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DEEP PLANE FACELIFT: Value or Hype

The current hot discussion in traditional and social media regarding facial rejuvenation surgery is the deep plane facelift.  What is the deep plane facelift?  How is it different from other facelifts? Is it worth it in terms of results, risks, downtime, and cost?

What is Deep Plane Facelift Surgery?

The SMAS (superficial musculoaponeurotic system) is the layer of fascial tissue on the superficial surface of the facial muscles. In the traditional SMAS facelift surgery, the skin and deeper tissues are treated as separate components as the surgeon’s dissection occurs in the plane between the skin and the SMAS layer. In the deep plane facelift, the dissection occurs beneath the muscles.

Pros of the Deep Plane Facelift

The proponents of the deep plane facelift technique say its advantages include being able to move the skin, connective tissue, and muscle as a single unit, fully releasing ligaments tethering the skin to the underlying facial bones and having better blood supply to the overlying skin. Thus, according to the deep plane technique proponents, this leads to a more youthful appearance and a longer-lasting rejuvenation of the facial appearance.

Cons of the Deep Plane Facelift

Those of us who can do a deep plane lift but favor the SMAS facelift surgical procedure would argue that there is a value to being able to customize the lifting vectors for the SMAS/muscle layer and the facial skin separately, that one can reach many of the same ligaments through a more superficial dissection and in non-smokers the incidence of interference with blood supply to the skin is extremely rare. Furthermore, the alleged greater longevity of the deep plane facelift procedure has never, to the best of my knowledge, been documented by any peer-reviewed paper or study.

In my opinion, as a board-certified plastic surgeon, the risks and downsides of the deep plane face lift approach are many.  It is a longer procedure, must be done under general anesthesia, places the facial nerves at greater risk, and has a longer recovery period for most patients. 

From an aesthetic perspective, it appears to me that after a deep plane facelift, many of those patients look good but no longer look like themselves.  Finally, it is much, much more costly than the traditional or SMAS facelift, with some surgeons in Manhattan reportedly charging upwards of $150,000 to $250,000 for the procedure.

I have, over the years, come to the opinion that the patients in my practice who look the best are those who have had several smaller procedures done over the course of years. For that reason, we are doing more facelifts in younger patients. We are able to do this under local anesthesia for most of these patients, can treat them when they are just beginning to see the signs of facial aging and get them back to work, family, and social engagements faster.

Schedule a Consultation

Want to learn more about the facial rejuvenation procedures we offer at RothausMD, don’t hesitate to schedule a consultation today. Call our NYC office or message us using our online contact form.