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).

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.

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).

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.
References:
- Hamra, S. T. (1998). The deep-plane rhytidectomy. Plastic and Reconstructive Surgery, 102(5), 1646–1653. https://doi.org/10.1097/00006534-199810000-00046
- Jacono, A. A., & Bryant, L. M. (2020). Extended deep plane facelift: A prospective analysis of long-term patient satisfaction and outcomes. Aesthetic Surgery Journal, 40(7), 711–724. https://doi.org/10.1093/asj/sjz089