Demystifying The
Deep Plane Facelift

Demystifying The Deep Plane Facelift

The subject of the deep plane is a hot topic term being used right now. In the many facelifts I perform each year, I've had an incredible uptick in women and men requesting a deep plane lift. During the course of our facelift consultations, it appears that social media and plastic surgery forums have stirred some confusion around the deep plane. So much so, that it begs further explanation and setting the record straight.

What Is A Deep Plane Facelift?

A deep plane facelift is an advanced procedure designed to restore the underlying aging caused by sagging skin and muscle. The deep plane refers to the deeper layer of the face which is called the SMAS or SubMuscular Aponeurotic System. This type of facelift elevates and recontours the soft tissue layers to ensure that women and men look more youthful and appear naturally refreshed.

The benefits of a deep plane facelift
include a more contoured face with reduced soft tissue laxity, as well as improved facial proportions, including elevation of the face and neck. Deep plane facelifts promise superior, longer-lasting, and more natural results. However, this term is so widely used that it has lost its meaning.

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Before and After Mini Deep Plane Facelift by Dr. John Burns

Before and after mini deep plane facelift
Before and after mini deep plane facelift by Dallas plastic surgeon, Dr. John Burns
Before and after mini deep plane facelift by Dallas plastic surgeon, Dr. John Burns
Before and after mini deep plane facelift by Dallas plastic surgeon, Dr. John Burns

What's The Big Deal About The Deep Plane?

Older and traditional facelift techniques focused solely on removing loose skin, resulting in a pulled, windswept, and short-lasting result. Since the skin is elastic and stretches over time (especially when placed under tension) older facelift methods coupled with unnecessary skin tension result in the widening of scars. They are also a dead giveaway of telling others that you've had a bad facelift.

Diagram of Deep Plane directional pull

Modern Day Facelifts

Modern and more advanced facelift techniques focus on restoring rejuvenation underneath the skin's surface at the SMAS a.k.a. the deep plane.

There are several reasons why the deep plane or SMAS needs to be addressed:

-To transfer tension to the deeper layer away from the skin

-Re-establish and readjust an individual's facial tissue to a more youthful position

-Create a rejuvenated effect that is longer-lasting

-Addresses the jowl, nasolabial fold, marionette lines, and facial fat compartments with a greater deal of precision

Addressing or re-suspending the SMAS can be done in several ways. When considering facelift surgery, it's important to know that there are advantages and disadvantages to each approach. Let's review them so that you have a more educated understanding of what technique might be best suited for you. 

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3 Advanced Deep Plane Facelift Surgery Techniques

1.  SMASectomy

The lateral SMAS technique is one of the most popular and advanced plastic surgery procedures available today. This particular type of procedure can provide an improved facial contour and shape through a relatively short and minimally invasive procedure. The lateral SMASectomy is precisely designed to achieve a one-of-a-kind result for the individual.

In this method, the SMAS is trimmed obliquely from the earlobe to a point lateral to the eye, near the temple.

Primary Advantage of Lateral SMASectomy

Helps thin a full face by removing excess tissue. In instances where a patient has more facial fullness, the lateral SMASectomy can reduce bulkiness and enhance facial contour.


The surgical technique can thin the face which is often not desired in modern facelifts. A tighter, thinner face is not a sign of youth as much as a taut face with well-balanced facial structures.

2. SMAS Plication or SMAS Stacking

The SMAS layer is sutured together or plicated.

During the plicated SMAS facelift, a SMAS flap created from this layer is sewn together to create a more youthful appearance. This plication technique results in a tighter and better oriented SMAS layer, thus giving sustained improvements to the face. 

The plicated SMAS facelift offers advantages for sagging around the cheeks and jowls specifically due to its unique and effective tightening capabilities. With this technique, an experienced plastic surgeon can create a more taut effect without creating overly pulled or stretched areas on the face for undesired results.

Primary Advantage

Safety. Allows the face to be resuspended using a variety of different vectors making it a highly versatile approach and helpful in dialing in customized facial rejuvenation.


In some instances, this technique can bunch up tissue giving unwanted fullness in the cheeks and underneath the eyes.

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3. SMAS Undermining

Undermining is an advanced technique that takes place in the deep plane and involves making incisions in order to gain access to deeper underlying tissues. The extent of the undermining depends on the changes present in the area and the particular manipulation being performed by the plastic surgeon. 

Primary Advantage

SMAS undermining allows for a powerful pull on the SMAS and some versatility when reattaching the SMAS.


More swelling with prolonged recovery. Risks damage to nerves of facial expression: facial nerves.

Peer Reviewed Research on SMAS Undermining

Some surgeons suggest that undermining and resuspending the SMAS gives a longer-lasting result. However, peer-reviewed research and data studies show no difference in longevity between deep-plane methods.

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Deep Plane Facelift Before and After by Dallas Facelift Specialist, Dr. John Burns

Before and After Revision Deep Plane Facelift
Left  Side View | Before and After Revision Deep Plane Facelift
Right Side View | Before and After Revision Deep PlaneFacelift
Profile View | Before and After Revision Deep PlaneFacelift

Do Your Research and Consult With An Expert

It is important to remember that all faces are not the same and the technique should be tailored to fit a particular face and desired result. Take your research along with an open mind into your facelift consult. Be prepared to have clear and open communication with your board-certified plastic surgeon. Your facelift specialist will ultimately create the best recommendation tailored to your unique facial anatomy utilizing the techniques designed to give you the most natural and rejuvenated outcome. 

A deep plane lift is an exciting and life-changing facelift procedure for many men and women who desire to reverse the effects of facial aging. It's absolutely essential that you find an experienced, highly credentialed plastic surgeon to perform the operation. The deep plane technique works on the same layer of tissues as your facial nerves, so locating these delicate nerves when dissecting below the SMAS layer of the face is absolutely critical to guarantee success. Good surgeons have an eye for detail backed by years of experience and natural-looking outcomes. The anatomy of the face is delicate and complex. Please be sure to do your research and opt for someone who has both stellar credentials and many years of experience that prove their knowledge in this field.

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