Over the past few years, the deep plane facelift has established itself as one of the most discussed facelift techniques in the specialized press and among the general public. Several public figures have openly mentioned it, which has contributed to its popularity. But how does this technique really differ from the classic facelift, known as the “SMAS lift” or “classic cervicofacial lift,” which has been practiced for several decades?
This article reviews both approaches, their indications, their outcomes, and recovery.
The traditional facelift (SMAS technique) stretches the skin and the musculoaponeurotic layer separately. It offers good results on the oval of the face and neck, with an average longevity of 7 to 10 years.
The deep plane facelift releases the retaining ligaments of the face and lifts the skin and SMAS together, in a single composite flap. Il agit plus efficacement sur la zone médiane du visage (pommettes, sillons nasogéniens), donne un résultat plus naturel et tient en moyenne 10 à 15 ans.
The deep plane is technically more demanding and is not always the best choice for every patient. The preoperative consultation remains the decisive step in choosing.
The classic facelift, also known as the SMAS facelift, is the reference technique practiced since the 1970s-1980s. SMAS means Superficial Musculoaponeurotic System, the fibrous and muscular layer that lies beneath the skin of the face.
In this technique, the surgeon
It is a proven, safe technique that produces excellent outcomes on the jawline, jowls, and neck. It remains the technique of choice in many cases.
The deep plane facelift was first described in 1990 by American surgeon Sam Hamra, then refined by surgeons such as Tim Marten and Andrew Jacono. Its key difference lies in the plane of dissection.
Instead of separating the skin from the SMAS and tightening each layer separately, the surgeon
It is this dissection beneath the SMAS, in a deeper anatomical plane, that gives the technique its name.
The deep plane facelift was first described in 1990 by American surgeon Sam Hamra, then refined by surgeons such as Tim Marten and Andrew Jacono. Its key difference lies in the plane of dissection.
Instead of separating the skin from the SMAS and tightening each layer separately, the surgeon
It is this dissection beneath the SMAS, in a deeper anatomical plane, that gives the technique its name.
Criterion | Traditional SMAS facelift | Deep Plane Facelift |
|---|---|---|
Plane of dissection | Subcutaneous + sub-SMAS, separate | Sub-SMAS, composite flap |
Main treatment area | Lower face, neck | Midface, lower face, neck |
Skin tension | Moderate | Low |
Effect on nasolabial folds | Moderate | Pronounced |
Effect on cheeks | Limited | Pronounced |
Naturalness of result | Very good | Excellent |
Preservation of expressions | Good | Excellent |
Surgery duration | 3 to 4 hours | 4 to 6 hours |
Anesthesia | General | General |
Social downtime | Around 2 weeks | 2 to 3 weeks |
Average longevity | 7 to 10 years | 10 to 15 years |
Technical demand | Standard | High |
Risk of temporary facial nerve weakness | Low | Low (with an experienced surgeon) |
A traditional facelift is well-suited for
It is also the default choice when the surgeon’s experience with the deep plane is limited. A perfectly executed traditional facelift is always preferable to a poorly executed deep plane.
A deep plane facelift is particularly indicated for
It is often the choice of patients whose priority is long-term result quality and preservation of natural expressions.
Slightly, yes. Swelling can last a little longer after a deep plane facelift because the dissection goes deeper. Most patients return to full social activities between the 2nd and 3rd week, compared with around 2 weeks for a traditional facelift.
In return, the postoperative sensation of skin tension is reduced because the skin is not bearing the lift’s tension.
Stage | Classic Lifting | Deep plane facelift |
|---|---|---|
Day 7 to 10 | Suture removal | Suture removal |
Week 2 | Social return possible | Partial social return |
Week 3 | Full return | Full return |
Month 1 | Minimal residual swelling | Moderate residual swelling |
Month 3 | Result at 90% | Result at 80 to 90% |
Month 6 | Near-final result | Near-final result |
Month 12 | Final result | Final result |
Not in experienced hands. The technique requires a precise command of facial nerve anatomy, since the nerve branches travel through the dissection zone. A surgeon specialized in face and neck surgery, trained in the deep plane technique, has a complication rate comparable to a traditional facelift.
The general risks of any facelift, traditional or deep plane, remain the same
Choosing a specialist surgeon working in an accredited clinic is the single most important factor in minimizing these risks.
In France, the cost of a facelift varies according to
A deep plane facelift is generally more expensive than a traditional facelift, because the operation takes longer and demands greater technical expertise. A personalized written quote is mandatory at the consultation, under French regulations.
These procedures are not reimbursed by French social security.
There is no “best” technique in the absolute. The best technique is the one that fits your anatomy, your expectations, and the experience of the surgeon you consult.
Questions worth asking at the consultation
A good preoperative consultation is more than a sales pitch. The surgeon should examine your face, propose a tailored treatment plan, and be willing to direct you to a different technique if it serves you better.
Qu’est-ce qui rend le deep plane facelift si “tendance” en ce moment
Non. La technique demande une formation spécifique et une pratique régulière. Tous les chirurgiens esthétiques ne la pratiquent pas. Les chirurgiens de la face et du cou, formés à l’anatomie nerveuse profonde, sont parmi les plus à l’aise avec cette technique.
Oui, c’est techniquement possible. Une reprise par technique deep plane peut être proposée à un patient ayant déjà bénéficié d’un lifting classique il y a 8 à 15 ans, et qui souhaite un nouveau rajeunissement. Le geste est plus délicat à cause des cicatrices internes mais reste réalisable.
Oui. La technique convient aux hommes comme aux femmes. Chez l’homme, le tracé des incisions est adapté à la barbe et à l’implantation des cheveux. Le deep plane peut donner un résultat très naturel, sans modifier les traits masculins.
Pour un relâchement modéré, certaines techniques de médecine esthétique (acide hyaluronique, fils tenseurs, ultrasons focalisés HIFU, radiofréquence) peuvent retarder l’intervention chirurgicale. En revanche, aucune technique non chirurgicale ne reproduit le résultat d’un deep plane facelift sur un relâchement marqué. C’est une option de complément, pas une alternative équivalente.
The deep plane facelift and the traditional facelift are not competitors, they are two tools in the facial surgeon’s hands. One works at the surface, the other in depth. One is shorter, the other more powerful on the midface. The choice depends on your anatomy, your expectations, and your surgeon.
If you are considering a facelift in Nice, a preoperative consultation with Dr Philippe Kestemont allows him to analyze your case and direct you to the most suitable technique.
Dr Philippe Kestemont is a board-certified head and neck surgeon based at Clinique Saint George in Nice, France. He is qualified in cervicofacial and ENT surgery and practices exclusively aesthetic and reconstructive surgery of the face and neck. He regularly speaks at international congresses and publishes on facial surgery techniques.
If you are considering a facelift in Nice, a preoperative consultation with Dr Philippe Kestemont allows him to analyze your case and direct you to the most suitable technique.
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