Deep-plane facelift, explained

Before Your Consult. Updated . Draft: not yet clinician-reviewed.

The short answer

A deep-plane facelift lifts the skin, fat and the support layer beneath them (the SMAS) together as one unit, so the skin is not doing the lifting alone. In one study of 11,300 facelift patients, across all techniques, about 1 in 55 had a major complication.1 No facelift stops aging.

Questions to ask your surgeon How it works

Watch

Will a Facelift Make You Look Pulled? The Deep Plane Facelift, ExplainedWatch on YouTube

At a glance

Incisions
Hairline and around the ear.
Swelling
Peaks around day 3 or 4.
Numbness
Can take months to fade.
Major complications
About 1 in 55 across all facelift techniques.1 Not a deep-plane or per-surgeon rate.

Ask your surgeon

  1. Which board certifies you?
  2. How many deep plane facelifts do you perform a year?
  3. Which ligaments do you release, and how far do you lift the skin?
  4. Where is surgery done, and who gives my anesthesia?
  5. What are your complication and revision rates?
  6. What is the all-in cost, and who do I call after surgery?

A printable PDF of these questions is coming.

How it works

  1. The incision follows the hairline and curves around the ear.
  2. The skin is lifted only a short way, so it keeps its blood supply.
  3. The surgeon enters a natural gliding space (the deep plane) and releases selected anchors, called ligaments, in the cheek and jaw. Nerves run close by, so precision matters.
  4. Skin, fat and SMAS are lifted together and secured. The neck muscle can be tightened too.
  5. Extra skin is trimmed and closed with low tension. Too much tension can flatten the face.

Surgeons define "deep plane" differently, and studies comparing techniques are debated. This guide does not claim it looks more natural or lasts longer than other methods. Whether any facelift suits you is decided at an exam. Ask what your surgeon does.

Recovery and risks

  • Swelling and bruising are expected. Swelling peaks around day 3 or 4.
  • Numbness can take months to fade, and can last up to a year.
  • Temporary nerve weakness can happen and usually resolves within 3 to 4 months.
  • About 1 in 55 (1.8%) had a major complication, most often bleeding under the skin (1.1%). Infection was 0.3%.1
  • Nicotine slows healing. Surgeons ask patients to stop at least 4 weeks before surgery. Smokers had about 12 times the wound-healing problems in facelift surgery generally.
  • Men had a higher risk of bleeding under the skin (relative risk 3.9).1

The 1 in 55 figure comes from a registry of facelift patients enrolled 2008 to 2013. It covers all techniques, not deep plane or any one surgeon. "Major" meant an emergency visit, hospital admission or reoperation within 30 days.

Plain words

Support layer
SMAS (superficial musculoaponeurotic system), a strong layer under the fat. Whether it is a distinct layer everywhere is debated.
Anchors
Retaining ligaments that hold the layers in place, a little like tent stakes.
Gliding space
The deep plane, a natural plane where tissue can be lifted.
Neck muscle
The platysma, the muscle behind neck bands.

Common questions

What is a deep-plane facelift?

A facelift technique that lifts the skin, fat and the support layer beneath them (the SMAS) together as one unit, after releasing selected ligaments. Incisions sit in the hairline and around the ear. Surgeons define "deep plane" differently, so ask what yours does.

What does SMAS stand for?

SMAS stands for superficial musculoaponeurotic system, a strong support layer under the facial fat. Whether it is a distinct layer everywhere is debated.

Will a deep-plane facelift make me look pulled?

Too much tension on the skin can flatten the face. A deep-plane lift moves the layers beneath the skin so the skin is not doing the lifting, but results vary and no technique removes the risk.

How long do swelling and numbness last after a facelift?

Swelling peaks around day 3 or 4. Numbness can take months to fade and can last up to a year. Your surgical team explains when activities can resume.

How risky is a facelift?

In a study of 11,300 facelift patients across all techniques, about 1 in 55 (1.8%) had a major complication, most often bleeding under the skin (1.1%). That figure is not specific to deep plane or to any one surgeon, so ask your surgeon for theirs.

Does smoking matter for a facelift?

Yes. Nicotine slows healing. Surgeons ask patients to stop at least 4 weeks before surgery, and smokers had about 12 times the wound-healing problems in facelift surgery generally.

Does a facelift stop aging?

No. Results vary with health, anatomy and goals.

Sources and review

Review status: not yet reviewed by a clinician. When one reviews this guide, their name, credentials and date will appear here. See our editorial standards.

  1. Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 Patients. Aesthetic Surgery Journal, 2016;36(1):1-13. PubMed 26578747. doi:10.1093/asj/sjv162
  2. Facelift Techniques: An Overview. PubMed 35709719.
  3. Mendelson, Plastic and Reconstructive Surgery: the layers of the face and retaining ligaments. PMC8700314.
  4. Mani, Aesthetic Surgery Journal, 2016; Jacono and Bryant, 2018: ligament release in deep-plane lifts.
  5. Rohrich and Pessa, Plastic and Reconstructive Surgery, 2007: facial fat compartments.
  6. American Society of Plastic Surgeons: facelift information, recovery guidance and facelift anatomy review.

Source 1 was checked against its PubMed record. Sources 2 to 6 are being checked and completed.

General education, not medical advice.This guide does not replace an individual consultation with a qualified clinician.

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