If you’ve been looking into ways to refresh your look, you’ve probably seen two names pop up a lot: the deep plane facelift and the SMAS facelift. It’s easy to get a certain idea about these procedures from a quick social media post or a headline, but there is a lot more to the story than what you see in a 30-second clip.
As a surgeon, I’m a big believer in having a solid plan. To make a good plan, you need good information. I want to give you a clear, honest look at these two choices so you can figure out which one fits your face, your goals, and your life.
When we look at a deep plane facelift and SMAS facelift, the main difference is how deep the surgeon goes. A SMAS facelift tightens the superficial musculoaponeurotic system (that’s just a fancy name for the layer of tissue that covers your facial muscles). A deep plane facelift goes deeper. It unhooks the facial retaining ligaments (the anchors of the face) to move the whole facial unit, including deep fat and muscle.
Both of these are types of facial rejuvenation, but they work on different levels. In my Baltimore office, I usually prefer the SMAS method. It gives a beautiful, rested look and is generally safer for the patient.
The SMAS facelift is often thought of as the gold standard for people who want to look like themselves, just a lot more well-rested. When we talk about the superficial musculoaponeurotic system, we are talking about the strong, fibrous layer that connects your facial muscles to your skin.
The biggest mistake in early cosmetic surgery was just pulling the skin. When you only pull the skin, you get that wind-swept or surprised look that everyone is afraid of. In a SMAS facelift procedure, we aren't just pulling. We are moving the foundation of the face back where it belongs.
By lifting and tightening this superficial muscular layer, the skin on top just rests naturally over a younger-looking shape. It’s like fixing a saggy sofa by tightening the frame instead of just stretching new fabric over the old, broken springs. By working on the SMAS layer, we make sure the lift comes from the inside. This helps restore youthful facial contours that last much longer than just a skin-only lift.
One of the first things patients ask me is, "Where will my scars be?" The secret to a natural appearance isn't just a steady hand. It’s all about where you put the pull or the tension.
Because we put all the lifting power on the strong superficial musculoaponeurotic system, there isn't too much tension on the skin where the cuts are made. This allows for what we call tension-free skin closure. Basically, the edges of the skin meet up softly and heal into a very fine, flat line. We hide these lines along the natural curves of the ear and into the hair. Whether you’re at a party or wearing your hair up at the gym, your surgery should stay your secret. It also helps us avoid the pixie ear deformity, which is when the earlobe looks like it’s being pulled down toward the jaw.
As a board-certified plastic surgeon, my number one job is to keep you safe. One reason SMAS facelift results are so consistent is that the surgery stays in a very safe part of the face.
The facial nerve branches, the tiny wires that let you smile, blink, and show emotion, live deep under the SMAS layer. By staying on top of that layer, we can get a great lift while staying far away from those important nerves. This gives us plenty of room to work while keeping the risk of a facial nerve injury very low.
The deep plane facelift has become a very popular term lately. You’ve probably seen it on Instagram or TikTok. The deep plane technique is a powerful tool for comprehensive facial rejuvenation, but it’s a big procedure that isn't the right choice for everyone.
While the SMAS lift tightens the girdle of the face, the deep plane lift goes a level deeper. In this surgical technique, we unhook the facial retaining ligaments. These are the strong bands that hold your facial tissue to the bone. Once those are released, the muscle and the malar fat pad (the fat in your cheeks) can be moved together as one big piece.
For patients with a lot of skin laxity, meaning their skin is very loose, the deep plane approach can be very effective. If you feel like your cheeks have fallen all the way down to your jaw, this plane facelift can move them back up. It’s a big shift that fills out the cheeks and smooths out deep nasolabial folds (the lines from your nose to your mouth).
If you are thinking about deep plane facelift surgery, you should know that the process gets a lot more complicated. Because the facial plastic surgeon is working under the muscle layer, they are working right in the same area as the facial nerve.
This takes a lot of skill and a deep understanding of facial anatomy. While deep plane face lifting can look amazing, there is less room for error. This is why it is so important to choose a board-certified plastic surgeon who knows exactly how those deeper anatomical structures are laid out.
I believe in being totally honest about deep plane facelift recovery. Because this surgery involves more tinkering with deeper tissues and unhooking ligaments, the body reacts more strongly.
Deep plane facelift surgery usually causes a lot more swelling than a SMAS lift, and it stays around longer. If you have a busy life, you have to plan for more time at home. You might not see your more youthful appearance for three or four weeks because those deeper layers need time to calm down and heal.
In my office, I don't believe in one size fits all. I also don't believe in pushing patients to fix parts of their face that don't bother them. Cosmetic surgery should be a conversation where we decide what you actually need.
Whether we do a plane facelift or SMAS lift, healing is a process we plan for together.
Right after your facelift procedure, you will be bruised and swollen. We keep a close eye on you to make sure everything is healing right and to prevent things like a hematoma formation (a pocket of blood under the skin). This is the time to stay on the couch and rest.
After about a week, we usually take out your stitches. You will still have some swelling and redundant skin (extra skin) that looks a bit puffy, but the worst of the discomfort is usually over. You’ll start to see a noticeable improvement.
For SMAS patients, this is usually when you feel ready to go out to dinner. If you had a deep plane, you might still be dealing with some swelling in your deep wrinkles. We make sure you stay out of the sun so you get those natural-looking results.
Choosing your facial plastic surgeon is the biggest part of your plan. You are picking a doctor's experience and their eye for detail.
I am a board-certified plastic surgeon. I actually wrote one of the textbooks that other surgeons use to learn advanced facelift techniques. My office has its own private surgery center with a dedicated anesthesia team to keep you safe. Whether we are fixing excess skin, deep wrinkles, or the deeper structures of your face, I am committed to giving you a result that looks like you, just younger and more vibrant.
We don’t just do a facelift surgery. We create a plan that fits your unique facial structure and helps you get that youthful appearance back.
Are you ready to see which tool in our toolbox is right for you?
Schedule a Consultation at Dr. Shermak's Lutherville Office
A facelift surgery fixes sagging skin and sagging cheeks, but it doesn't change the texture of the skin. If you have sun damage or fine lines, we can add things like chemical peels to help restore youthful facial contours.
The goal of a modern facelift procedure is a natural appearance. By tightening the superficial muscular layer or the deeper anatomical structures instead of just pulling the skin, we avoid that fake, wind-tunnel look.
We can't stop time, but a facelift turns back the clock by about 10 years. Both the SMAS facelift and the deep plane facelift last a long time, but how you age later depends on your lifestyle and your genes.
Yes. This is called revision surgery. If you had a facelift 10 or 15 years ago and want to refresh your look, we can look at your SMAS layer and create a safe plan to help you look your best again.
It depends on your face! If you have very deep lines and heavy sagging cheeks, the deep plane might give you a more noticeable improvement. If you mostly want to fix your jawline and neck, a SMAS lift can give you natural-looking results with less downtime.
