Expert Doctor

Deep Plane Facelifts

elite image

Jacob Steiger, MD

Boca Raton, FL

Deep Plane Facelifts

Deep plane facelift is actually an advanced type of rhytidectomy. First of all, a facelift is a procedure designed to improve the appearance of the jowls and the neck.  There are several ways that facelifts may be performed. 

In the old days, the usual procedure was skin only facelifts where a surgeon would just cut out the skin. In the past 40 or so years, facelifts have evolved to include the muscle layer of the face that is tightened up in order to improve the appearance of the neck and jowls as well as moving some of the lose skin. This gives a more natural result since the surgeon does not pull in the skin so tightly and the results do not have that windblown look.

Over the years, doctors have learned that the face actually has ligaments just like the rest of the body. Deep plane facelift goes deeper into the muscle layer where the ligaments are located and lifts them back to where they belong in order to give a finer appearance to the neck and the jowls.



The same candidates for a regular facelift are also candidates for a deep plane facelift. The incisions and the length of the surgery are almost the same amount. The main difference is that a deep plane facelift gets deeper into the muscle layer where the ligaments are and lifts them all back to the more youthful position.

Anyone from ages 40 to 90 who is concerned about the appearance of their sagging cheek, their sagging jowls, and their sagging neck is a candidate to improve their appearance.

Deep plane facelift is not necessarily only for the advanced stages of skin sagging and wrinkling. It can also be used in the earlier stages when somebody might want more of a surgical correction to address sagging that bothers them. They are treating the problem when it begins in order to not let it advance.



SMAS facelift stands for superficial musculo aponeurotic system. The SMAS is the muscle layer of the face. It is the layer of the face that is fibrous tissue and is the strength layer of the face below the skin. Usually when someone refers to a a lateral SMAS facelift, they remove a small part of the muscle layer that is in front of the ear by excising it and tidying it up.

The deep plane facelift extends deeper to where those ligaments are and lifts all the ligaments up to reposition them. Another accomplishment of a deep plane facelift is to lift the cheek fat so the patient receives a lift of the cheeks, jowls, and neck. The procedure restores youth in the most natural manner. An extensive SMAS facelift with a mid-face component lifts the cheeks up as well. An extended SMAS facelift only lifts the jowls and the neck while a deep plane goes into the cheek as well.



A deep plane facelift addresses the cheeks, jowls, and neck. There is a limit to how much can be lifted and there are some things that a facelift cannot do.

One area where people show signs of age is in the front of the face along their jaw line. This is especially true in the chin area where they lose bone and that sometimes causes a deep area in that pocket line. While a deep plane facelift does improve that line, and gets rid of it in some people, it does not work as well on other patients. It really depends on how much bone loss there is in the patient. It does not replace the fat that is missing. All it does is tighten up those ligaments and lifts the cheeks, jowls, and neck. Oftentimes, the facelift is combined with fat transfer, fat injections, or laser to improve the fine lines and wrinkles around the mouth. The laser rejuvenates the skin.



The complications of a deep plane facelift are similar to any facelift procedure. The most common complication is something called a hematoma which is a blood collection. This is actually a complication that can usually be drained. It is the most common complication with any facelift.

Any facelift has the risk of causing nerve damage. That is very uncommon and the risk is the same as any other facelift.



The recovery and downtime of deep plane facelift versus a regular facelift is about the same.

Patients do not stop aging once the facelift happens so they continue to age after the permanent changes made with the surgery. Even though the facelift lifts the ligaments back where they belong in the cheeks, jowls, and neck, the patient will still continue to age at the normal rate. Most people get about 10 or 15 years of results from the deep plane facelift. The changes are permanent but some people might want another facelift in 10 years because of the sagging. However, they will still look much better in 10 years than they would have looked if they did not have the facelift at all.



Having another deep plane facelift later in life depends on the person. Some people might never need it again while others might want it again. Deep plane facelift is normally a one-time procedure. If a patient does want another facelift later in life, they might do something like a small mini-lift. It all depends on what results they desire as well as how long it has been since they had a deep plane facelift.


Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Jacob Steiger, MD in Boca Raton, FL