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Deep Plane Facelift

Deep Plane Facelift

What is a Deep Plane Facelift?

A facelift, also called a rhytidectomy, is a surgical procedure to restore a youthful facial appearance. A deep plane facelift is a specific type of facelift in which the deeper layers of muscles and tissues underneath the skin are repositioned in order to correct facial aging without an overly tight look. This technique is especially beneficial for patients seeking to address loose or sagging skin in the mid-face and lower face.

Dr. David Cangello is a board-certified plastic surgeon in New York City, renowned worldwide for his artistry and exceptional surgical skill. Dr. Cangello is highly experienced in facial plastic surgery and dedicated to delivering natural-looking results.

Deep Plane Facelift Vs. Standard or SMAS Facelift

Traditional facelift surgeries were cutaneous, meaning that only the skin was pulled back, with no repositioning or tightening of the underlying tissue or muscles—which often led to an overly tight or “done” appearance. However, these signs of facial aging are the result of more than just sagging skin. The soft tissue of the face below the skin level also tends to sag with age as the ligaments of the face weaken. Hence the SMAS facelift was developed to address the superficial musculoaponeurotic system (SMAS), which is the layer of connective soft tissue that sits within the subcutaneous layer of the face between the facial muscles and the skin and plays an important role in our facial expressions.

The SMAS layer of the face can be treated in many ways, through plication, SMASectomy and SMAS flap elevation. With SMAS plication the SMAS layer is folded over on itself after it is pulled in a posterior and upward direction and sutured into place. With SMASectomy, the small section of the SMAS that is folded over on itself when a plication is performed is actually excised. Typically plication would be performed in patients who can benefit from volume distributed to the lateral aspect of the face and cheek bone area where the plication occurs. A patient who does not need additional volume in this area would likely be treated with SMASectomy. SMAS plication and SMASectomy are good options for some facelift patients (generally those with good skin elasticity and mild to moderate facial aging).

Extended SMAS flap and deep plane lift both involve a dissection below the SMAS layer with repositioning of the muscles and fat pads themselves. Extended dissection under the SMAS, employed with these techniques, allows for greater elevation and repositioning of the soft tissues of the face in order to restore a youthful appearance. As an added benefit of deep plane face lifting, minimal tension is placed on the skin closure, which will contribute to more inconspicuous scarring.1

While some consider the deep plane lift more invasive than an SMAS flap, the deep plane technique keeps the muscles, fat and skin intact as one composite layer. The skin does not need to be elevated off of the SMAS to the extent that it may when a SMAS flap is performed—thus the skin and SMAS are lifted and repositioned together, as opposed to the SMAS flap technique that separates the skin from the muscle and tissue. By moving not just the skin, but also the underlying deeper tissue, ligaments, and muscles, the deep plane facelift technique allows for increased flattening of the nasolabial fold, greater restoration of facial volume, and possibly longer-lasting results than a SMAS lift.

Benefits of Deep Plane Facelift

  • Comprehensive facial rejuvenation
  • Improvement of deep nasolabial folds
  • Restoration of lost volume in the mid-face
  • Jawline enhancement and correction of jowls
  • Delivers a natural-looking appearance
  • Long-lasting results

Candidates for Deep Plane Facelift Surgery

Dr. Cangello offers a range of facelift procedures so you can rest assured that he will recommend a treatment plan that is tailored to your unique needs and goals.
Good candidates for deep plane facelift surgery are:

  • In good general health
  • Non-smoking, and do not use nicotine in any form
  • Seeking a long-term solution for sagging or drooping skin and/or volume loss in the lower and mid face

Your Deep Plane Facelift: What to Expect

Preparing for a Deep Plane Facelift

The first step is a consultation appointment with Dr. Cangello, during which he will examine your face and discuss your concerns and aesthetic goals. If deep plane facelift surgery is right for you, he will create a treatment plan and review pre-surgical guidelines with you.

What Happens During Deep Plane Facelift Surgery

Deep plane facelift surgery is typically an outpatient procedure performed with general anesthesia. Dr. Cangello will make incisions at the hairline and around the ears and then proceed to release the underlying ligaments in order to manipulate the facial tissue and muscle into a more youthful position.

Recovery After Deep Plane Facelift Surgery

After the procedure you will have drains in place to remove any fluid that may accumulate under the skin. They are usually removed the following day. When you leave Dr. Cangello’s operating suite you will have nursing care at your apartment in Manhattan or at a local hotel in Manhattan. This will be arranged for you by our patient coordinator.

Recovery time after a deep plane facelift can vary, but patients should generally expect about 2 weeks of downtime. Some temporary bruising and swelling is normal in the days after surgery. Dr. Cangello will advise you on pain medication and give you guidelines for your recovery period.

Frequently Asked Questions About Deep Plane Facelift Surgery

As it is the most comprehensive type of facelift, the cost of a deep plane facelift will typically be a bit higher than a standard or SMAS lift. However, the deep plane facelift will generally provide the longest-lasting results and is the most effective option for many patients. The exact cost of your facelift will vary depending on the treatment plan that will be customized just for you at your consultation appointment.

A facelift is permanent, but does not stop time and the continuing effects of gravity and lifestyle. Individual results vary, but patients typically enjoy results for up to 15 years. You can increase the longevity of your results with quality skincare products and non-surgical treatments.

You will look like a refreshed and youthful version of yourself. One of the primary advantages of the deep plane facelift technique, when performed by a skilled surgeon, is that the results are very natural-looking.

Since there is no tension on the skin, the incisions are very easily camouflaged and heal quickly and you avoid the overly tight appearance of traditional facelift techniques.

Any surgical procedure carries some risk of side effects or complications. You can reduce your risk by choosing a board-certified surgeon and following all pre and post surgical instructions. The most common risks of facelift surgery include bleeding, infection, changes in skin sensation, and anesthesia risks.2 Dr. Cangello will review all risks and benefits with you at your consultation appointment.

Depending on their goals and concerns, patients may choose to include eyelid surgery or a neck lift with their facelift procedure.

Contact Dr. David Cangello

Dr. Cangello is happy to answer any questions and discuss your options. Contact us to learn more or schedule a consultation appointment at our Manhattan office.

1 Raggio BS, Patel BC. Deep Plane Facelift. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
2 American Society of Plastic Surgeons. Facelift surgery. Available: Accessed May 25, 2022.

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The consultation fee with Dr. Cangello starts at $250. Your consultation fee may be applied to your procedure, provided you undergo the same procedure for which you had the consultation.