · Answer

You certainly could benefit from a face and neck lift procedure.  The two types of lifts you describe are technical and vary amongst surgeons.  The SMAS layer must be addressed during all facelifts by lifting it and tightening it.  The vector of pull is vertical in from of the ear and posterior/ superior  behind the ear. This gives the most natural result and avoids an unnatural appearance.  A deep Plan facelift is. one of the methods used to tighten the SMAS Layer.  It involves lifting the SMAS with the overlying skin as a thick flap. Excellent results can be achieved with different methods as long as the deeper layers (SMAS) layer are repositioned.    I tend to use a deep plane lift in any patient with heavier soft tissues.  See a few surgeons and  review your options.   I hope this helps.

Sammy Sinno, MD · Answer

You would benefit tremendously from a face and neck lift. The major goals of most techniques are to restore cheek deflation and descent, improve the jowls, and refresh the neck. The various techniques accomplish these goals to various degrees, but the most important aspect in facial rejuvenation is the preoperative assessment of your unique facial aging as well as skill level of the surgeon.

Kevin Sadati, DO · Answer

There are several different types of facelift techniques that are currently performed by facelift surgeons. The most important factor is that the technique that is used by a facial surgeon will create a youthful, natural with long lasting result. Experience is the key in facial rejuvenation. Vectors of facial tightening vary from patient to patient. For a 45- 50-year-old patient, I would not apply the same vector and tension that I normally apply to a 70-year-old face. In addition, direction of vectors must be modified during secondary or tertiary facelift to avoid artificial look. I have performed well over 3000 facelifts and published a specific technique that describe the rotational angles and amount of tension that must be applied during SMAS plication to avoid over or under tightening. A well-performed neck lift during facial rejuvenation is the paramount in a youthful-appearing face. I apply gradual tension on my SMAS as follow: starting at temple area there is only 20-30% tension on muscle plication, once at the jawlines the muscle is tightened 100%. This prevent pulled looked at the corner of mouth. In neck area the muscle must be tighten with greater tension than 100%, depending on the neck laxity. Look at the doctor’s before and after pictures, a talented and experienced facelift surgeon will have a smooth and well-contoured neck that enhances the facelift results. There is no substitute in experience and artistic eyes.

Sam Speron, MD, FACS · Answer

You seem to be good candidate but a lot of patients are confused with all the different marketing names for various facelifts, some of which are the same but some of which are totally different. Additionally, different surgeons are trained in different fields, hospitals and tweak the procedures differently so there's a lot of confusion out there. 
You should discuss with your surgeon the various types of face/neck lift they perform and is most appropriate for you. Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. I hope my answer helps and if it does, please take a moment to up vote this answer on the “respond” button on the top right.

Zoran Potparic, MD · Answer

You seem to be good candidate for face/neck lift and eyelid surgery. Very frequently these days, fat grafting and volume replacement is a part of facial rejuvenation done in the course of face lift. Once you select your surgeon let him decide which type of face/neck lift is most appropriate for you; they may be similar in the way we handle SMAS but individual needs of the patient will guide an experienced surgeon to make needed adaptations. Good luck.

John Mesa, MD · Answer

High SMAS, Deep Plane face lifts ,and vertical face lifts are NOT the same facelifts with different names. There are totally different facelifts that rejuvenate the face with different outcome. The most important aspect about the facelift technique is the after look. Patients interested in facelift surgery should choose the surgeon not based on the technique type, but the the appearance of the before and after pictures that best fits the patients goals.

Toby Mayer, MD · Answer

Which type of facelift is best? You could listen to 20 different lectures about facelifts and be even more confused. Don’t try to select the technique—select the surgeon who does Natural facelifts and he will know which technique is best.

John Michael Thomassen, MD · Answer

A high SMAS lift is similar to a vertical lift where a SMAS flap is elevated and pulled mostly vertically.  The deep plane lift is different in which the SMAS and the skin is elevated as one flap.  I believe the SMAS flap technique gives a natural long lasting result.  You could probably do great with neck lipo.

Evan Ransom, MD, FACS · Answer

Thank you for the question and your photos. There are so many different terms surrounding face and neck lifting that it can be quite confusing. Many of the terms are technical and have to do with the anatomy of the face and the procedure specifics. Some of the terms are just marketing -- surgeons attempting to present a particular technique as their own special invention or discovery. The SMAS is a connective tissue layer of the face that is continuous with the platysma muscle of the neck. Facelift procedures that go under this layer, release it, and reposition it, are much more powerful and give longer-lasting results. The direction of the lift is also important; vertical (or mostly vertical) lifts tend to give a more natural appearance and avoid the stretched or tight look of horizontal pull. Lastly, the difference between a deep-plane approach and a sub-SMAS approach has to do with the skin. In the former, the skin is kept attached to the SMAS medially (toward the nose) and is lifted as a unit. This gives a more natural appearance to the lift (in my opinion) and also reduces the rate of hematoma. Best of luck moving forward!

William Portuese, MD · Answer

These are all different types of face lifting techniques. It's very difficult to understand the technical nuances of the different types of face lifting techniques, so it's best to choose your surgeon based on producing natural results. Study your prospective surgeon's before and after facelift gallery make sure that is extensive and with many appearing natural results.  In our practice, we perform a high-SMAS lower face and neck lift procedure. For many examples, please see the link and the video below

Are high SMAS, Deep Plane face lifts ,and vertical face lifts the same lifts using different names? (photo)

Answers (15)

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