Not all facelifts are the same. The technique your surgeon uses determines how deeply the tissue is repositioned, how natural the result looks, and how long it lasts. Dr. George Moynihan explains the key differences between traditional and deep plane facelift techniques.
The Right Approach For You
If you have been researching facelift surgery, you have almost certainly encountered the term "deep plane facelift" alongside references to traditional techniques. The two are frequently compared, and patients often want to know which is better. The honest answer is that the right approach depends on the individual patient, but understanding what distinguishes them is the first step toward a well-informed consultation.
At Gold Coast Plastic Surgery in Chicago, Dr. George Moynihan is a double board-certified facial plastic surgeon known for achieving natural, undetectable results in facial rejuvenation. Here is how he explains the deep plane versus traditional facelift question.
What a Traditional Facelift Actually Does
The term "traditional facelift" covers a range of techniques, but in its most basic form, it refers to a procedure that primarily addresses the skin layer. Excess skin is removed, the remaining skin is pulled tighter, and the incisions are closed. In older iterations of this approach, the skin itself bore most of the tension of the lift.
The Problem With Skin-Only Facelifts
The problem with skin-only techniques is structural. Skin alone does not provide durable support. When the primary mechanism of the lift is skin tension, the results tend to relax faster, the face can appear pulled or windswept in the early recovery period, and telltale signs of surgery, such as distorted hairlines, visible tension around the ears, and an unnaturally tight lateral pull to the face, are more likely.
Modern facelift surgery has largely moved past purely skin-based techniques. The most commonly performed facelift today is the SMAS facelift, which represents a meaningful evolution from the skin-only approach and forms the baseline against which deeper techniques are often compared.
The SMAS Layer: Why It Matters
The SMAS, or Superficial Musculoaponeurotic System, is a fibrous layer of muscle and connective tissue that lies beneath the skin of the face. It forms the structural foundation of the lower face and is continuous with the platysma muscle in the neck.
Benefits of Addressing the SMAS
Addressing the SMAS rather than relying purely on skin tension changed the trajectory of facelift surgery. By repositioning and securing the SMAS layer, surgeons can support the overlying skin without placing excessive tension directly on it. The result is a lift that holds longer, looks more natural, and avoids the pulled appearance associated with older techniques.
A standard SMAS facelift elevates the SMAS and either plicates it (folds it on itself) or implicates it (tucks it beneath itself) to reposition the lower face. This is an effective approach for many patients, particularly those with moderate laxity in the jowls, lower face, and upper neck.
What the Deep Plane Changes
A deep plane facelift goes a layer deeper. Rather than operating above the SMAS, the surgeon dissects beneath it, entering the deep plane of the face. This allows the skin, fat, and SMAS to be mobilized together as a single, unified composite unit rather than separately.
The Importance of Releasing Ligaments
The critical distinction is the release of the retaining ligaments.
The face is anchored to the underlying bone by a series of fibrous ligaments that prevent the soft tissues from migrating. Over time, as these ligaments weaken and the overlying tissue loses volume and elasticity, the classic signs of aging appear: jowling, nasolabial fold deepening, midface descent, and neck laxity.
In a standard SMAS facelift, these ligaments remain intact. The SMAS is repositioned, but the tethering points that anchor the tissue to the bone are not released. In a deep plane facelift, the surgeon releases these ligaments, allowing the entire composite unit of skin, fat, and SMAS to be repositioned more completely and with less surface tension.
This is what produces the natural result for which deep plane surgery is known. Because the skin is not being used to provide the tension of the lift, it can redrape smoothly and settle without the stretched, operated appearance that tension-based techniques can create.
What Each Approach Addresses Best
The difference in technique produces differences in what each approach accomplishes most effectively.
Traditional SMAS Facelift
Well-suited for patients with moderate lower face and jowl laxity who do not yet have significant midface descent or deep nasolabial fold involvement. The technique addresses the lower third of the face effectively and produces good results in the right patient population with a somewhat more limited scope of dissection.
Deep Plane Facelift
Better suited for patients with more advanced or comprehensive facial aging, including midface descent, deep nasolabial folds, significant jowling, and neck laxity. Because the ligament release allows the composite tissue unit to be repositioned further and more completely, the deep plane approach can address the midface in ways that a standard SMAS lift cannot easily replicate.
At Gold Coast Plastic Surgery, Dr. Moynihan performs a modified deep plane facelift with a low-tension closure technique specifically designed to produce results that are natural, undetectable, and long-lasting. His signature Gold Lift combines the deep plane facelift with complementary procedures, including a brow lift, lip lift, and blepharoplasty, to address all aspects of facial aging in a single comprehensive procedure.
Recovery: How the Two Approaches Compare
Both SMAS and deep plane facelifts involve incisions along the hairline and around the ears, and both carry similar recovery expectations in broad terms. Swelling, bruising, and tightness are expected in the early weeks regardless of which technique is used.
Swelling
Deep plane surgery involves more extensive dissection than a standard SMAS facelift, which means slightly more swelling in the immediate post-operative period for some patients. However, because the skin is under less tension in a deep plane case, the tissue often settles more naturally and quickly once the initial swelling resolves.
Returning to Work/Activity
Most patients undergoing a deep plane facelift with Dr. Moynihan can return to non-strenuous work within ten to fourteen days, with full activity resuming after four to six weeks. Results from deep plane surgery tend to be both more comprehensive and longer lasting than those from less extensive techniques, reflecting the more complete repositioning of the underlying structural support.
The Surgeon's Role in the Outcome
A facelift is only as good as the surgeon performing it. The deep plane facelift is a technically demanding procedure that requires extensive experience with facial anatomy and the three-dimensional relationships between tissue planes, ligaments, and neurovascular structures. In less experienced hands, the additional complexity of deep plane dissection carries greater risk. In experienced hands, it is a powerful tool for achieving results that genuinely look natural.
Dr. Moynihan is a recognized leader in facial rejuvenation and has built his practice around the principle that facelift results should never look obvious. His clients leave looking like a younger version of themselves, not like someone who has had surgery.
Choosing the Right Approach for You
The decision between a traditional SMAS technique and a deep plane approach is not one-size-fits-all. It depends on your anatomy, the degree and pattern of your facial aging, your goals, and the surgeon's honest assessment of what will produce the best result for your specific face.
If you are considering a facelift in Chicago and want to understand which approach is right for you, Dr. Moynihan welcomes you to schedule a consultation at Gold Coast Plastic Surgery. Contact us today to begin the conversation.
