SMAS vs Deep Plane Facelift: Which Method is Right for You?

The Procedure

The SMAS facelift is performed under general anesthesia, with the procedure generally lasting 2 to 4 hours. Incisions are made in the hairline above and behind the ear. The surgeon then shifts and repositions the skin and SMAS muscle separately. After the skin is lifted a short distance to allow access, the SMAS muscle layer is lifted and tightened in a separate layer. Finally, the skin is placed back down and tightened, and then excess skin is removed.

Aftercare and Recovery

The recovery for a SMAS facelift takes about 2-3 weeks, with the patient wearing a compression garment for the first 10 days. During this, the patient may experience temporary bruising, swelling, redness, pain and discomfort. Because the incisions are made tucked behind natural folds of the skin, scarring is minimized and naturally concealed as the patient recovers. Results typically last about 10 years. 

What is a Deep Plane Facelift?

A deep plane facelift is a more invasive facelift that goes past the superficial tissues of the face to address deeper structural components. The procedure primarily focuses on the repositioning of muscle and fat layers below the SMAS layer, rather than skin pulling and removal. This deeper technique allows for the treatment of a wider array of aging signs such as marionette lines and nasolabial folds. The goal of the deep plane facelift is to tighten the skin and muscles of the face, jaw, and neck as a single unit to create a rejuvenated, youthful but natural look.

The Procedure

The deep plane facelift is performed under general anesthesia, and takes about 2 to 5 hours to complete. Just as in the SMAS facelift, incisions are made behind the ear and along the hairline for concealed scarring. The patient’s sagging skin and muscles are lifted together in one layer, releasing the ligaments between the skin and bone to allow access to underlying fat pads. The doctor is then able to go underneath to lift underlying fat pads and tissues. The results are a lifted look in the middle portion of the face especially, giving the appearance of added volume to the cheeks and face.

Aftercare and Recovery

Because most work is done on deeper tissues away from the dermis, patients experience favorable recovery and healing periods rather than the extended downtime that would be expected from a more invasive procedure. This also enables long lasting results, from 10 to 15 years. Thus, the recovery is comparable to that of the SMAS facelift, with compression bandages worn for the first one to two weeks and the typical bruising, pain, and swelling. The recovery lasts about 3 weeks.

Benefits

The superficiality and separation of the SMAS facelift enables more directionality in the desired result of the patient. Because the skin and the muscles of the SMAS layer are lifted separately, doctors can especially customize results to suit the patient’s face via the directions of lifting and tightening. However, because the work of the SMAS lift is not reconstruction but rather of stretching, shifting, and tightening, doctors find that the results can have an undesirable tight appearance, looking less natural than that of the deep plane. When the skin is placed back down after lifting the SMAS muscle, disruption or contour irregularities in the skin can cause unnatural effects.

All in all, the SMAS facelift is a relatively superficial procedure which means that deeper structural components of the face that fall to aging and shifting are not addressed. By lifting the skin and muscles as a singular unit, this procedure allows doctors to access deeper tissues and muscles to create a more natural elevated look. The deep plane facelift goes beyond the SMAS, and by suspending the ligaments that anchor down aged muscle structures, is able to create more realistic comprehensive results throughout the face and neck. Thus, this procedure is not only found to be more natural looking, but more effective and long lasting in terms of results. Patients can appear younger without a dramatic difference, without substantial added risk or pain. 

Cost and Pricing

The average cost of a SMAS facelift is around $11,000. The pricing for a deep plane facelift typically ranges within $15,000-$30,000. 

Am I a good candidate?

The goal of a facelift is to reverse signs of aging to promote a more youthful, toned look in the patient. Both facelifts are best suited to patients over 50 years old, or those suffering from signs of aging such as skin sagging, hollow cheeks, jowling, nasolabial folds, or loose skin in the chin, jaw, and neck areas. However, where they differ most is regarding the depth and techniques of the surgery, which can present very differing results.

SMAS vs Deep Plane: Treatment Areas

The fundamental separation between the two procedures occurs at the level of four major ligaments core to the connective tissues and muscles that allow for facial movements. The deep plane facelift suspends these ligaments that anchor down the muscle and connective tissues of the lower face to allow for true resuspension at a constructional level. But in a SMAS facelift, the ligaments remain tethered to the tissues and muscles, so the procedure stretches and shifts rather than reconstructing the facial structures. 

The SMAS targets just the skin and SMAS muscle layer, allowing for shifting and repositioning and skin removal and tightening. This procedure is much less invasive, prioritizing work near the surface of the skin. The deep plane facelift goes much deeper into the facial structure to target muscles, fat layers, and ligaments. This procedure prioritizes the movement of these structures rather than tightening, pulling, and removing skin. The result avoids tightness in the face by focusing instead on its structural composition.

Risks and Side Effects

For both procedures, side effects typically include temporary redness, swelling, bruising, and soreness. Scarring is also to be expected at the incision sites, but these are typically concealed by natural folds or contours of the face. Like any other procedure, facelifts run the risk of bleeding or infection, but these are rare and virtually nonexistent in the hands of a skilled physician.

If you are interested in getting a facelift, or even just curious if either of the treatment options may be right for you, feel free to call us at (310) 273-3007 with any questions you have. We will be happy to assist you and provide guidance to various treatment options, whether it concerns eyebrow divots or any procedure you are considering!