Over the past few years, the deep plane facelift has become one of the most discussed facelift techniques in the specialist press and among the general public. Several public figures have spoken openly about having had one, which has fueled its popularity. But how does this technique actually differ from a traditional facelift, also known as an SMAS facelift, which has been performed for decades?
This article reviews both approaches, their indications, their outcomes, and recovery.
The traditional facelift (SMAS technique) tightens the skin and the underlying musculoaponeurotic layer separately. It produces a good outcome on the lower 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 as a single composite flap. It works more powerfully on the midface (cheeks, nasolabial folds), produces a more natural appearance, and lasts on average 10 to 15 years.
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.
A traditional facelift, also called an SMAS facelift, is the reference technique that has been refined since the 1970s and 1980s. SMAS stands for 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.
Why has the deep plane facelift become so popular recently
No. The technique requires specific training and regular practice. Not all aesthetic surgeons perform it. Head and neck surgeons trained in deep facial nerve anatomy tend to be among the most comfortable with it.
Yes, it is technically possible. A revision using the deep plane technique can be offered to a patient who had a traditional facelift 8 to 15 years earlier and now seeks renewed rejuvenation. The procedure is more delicate due to internal scarring but remains feasible.
Yes. The technique suits men and women alike. In men, the incisions are adapted to the beard line and hairline. A deep plane facelift can deliver a very natural outcome without altering masculine features.
For mild sagging, non-surgical treatments (hyaluronic acid fillers, thread lifts, focused ultrasound HIFU, radiofrequency) can delay the need for surgery. However, no non-surgical technique reproduces the outcome of a deep plane facelift on moderate to advanced sagging. They are complementary options, not equivalent alternatives.
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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