Deep Plane vs SMAS Facelift: What Is the Difference?

The longevity and naturalness of a facelift depend on how the SMAS (superficial musculo-aponeurotic system) layer beneath the skin is handled. There are two common approaches: classic SMAS and deep plane. In both, the aim is to address sagging and restore a rested expression; the difference lies in the depth at which tissue is released. The suitable technique is determined by facial structure and degree of sagging at a medical examination.

Classic SMAS Facelift

In this approach the skin and SMAS are handled as separate layers; the SMAS is tightened or folded (plication/imbrication). It is a common, reliable method and gives effective results in suitable cases.

Deep Plane Facelift

In the deep plane technique, the retaining ligaments that let the face sag with age are released at a deeper plane and the skin-SMAS is moved as one unit. This aims for a more natural, longer-lasting result especially in the midface and nasolabial region, avoiding a tight, "pulled" look.

Which Is Preferred?

There is no single superior technique; both give natural results in experienced hands. Skin thickness, degree of sagging, anatomy and the surgeon's assessment determine the choice. A definitive decision is made after an in-person examination.