Jack P. Gunter, M.D., FACS
What is the difference between a deep plane facelift and the usual SMAS facelift? Are the results longer lasting? What are the advantages of undergoing this procedure?
There are three “planes” on the face that can be used for face lifting: the superficial plane (under the skin), the mid plane (under the SMAS) and the deep plane (next to the bone). Each of these has its proponents and some plastic surgeons use a combination of these approaches. Proponents of the deep plane lift feel like they can better restore the cheek contour (by lifting the cheek pad) and soften the nasolabial fold (the fold running from the corner of the nose to the corner of the mouth). They feel that corrections will be more secure because fixation is to the periosteum (the strong adherent covering of the bone). However, many of these surgeons will change to the mid plane (sub SMAS) when doing the jowl area and to the superficial plane in the neck as these areas are better controlled in those planes. Proponents of the deep plane facelift feel the results last longer and can be more dramatic than results of lifts in the mid plane or superficial planes. However, there are no valid scientific studies to tell us if this is true. The main disadvantages to the deep plane lift are that it is technically more difficult to perform, takes longer in the operating room and there is more down time for the patient. In summary, it is my feeling that the choice of surgeon is more important than the choice of plane. Most of the surgeons whose work is well known perform the mid plane facelift and some combine it with the deep plane and/or the superficial plane. Very few are doing superficial plane only.