I want to raise my drooping, long cheek muscles. Deep plane vs high SMAS lift? (Photo)

Question

Hi, I'm in my early 40's, I've always had genetically long drooping asymmetrical cheeks since I was I was younger. I have deepening Nasolabial folds in my 40's now that bother me which I have had filler twiice for. I don't have much skin laxity or jowls yet. My primary interest is to raise the actually cheek muscle to a higher position. Would deep plane face lift be best for this then? As I have read although SMAS is less invasive, it only lifts sagging cheek fat. I have gotten differing opinions when I have consulted. One said, I am a candidate for endoscopic mid face lift deep plane approach. Another said endoscopic mid face lift is rarely ever true deep plane and results fall in 1 year, so recommends mini face lift instead. Another recommended full face lift via high smas approach. Can someone tell me which type will be best to raise my drooping long cheek muscles?

Ali Cetinkaya, MD · Answer

Hello,In patients with genetically long and downward-positioned cheek muscles (malar region), the aging process can make this feature more prominent &mdash; especially with deepening nasolabial folds and a tired midface appearance.
Based on your description:
A mini facelift is better suited for mild jowling and jawline definition, but it typically does not effectively elevate the cheek muscles or midface.
An endoscopic mid-face lift can offer improvements, but it often targets more superficial tissues and in many cases is not a true deep plane approach. As you've heard, results can be limited in duration unless it's done with advanced technique and proper indication.
A high SMAS facelift does provide stronger lifting compared to mini lifts, but still may not sufficiently address deeply set or genetically low cheek muscles.
The Deep Plane Facelift, on the other hand, is specifically designed to reposition the entire SMAS and skin layer together, allowing for more effective lifting of the cheek muscles and fat pads to a more youthful and natural position.
For patients like you, with early signs of aging and genetically long cheeks rather than skin laxity, a deep plane facelift &mdash; performed by a highly skilled and experienced surgeon &mdash; would likely offer the most natural, effective, and long-lasting improvement.
However, a detailed in-person consultation with imaging and physical assessment is always necessary to determine the best individualized approach.

Erin Smith, MD · Answer

Hi,

I would be hard pressed to suggest one particular technique as best, as both the deep plane and high SMAS approaches may be effective in the right hands. I recommend seeing a board certified surgeon and reviewing their before and after photos before making your selection, as these will inform your anticipated result. Hope this helps!

Anya Costeloe, DO · Answer

Thank you for the photos and your question. Given your young age I recommend a deep plane facelift for several reasons. Deep plane facelifts provide longer-lasting results because they address the fundamental structural changes that occur with aging. By repositioning the deeper tissues rather than just tightening the surface layers, the results tend to be more durable and age more gracefully over time. Also, deep place typically produces more natural-looking results because it maintains the natural relationships between facial tissues rather than simply pulling them tighter. The deeper dissection allows for treatment of nasolabial folds better than other techniques. A mini facelift will not resolve nasolabial folds. I hope this helps, best of luck!

I want to raise my drooping, long cheek muscles. Deep plane vs high SMAS lift? (Photo)

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I want to raise my drooping, long cheek muscles. Deep plane vs high SMAS lift? (Photo)

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Everything you need to know about Deep Plane Facelift

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