Is it true that a SMAS facelift is a better option for crepey, wrinkly cheek skin than a deep plane facelift?

Question

Lucian Ion, FRCS · Answer

Hello, and thank you for your question. In my experience, neither technique is a one-size-fits-all solution for crepey, wrinkly skin. When it comes to managing reduced skin elasticity, the Deep Plane facelift seems to offer a slight advantage. This approach, especially when executed with a more vertical vector and an extended temple scar along the hairline, can discreetly enhance the mid-face and lower face appearance.

That said, the deep plane facelift tends to require less fat transfer or ancillary treatments to achieve significant and lasting improvement. It also exerts a stronger impact on the contour of the neck. In many cases, combining a facelift with a neck lift can yield the most comprehensive rejuvenation for both the lower face and neck.

Simona V. Pautler, MD · Answer

There are definitely pros and cons to both facelift types. DEEP plane involves less undermining of skin whereas SMAS goes more superficial and provides wider separation of skin from underlying structures. Both provide great results in the right hands. Whatever your surgeon is most comfortable with is probably the right type of lift to choose IF YOU LIKE HIS OR HER RESULTS IN THE BEFORE AND AFTER PHOTO GALLERY. But yes, the SMAS would be considered the better choice for more tightening of thin wrinkly cheek skin.

Anil R. Shah, MD · Answer

I am not a big a fan of SMAS lifts in general because they do not address the main cause of aging. Both lifts improve the appearance of aging. Consider lasers, skin care, a balanced diet, and active lifestyle to better the overall appearance. Best of luck.

Jacob Tower, MD · Answer

Hello, hope you are well. Thank you for posting your questions! The short answer is 'no'. All facelift techniques involve reducing skin redundancy to reduce wrinkles from skin laxity. I wouldn't say that there is definitively a better technique, but each surgeon will have an opinion on this and will gravitate toward the technique that provides the best results in their own hands. Studies have shown that more skin redundancy is removed with a deep plane lift than with a SMAS lift, and that aligns with my professional experience as well.

Best,
Dr. Tower

Best,
Dr. Tower

Jeffrey M. Darrow, MD · Answer

There are many ways to treat the SMAS during a facelift, and any of these where the dissection plane is deep to the SMAS are deep plane facelifts. It is important to understand that no single type of facelift technique has ever proven to be superior. Any of the procedures, done properly by a skilled plastic surgeon, should give an excellent result. What is not improved with the facelift is the quality of your skin. If the skin is creepy, some of it will be improved by the smoothing and tightening of the skin, but any further improvement would have to come with some form of skin resurfacing , whether it be by chemical peel, lasering, or some other energy base system. Speak to your plastic surgeon in detail about these options. Best wishes.

Andrew Miller, MD · Answer

In general, a facelift, SMAS or deep plane, is for lifting saggy tissues in the face and neck. It is not really a treatment for cheeks wrinkles as they will come back after the swelling goes down. Laser resurfacing is the treatment for wrinkles and it can often be done at the same time as a facelift if you want both treated. Be sure to see a facial specialist for consultation.

Zoran Potparic, MD · Answer

Every type of contemporary face lift is based on SMAS, including deep plane face lift.  Based on the current experience, slightly different types of face lift will produce similar results in the hands of experienced surgeons.  Selection of the procedure should be based on surgeon’s experience rather than patient’s demand. Hope this helps.

Connie Hiers, MD, FACS · Answer

For most people, yes, the SMAS lift is better at treating facial wrinkles. However, neither addresses thin crepey skin. For your skin, micro-needling with Sculptra injections can be helpful.

Robert Singer, MD · Answer

There are a variety of procedures that are called “facelifts.”  A well performed facelift which elevates and supports the deeper tissue of the face called the SMAS as well as removing the excess loose skin and adding appropriate amounts of volume to deficient areas of hollows and depressions not only turns back the clock, but also slow the aging process. However, the clock keeps ticking. 
Good results can be achieved with either technique, a SMAS or Deep plane, in the appropriate patient. What is more important than the specific technique is the experience and artistry of the plastic surgeon.

Some surgeons claim that “Deep Plane Facelifts” last longer, but there is no valid scientific evidence to support those claims.

I would suggest your  plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with who has all of the modalities of treatment available. You should discuss your concerns with that surgeon in person. Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

William Portuese, MD · Answer

Much more information is needed, such as your age and a full set of facial photographs to make a determination about many different styles and types of facelift procedures that are performed in the face and neck.

Is it true that a SMAS facelift is a better option for crepey, wrinkly cheek skin than a deep plane facelift?

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Answers (10)

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