Considering a facelift but unsure which technique is right for you? Several methods exist, each with its own advantages and trade-offs. Here we compare three: the deep plane facelift, SMAS plication, and the subcutaneous facelift.
Deep Plane Facelift: The Comprehensive Lift
The deep plane facelift targets the deeper facial tissues. It repositions the SMAS layer and its attached fat to a higher, more youthful position. Integral to the technique is releasing the retaining ligaments of the face (zygomatic, buccal, cervical, and mandibular), which normally tether the tissue in place. If these aren’t released, the tissues can’t be repositioned properly — this is the single most important difference between the deep plane and more superficial lifts.
- Natural results: because it addresses the deep structures and avoids pulling on the skin, results look natural. The vector of lift is typically more vertical than the oblique pull of plication or subcutaneous techniques.
- Recovery: slightly longer than the other methods, but the durable, natural result is often worth it.
SMAS Plication: Balancing Efficacy and Recovery
SMAS stands for Superficial Musculoaponeurotic System. SMAS plication folds and tightens this layer with sutures to lift sagging tissue, without creating the large raw surface of a deep plane dissection.
- Theoretically safer dissection: because the deep plane (where the facial nerve branches run) isn’t entered.
- Less invasive: a marginally shorter recovery than the deep plane lift.
- Results: impressive, though they may not last as long as a deep plane lift because the effect relies on sutures rather than fused tissue planes.
Subcutaneous Facelift: The Minimally Invasive Option
This is how facelifts were originally performed and is less common today. It addresses primarily the superficial skin and fat layer.
- Least invasive with the quickest recovery.
- Best for mild-to-moderate signs of aging.
- Limited longevity, and scarring is a concern: because all of the pull is on the skin, and scars under tension tend to perform poorly.
Choosing the Right Technique
The right choice depends on your goals, your anatomy, and your tolerance for recovery. Importantly, great results are achieved by skilled surgeons using different techniques — there isn’t one method that’s universally best. What matters most is the experience of your surgeon and a technique they can perform safely and confidently. The way to find your answer is a consultation, and you can also explore the different facelift options in more detail.