Is a deep plane facelift or SMAS facelift the better choice? It’s a question that comes up often when discussing more advanced facelift techniques, as both involve working with the deeper structures of the face than other approaches.

While they share some similarities, the way each technique is performed, the tissues addressed, and the level of surgical work involved can differ.

In this blog, we’ll go over the differences between the two procedures. If you want help deciding which approach may be more suited to your needs, we recommend discussing what you would like to achieve during a consultation with Dr Rastogi.

How does the SMAS facelift work?

The SMAS facelift focuses on the Superficial Musculoaponeurotic System, which is a layer of connective tissue and muscle that lies beneath the skin and fat. In a SMAS facelift, the doctor repositions and tightens this layer.

The surgery is generally performed through incisions around the hairline and ears, with the doctor working to separate the skin from the underlying SMAS layer. Once exposed, the SMAS is lifted and secured, sometimes with excess tissue trimmed. The skin is then placed back over the area with less tension, using the deeper changes to maintain the results for longer.

By addressing the SMAS, there can be a stronger underlying framework, which can help maintain results over a longer period. However, this method typically does not involve significant release of deeper retaining ligaments in the mid-face, so changes in that area can be more limited compared to other techniques.

How is the deep plane facelift performed?

A deep plane facelift goes beyond the SMAS by releasing and repositioning the deeper facial layers as a single unit.

In this technique, the doctor lifts the skin and SMAS together rather than separating them. The dissection occurs beneath the SMAS layer, allowing for the release of deeper ligaments that tether the facial tissues.

The deep plane method can allow for more movement of the mid-face structures, including lifting tissue in the cheek area without directly pulling on the skin. The repositioning happens at a deeper level, which means less tension is placed on the outer layers during closure. This can result in a more even skin surface and may address areas that a standard SMAS lift cannot fully reach, such as volume descent in the mid-face.

Since the technique involves working closer to the facial nerves, it can be considered a more complex procedure than the SMAS facelift.

What can I expect during recovery?

Recovery from either procedure will involve swelling, bruising, and some discomfort, particularly in the first couple of weeks. Since both involve deeper tissue adjustment, the internal healing will take longer than the surface appearance might suggest.

Patients are generally advised to keep the head elevated and avoid activities that increase blood pressure to the face during the early stages of recovery. Gentle walking is usually fine as soon as you feel able, but any strenuous exercise or lifting should be avoided until your doctor confirms it is okay to resume.

With a deep plane facelift, swelling in the mid-face can take longer to subside due to the more extensive changes made in that area. In a SMAS facelift, swelling may be more concentrated around the jawline and lower face. Bruising can last for a couple of weeks in both cases, though the exact timeline depends on individual healing rates.

Numbness in certain areas is common with both methods, as the skin and underlying tissues adjust after being lifted. Sensation typically returns gradually over several weeks to months. The incision lines will initially appear red or pink but will usually fade over time.

How long do the results last?

Both a deep plane facelift and an SMAS facelift aim to produce results that last significantly longer than other techniques, since they address the structural layers of the face. The duration of these results can vary depending on factors such as skin quality, bone structure, lifestyle habits, and the extent of the procedure.

The deep plane method, with its ligament release and more comprehensive repositioning, can offer changes that may hold for longer in the mid-face compared to SMAS techniques. However, the SMAS facelift still provides long lasting results, particularly in the lower face and jawline.

Essentially, the longevity of the results of either procedure will depend on your personalised procedure and other individually-varying factors.

How can I choose between the two techniques?

Deciding whether a deep plane facelift or SMAS facelift is more suitable for you involves more than just looking at the techniques in isolation.

The best choice will depend on which facial areas require the most adjustment, your individual anatomy, and the doctor’s experience with each method.

Some doctors prefer SMAS techniques for patients with more lower face laxity and less mid-face change, while others recommend the deep plane approach when both the mid-face and lower face will be addressed. The surgical plan is often individualised rather than following a one-size-fits-all approach.

A thorough consultation that includes facial assessment, medical history review, and a discussion of surgical goals is important. A consultation ensures the technique selected aligns with the areas being targeted and the patient’s overall treatment plan.

Book a consultation for a deep plane facelift or SMAS facelift with Dr Rastogi in Double Bay, Sydney

A consultation with an experienced cosmetic doctor will be the most helpful step in deciding which type of facelift will be the most suitable approach to address your needs and expectations.

Based in Double Bay, Sydney, Dr Rastogi is a cosmetic doctor, as well as a fellow and the President of ACCSM (Australasian College of Cosmetic Surgery and Medicine).

Dr Rastogi provides his patients with a warm and understanding consultation process, allowing two hours or more for sufficient communication and planning. He has a supportive team that will also play a helpful part in your surgical journey.

Once you’re ready to book a consultation, please feel free to contact our team.

Read more about facelift:

Is Deep Plane Facelift Better Than SMAS Facelift?