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Deep plane vs SMAS facelift

Choosing between a deep plane facelift and a superficial musculoaponeurotic system (SMAS) facelift involves understanding the differences in techniques, benefits, and potential outcomes. Both are advanced techniques designed to address facial aging, but they differ in their approaches and results.

Deep Plane Facelift


  • The deep plane facelift involves lifting and repositioning the deeper layers of facial tissues, including the muscles, fat, and skin.
  • The procedure targets the deeper structures of the face, specifically the layer of tissue beneath the SMAS.
  • By releasing and repositioning these deeper tissues, the deep plane facelift provides a more natural and longer-lasting result.


  1. Natural Results: Provides a more natural look by repositioning the deeper tissues, avoiding the overly tight appearance.
  2. Long-Lasting: Results are typically longer-lasting compared to SMAS facelifts due to the repositioning of deeper structures.
  3. Comprehensive Rejuvenation: Effectively addresses sagging in the mid-face, jawline, and neck.
  4. Less Skin Tension: Since the deeper tissues are lifted, there is less tension on the skin, reducing the risk of visible scars.


  1. Complexity: The surgery is more complex and requires a highly skilled and experienced surgeon.
  2. Longer Recovery: Recovery time may be longer compared to SMAS facelifts due to the more extensive nature of the surgery.
  3. Higher Cost: Generally more expensive due to the complexity and expertise required.

SMAS Facelift


  • The SMAS facelift involves lifting and tightening the SMAS layer, which is a layer of tissue that covers the deeper structures of the face and neck.
  • This procedure can be performed by either lifting the SMAS layer separately or incorporating it into a composite lift with the skin.


  1. Effective for Lower Face: Particularly effective for improving the appearance of the lower face and neck.
  2. Versatile: Can be customised to the patient’s needs, whether a mini-lift or a more extensive lift.
  3. Moderate Recovery: Generally has a shorter recovery time compared to the deep plane facelift.
  4. Widely Available: More surgeons are experienced in this technique, making it widely available.


  1. Less Comprehensive: May not address mid-face sagging as effectively as the deep plane facelift.
  2. Potential for Skin Tension: Tightening the SMAS layer alone can sometimes result in an overly tight appearance if not done carefully.
  3. Durability: Results may not be as long-lasting as those from a deep plane facelift.

Factors to Consider

  1. Age and Skin Condition: Younger patients with less severe sagging may benefit more from an SMAS facelift, while older patients with significant sagging may achieve better results with a deep plane facelift.
  2. Desired Results: Consider whether you need more comprehensive mid-face rejuvenation or if your concerns are primarily with the lower face and neck.
  3. Surgeon’s Expertise: Choose a surgeon who is highly experienced in the technique you are considering.
  4. Recovery Time: Factor in how much downtime you can afford and your ability to follow post-operative care instructions.
  5. Cost: Be aware of the differences in cost and ensure that the benefits justify the expense for your situation.

Discussion with Your Surgeon

Having an in-depth consultation with a well trained surgeon is crucial. For many years most surgeons performing deep plane facelift surgery came from an otolaryngology (ENT) training background however with the rise in popularity of this technique it has become more universally performed. Here are some questions to guide your discussion:

  1. Which technique do you recommend for my specific facial concerns and why?
  2. Where did you
  3. Can you show me before-and-after photos of your patients who had these procedures?
  4. What can I expect in terms of recovery and potential complications?
  5. How long will the results last for each technique?

Your surgeon will help you make an informed decision based on your individual needs and goals. Dr Jason Roth is an otolaryngology surgeon who now almost always recommends and performs the deep plane facelift technique due to it’s superior results.

Before and After Photos Sydney
Dr Jason Roth Associations