Deep Plane Facelift vs SMAS Facelift: Understanding the Differences

Concerns about achieving a natural appearance after facelift surgery are common among individuals considering the procedure. Two primary facelift techniques are the Superficial Musculoaponeurotic System (SMAS) facelift and the deep plane facelift, each differing in their approach to repositioning facial tissues.

The SMAS facelift involves lifting the skin and tightening the SMAS layer without releasing or repositioning deeper facial structures. This technique primarily targets the lower face and jawline but may not effectively address midface laxity or deeper nasolabial folds. Additionally, separating the skin from underlying muscles in this method can sometimes result in a taut appearance (Jacono & Bryant, 2020).

Deep Plane Facelifting and Complementary Facial Rejuvenation
The deep plane facelift approach involves an entry point positioned closer to the midface and jowl compared to traditional or lateral SMAS techniques. This placement allows for direct access to deeper facial structures, which may facilitate repositioning of central facial tissues (Image Reference: The Art and Science of Extended Deep Plane Facelifting and Complementary Facial Rejuvenation Procedures. Dr Andrew Jacono.)

In contrast, the deep plane facelift maintains the integrity of the SMAS layer and involves accessing deeper attachments in the cheeks and lower face to lift and reposition tissues. This approach allows for comprehensive correction of facial laxity, including the midface region, and may result in longer-lasting outcomes (Jacono & Bryant, 2020).

Traditional facelift techniques also typically involve tightening the face horizontally, resulting in an artificial and stretched appearance that can affect the corners of the lips and create an artificially tight appearance.

Traditional horizontal facelift and new more natural vertical vector facelift

A study indicated that the need for secondary procedures, such as a tuck, was 71% less frequent after a deep plane facelift compared to a SMAS facelifts, suggesting that the deep plane technique may be more effective in certain cases (Hamra, 1998).

Vertical vector facelift

The deep plane facelift technique involves repositioning deeper facial structures, which may contribute to changes in cheek volume, elevation of tissue around the mouth, and softening of nasolabial folds and marionette lines.

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