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SMAS vs. Deep Plane: Which Facelift Is Right For You?

older woman looking in the mirror

Facelift surgery, medically referred to as rhytidectomy, has long been a popular solution for those looking to rejuvenate their appearance and combat the signs of aging. With advancements in cosmetic surgery, there are now various facelift techniques to choose from, each with its own set of advantages. Two of the most discussed methods are the Superficial Musculoaponeurotic System (SMAS) facelift and the Deep Plane facelift. Understanding the differences between these two facelift procedures can be crucial in determining which is right for you.

The SMAS Facelift: A Traditional Approach

The SMAS technique, or traditional facelift, is one of the most widely performed types of facelifts. This technique focuses on the layer of tissue just beneath the skin and the fat called the Superficial Musculoaponeurotic System. The SMAS layer is responsible for much of the facial structure and aging changes.

How The SMAS Facelift Works

When using this less invasive surgical technique,1 the surgeon will typically make incisions along the hairline and around the ears. The skin is then lifted, and the SMAS layer is tightened and repositioned. This helps to lift and firm the lower two-thirds of the face, reducing sagging in the cheeks, jowls, and neck.

SMAS Benefits

  • Widely Available: Most plastic surgeons are familiar with this technique.
  • Proven Results: It has a long track record of providing a more youthful appearance.
  • Recovery Time: Generally, the recovery time is shorter compared to more invasive procedures.

SMAS Considerations

  • Limitations: It may not address severe sagging in the neck and cheek area.
  • Skin Tension: More tension on the skin can lead to a slightly less natural look in some cases.

The Deep Plane Facelift: A Deeper Correction

The Deep Plane technique is a more advanced surgical procedure that goes deeper than the traditional SMAS lift. It addresses not only skin laxity in the SMAS layer but also the deeper tissues and structures of the face, including the facial muscles, ligaments, and fascia for more comprehensive facial rejuvenation and definition in the lower face and jawline.

How The Deep Plane Facelift Works

In this procedure, the surgeon works beneath the superficial SMAS layer, releasing ligaments and repositioning the entire facial musculature. This allows for a more comprehensive repositioning of the face’s structure, potentially leading to more dramatic and longer-lasting results.2

Deep Plane Facelift Benefits

  • Natural Appearance: By addressing deeper layers, it can achieve a more natural-looking rejuvenation.
  • Longevity: Results may last longer than those of a SMAS lift.
  • Comprehensive Correction: It can address more severe signs of aging, including deeper nasolabial folds and sagging in the mid-face and neck areas.

Deep Plane Facelift Considerations

  • Surgical Complexity: It’s a more complex procedure and requires a surgeon with specific training and experience.
  • Recovery Time: Recovery can be longer and might include more swelling and bruising.
  • Cost: It may be more expensive due to its complexity.

Which Facelift Is Right for You?

Deciding between the SMAS and a Deep Plane facelift primarily hinges on your individual aging concerns, desired outcomes, lifestyle, and budget. If your aging signs are moderate, a SMAS facelift might be sufficient. It offers a shorter recovery time and is generally less expensive, making it a pragmatic choice for those looking for noticeable yet less extensive rejuvenation. However, for those facing more advanced signs of aging and desiring a more profound and lasting transformation, the Deep Plane facelift is likely a better fit. This technique delves deeper into the facial structure, addressing more severe sagging and aging features, and typically yields more natural-looking, long-lasting results. However, it requires a longer recovery period and can be more costly.

Ultimately, the decision should be made in consultation with a board-certified plastic surgeon. Factors like the surgeon’s expertise in specific facelift and neck lift techniques and your own needs and cosmetic goals should be considered.3 A well-chosen facelift should not only enhance your physical appearance but should also align with your lifestyle and boost your overall well-being and confidence.

Learn More About SMAS and Deep Plane Facelifts

Both SMAS and Deep Plane facelifts have their unique advantages and considerations. It’s essential to have a thorough consultation with a board-certified plastic surgeon to discuss your goals, examine your facial structure, and understand the risks and benefits of each procedure. Dr. Cangello is an experienced surgeon who can guide you in making an informed decision that aligns with your aesthetic goals and lifestyle and can also provide recommendations on complementary procedures such as rhinoplasty, blepharoplasty, or fat grafting. Remember, the best choice is one that not only enhances your appearance but also boosts your confidence and quality of life.


1 StatPearls. SMAS Plication Facelift. Available: https://www.ncbi.nlm.nih.gov/books/NBK531458/. Accessed January 18, 2024.
2 StatPearls. Deep Plane Facelift. Available: https://www.ncbi.nlm.nih.gov/books/NBK545277/. Accessed January 18, 2024.
3 StatPearls. Extended SMAS Facelift. Available: https://www.ncbi.nlm.nih.gov/books/NBK562296/. Accessed January 18, 2024.

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