Deep Plane Facelift: Technique, Candidates & Recovery

What Is a Deep Plane Facelift?

“Deep plane facelift” is a coined term in facelift surgery where the undermining of facial tissues is performed beyond the SMAS (superficial musculoaponeurotic system), beyond its anatomical confines, in select facial regions.

The aging process changes the soft tissue surrounding the microscopic anchors of the facial retaining ligaments, which are fixed to the underlying facial skeleton, and lead to the droop or descent of the facial contours, as well as jowling. Deep plane techniques are able to liberate select ligaments and allow the overlying tissues to be repositioned.

For this reason, “what is a deep plane facelift” can’t be adequately addressed by responding with “it’s a deeper facelift.” Some patients may also search for the procedure as a “deep face lift.” The distinction is primarily with respect to the plane of dissection, SMAS, retaining ligaments, and the repositioned tissues.

Some surgeons may adopt extended deep plane facelift techniques. Because terms are not always used the same way, we encourage patients to ask their plastic surgeon for specifics.

What Does the Deep Plane Technique Treat?

The primary use of the deep plane facelift technique is for repositioning of the soft tissues of the face that descend with age.

This can include the jowls, the definition in the lower portion of the face, and changes to the midface and the cheeks, with folds that become more pronounced as facial tissues descend.

Extended facelift techniques may be used to provide more movement of the midface and lower-face tissues by releasing some of the retaining ligaments that are often not released in traditional facelift techniques.

However, there are many facial concerns that a deep plane facelift technique does not address.

This technique does not address aging of the forehead, changes to the eyelids, pigmentation of the facial skin, or loss of volume in the face. When choosing a surgical facelift technique, the area and reasons for aging and the concerns of the patient should be the focus, rather than the surgical technique the patient is requesting.

This technique may offer some improvement to the jawline and jowls, however the starting facial anatomy and the extent of the facelift will determine the degree of change.

Deep Plane Facelift vs Traditional Facelift

Understanding how a deep plane facelift works starts with the surgical plane.

There are many different approaches to a traditional facelift. Some techniques entail tightening or folding of the SMAS, while in other techniques a SMAS flap is elevated. Deep plane techniques go beneath the SMAS and, along with dissection, release select retaining structures to allow repositioning of the deeper tissues of the face.

Skin is not expected to withstand all lifting forces.

It is important to note that tension that is too great can cause abnormal scar formation, result in a “flattened” appearance and can lead to complications in wound healing. Modern techniques for facelifts tend to focus on the underlying support systems of the face rather than relying on the tension of the skin.

“Better” should not be associated with “deeper” by default. Different techniques serve specific purposes and can produce great outcomes when the appropriate technique is selected and implemented. Current knowledge demonstrates that no single technique is the best for all patients.

Deep Plane Facelift vs SMAS Facelift

When comparing deep plane vs SMAS facelift techniques, these two approaches have more in common than you may currently think.

The SMAS facelift describes a family of techniques that focus on the superficial musculoaponeurotic system that incorporates a SMAS flap, SMASectomy, elevation, and various techniques of SMAS imbrication and plication.

A deep plane facelift also focuses on the SMAS layer and also incorporates dissection that engages deeper structures that may be beyond the facial SMAS and the retentive ligaments.

Simply put, dissection and the release of ligaments have more to do with the main differentiators of the SMAS and deep plane facelift than if one technique focuses on the SMAS while the other one does not.

That said, particularly the research on the two techniques, should be carefully considered.

A 2025 systematic review noted high patient satisfaction with both Deep Plane and SMAS, concluding that both methods appear to provide strong long-term results. Another recent prospective comparison noted that, at least in its short-term follow-up, participants did not report significant differences in satisfaction, the length of postoperative recovery, or overall complication rates. However, that study also had limitations.

For the patient, the more relevant question is what aspect of their anatomy leads one surgeon to prefer one method over another.

Deep Plane Facelift vs Mini Facelift

A comparison of a Mini Facelift and a Deep Plane Facelift can be misleading since the terms refer to different concepts.

“Deep Plane” refers to the level at which the surgeon operates.

“Mini Facelift” typically refers to a procedure involving a shorter incision and a less thorough operation.

So, a Mini Facelift is not the opposite of a Deep Plane Facelift, since a surgery with a limited incision may involve a significant amount of deeper tissue work.

The difference is generally the extent of facial aging that the surgeon intends to treat, and the amount of surgical access that is required to do that.

If Lower Face laxity is only beginning to show, a surgeon may opt for a more limited procedure. If more advanced descent is present, a more extensive procedure with a more thorough surgical approach will be required.

The goal is not to undertake the least extensive or the most extensive procedure, but rather to be thorough, showing enough surgery for the anatomy, but not more than what is necessary.

Who May Be a Suitable Candidate?

There is no one perfect age for a Deep Plane Facelift.

It is understandable that searching “deep plane facelift” at ages 40, 50, and 60 reflects a general concern regarding age, but age alone does not justify the technique. More consideration should be given to: the distribution of signs of aging on the face, the quality of the skin, the jowls, and the overall health of the patient.

It may be appropriate to surgically intervene on a patient when the descent of the skin across the face has become so severe that the surgeon believes the release of the face’s ligaments and the repositioning of deeper levels of face tissue are required to achieve a sufficient correction.

It is also possible that the patient’s peer, at the same age, may not require such an invasive procedure.

Patients also need to be medically appropriate for this type of facial plastic surgery. A history of smoking, certain medications, and a history of prior surgical procedures on the face or difficulties with the face’s healing or the face’s reaction to anesthesia also need to be assessed prior to planning the surgery.

What are appropriate expectations? While a deep plane facelift can reposition the skin across the face, it does not halt the ongoing aging of the skin on the face or provide a patient with a guaranteed desired outcome.

Does a Deep Plane Facelift Include a Neck Lift?

No, but a deep plane facelift and a neck lift are often performed together because they are usually complementary procedures.

A deep plane facelift isolates and concerns itself with the tissues of the face, while a neck lift deals with the tissues that lie beneath the mandible, the jaw bone, and may involve the platysma, a muscle of the neck, the superficial fat of the neck, and, depending on the technique selected, may also involve the deeper levels of the neck.

Some patients may require both a facelift and a neck lift, while others may not need a significant lift of the neck at all.

The specific elements of deep neck surgeries vary, and published accounts demonstrate that the descriptor itself incorporates various techniques.

Patients should inquire whether the surgery plan includes the neck, rather than assuming terms like “full” or “deep plane” encompass both.

How Is the Deep Plane Facelift Procedure Done?

The surgery entails a series of steps including formulation of an anesthesia and an incision plan.

Facelifts can be done under general anesthesia or IV sedation, depending on the type of surgery, the facility, and the patient. This choice should follow the surgery plan and not be selected due to a convenience preference that the patient remain an active participant by being awake.

Incisions are made, and the surgeon elevates the layers to reach the targeted surgical depth.

In a deep plane technique, the dissection is done under the SMAS in selective regions. The surgeon can dissect selective retaining ligaments to free the tissue in the lower face and cheek while navigating the complex anatomy of the facial nerve.

The skin is repositioned to the depths and direction of the planned lift, then redraped. Skin excess is removed, and the lift is accomplished without placing the tension on the skin.

Each specific technique can be different, and the same extended deep plane facelift can be done with a larger area of release than other similarly named deep plane facelifts.

Where Are Deep Plane Facelift Incisions and Scars?

The deep plane facelift is not without scarring.

Patterns of incisions can change based on technique, based on the technique utilized by the surgeon, the amount of surgery, and the inclusion of the neck.

An incision for typical facelifts largely starts around the temporal hairline and continues in natural contours around the ear and possibly behind the ear or into the scalp.

The deep plane refers to the internal surgical dissection. It still requires open access.

It is important when patients see the term ‘scarless deep plane facelift’. Every surgical procedure produces a scar. A scar may be designed to be less noticeable.

The visibility of deep plane facelift scars depends on a patient’s healing, the placements of incisions, the tension on the wound, smoking, and the aftercare.

More information about healing and incision appearance is available in our guide to facelift scars.

What Is Deep Plane Facelift Recovery Like?

The deep plane facelift involves recovery that still includes a brief period of swelling, bruising, and tightness of the tissues.

Dressings may be placed at the conclusion of the procedure and drains may be utilized. Incision care, along with medication and activity restrictions, is provided.

The keyword data indicates that there are searches for day 5, one, two, and four week, and deep plane facelift recovery day by day timelines. Although these searches are understandable, healing is not on an exact schedule.

The first week is generally considered the initial recovery phase. Swelling and bruising continue to improve in the weeks that follow.

Returning to social and work activities does not mean the body has completely healed. Swelling, facial numbness, scar maturity, and settling of the tissues may take months to fully resolve.

There’s little recent comparative evidence to show deep plane facelift recovery time is significantly shorter than SMAS surgery. In fact, in at least one prospective comparative study, recovery time was essentially the same for both surgeries.

For this reason, any claims of “fully recovered in two weeks” should be considered with skepticism.

Our facelift recovery timeline covers the wider stages of healing in more detail.

How Much Does a Deep Plane Facelift Cost?

There is no one answer for the question of how much a deep plane facelift costs because there are a number of variables involved.

These variables may include the surgeon, the country, the facility, the type of anesthesia, the extent of the dissection and the possible addition of a concurrent neck surgery.

There are differing levels of dissection that may be covered by the term deep plane facelift.

Because of all this, there can be no one answer to the question of what is the average cost of a deep plane facelift, what is the cost of deep plane facelifts, and how do deep plane facelift prices compare internationally.

A quotation should specify the extent of the proposed surgery.

If you are considering a deep plane facelift in Turkey, be sure to list the cost of surgery separately from the cost of accommodation, transportation, transfers, and any extra postoperative care. The facelift cost in an individual country should be considered within the total cost of care and travel, rather than a single cost taken out of the complete cost.

What Are the Deep Plane Facelift Risks and Complications?

Deep plane facelifts carry the standard risks of a facelift, plus the risks of operating at a deeper level within the facial planes.

Surgery may be complicated by bleeding, the formation of a hematoma, an infection, impaired healing, altered sensation, prolonged swelling, adverse scarring, hair loss near the incisions, complications with anesthesia, and injury to the facial nerve with resultant weakness.

Dissections that involve facial nerve anatomy and ligaments require a well-trained eye to appreciate their close and important relationship.

That does not mean dissection will damage nerves.

Familiarity with surgical anatomy and technique is necessary, and this explains why.

Published comparisons do not show that deep plane surgeries can be done without any risk. A large review showed that various SMAS techniques report varying rates of temporary nerve damage and hematomas, but studies done recently have reported similar early complications, in the groups they looked at.

The dangers for a patient are determined by their health, the type and size of the surgery, their anatomy, past surgeries, and the planned technique of the surgeon.

These issues are also discussed in our guide to facelift risks and complications.

How Should Deep Plane Facelift Before and After Results Be Evaluated?

When evaluating deep plane facelift before and after photographs, they should be looked at with care.

The lighting, camera angles and camera position should be roughly in the same place.

Taking photographs too early directly after the surgery should not be regarded as final results.

The more stable aspects of the results, the changes in the jowls, cheeks, and jawline, should fit the natural features of the person.

Research has shown that satisfaction is likely for both deep plane and SMAS techniques, but it does not support that the results for deep plane techniques are intrinsically more satisfactory.

How Long Does a Deep Plane Facelift Last?

Common queries like “how long does a deep plane facelift last?” or searches for “10 years later” or “20 years later” tend to overemphasize the permanence of a facelift. No facelift halts the aging process. Long-term outcomes are determined by one’s anatomy, the technique employed, the quality of the skin, the presence of weight fluctuations, habits like smoking, sun exposure, and of course, the aging process.

It is more accurate to say facelifts produce an enduring alteration to anatomy that continues to change with time as opposed to a procedure that has a definitive timeline.

Final Thoughts

A deep plane facelift is difficult to define solely by the magnitude of the procedure.

The plane utilized, how retaining ligaments are addressed, the specific areas of tissue descent, and the individual’s anatomical structures all play a role in the decision of whether the technique is warranted.

For select patients with mid- to lower-facial changes, it may be a more appropriate option, but it is not automatically more advantageous than a SMAS facelift, and it does not entail a neck lift.

The patient must be informed as to the specific meaning of deep plane, including which ligaments are to be released and repositioned, the location of incisions, the nature of recovery, and the risks of the proposed surgery.

This assessment must occur prior to facelifts of this nature.

Medical Sources

• Deep Plane Anatomy for the Facelift Surgeon: A Comprehensive Three-Dimensional Journey — PubMed.
• The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis — PubMed.
• A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques — PubMed.
• Current Trends in Deep Plane Neck Lifting: A Systematic Review — PubMed.
• Facelift Recovery — American Society of Plastic Surgeons.
• Facelift Risks and Safety — American Society of Plastic Surgeons.