What is Deep Plane Facelift? The Difference from Classic Facelift

What is Deep Plane Facelift? What is its Difference from Classic Facelift?

When researching facelift surgeries, one of the most frequently encountered terms in recent years is “Deep Plane Facelift,” or the deep plane facelift technique. So, what is a deep plane facelift, how does it differ from a classic facelift, and is it suitable for everyone who wants a facelift?

In the shortest explanation, deep plane facelift is one of the advanced facelift techniques that aims to reposition the deeper soft tissues of the face, which shift downwards with aging, by anatomically releasing them, rather than just tightening the skin of the face. During the operation, the SMAS layer, which is called the superficial musculoaponeurotic system of the face, and the anatomical planes beneath it are taken into consideration.

However, there is an important detail here: the approach that “deep plane is the newest method, therefore it is the best method for everyone” is not medically correct. In modern facelift surgery, there are different techniques, and the method to be applied should be determined according to the individual’s facial anatomy, aging pattern, skin quality, midface tissues, jawline, neck area, and the surgeon’s evaluation.

At Op. Dr. Şükrü İşler Aesthetic Clinic, the first examination or initial consultation is free. During this consultation, a personalized facial rejuvenation plan can be evaluated by looking not only at the person’s facial skin but also at the midface, cheeks, jawline, neck, skin quality, and volume distribution together.

What Does Deep Plane Facelift Mean?

“Deep plane” can be translated into Turkish as “derin plan” or “derin düzlem” (deep plan or deep layer). The term refers to the anatomical plane where the surgeon works during the operation.

The skin on our face is not an independent structure that stands alone. Beneath the skin, there are fat tissues, connective tissues, facial mimic muscles, a fibromuscular layer called SMAS, and various retaining ligaments that connect these to deeper structures.

As we age, changes seen in the face are not solely due to skin laxity. Midface fat compartments can shift, cheek tissues can descend, changes can occur in the ligaments that fix the face at certain points, and sagging, referred to as “jowl,” can develop along the jawline.

The fundamental idea behind the deep plane facelift approach is to mobilize and reposition the deeper soft tissues affected by aging in the appropriate anatomical plane, rather than just intervening with the excess surface skin.

For detailed scientific information about deep plane anatomy and technique, the NCBI Bookshelf – Deep Plane Facelift resource can be reviewed.

What is SMAS and Why is it Important in Facelifts?

To understand the difference between deep plane and classic facelifts, it is first necessary to know the concept of SMAS.

SMAS is an abbreviation for “Superficial Musculoaponeurotic System”. In Turkish, it can be referred to as the superficial musculoaponeurotic system. It is one of the important supporting structures of the face’s soft tissues and is considered one of the fundamental anatomical layers of modern facelift surgery.

In facelift operations performed in earlier periods, the skin was predominantly lifted, and excess skin was removed to make the face tighter. In modern surgery, it has been understood that merely tightening the skin is not sufficient. This is because a significant portion of facial aging occurs in the deeper soft tissues.

For this reason, in many facelift techniques today, the SMAS layer is addressed using different methods.

In the deep plane technique, a significant portion of the dissection continues along the anatomical plane located beneath the SMAS. This allows for the release of certain retaining ligaments and the mobilization of the midface and lower face tissues together.

How is a Deep Plane Facelift Performed?

A deep plane facelift is not a simple surgery consisting of a single standard movement. The details of the surgical technique can vary depending on the patient’s anatomy, the surgeon’s approach, and simultaneous procedures that may be required.

In general principle, during the surgery, facial tissues are accessed through planned incisions around the ear and, if necessary, along the hairline. After a certain point, the dissection is advanced to a deeper anatomical plane.

In this plane, it may be possible to controlledly release the retaining ligaments, which are supportive ligaments that fix certain areas of the face. This allows displaced tissues in the cheek, midface, and lower face to be moved as a larger, unified structure.

After the tissues are repositioned in the appropriate direction, fixation procedures are performed on the deeper supporting tissues. The skin is then adapted to the new position without excessive tension, and any necessary excess skin is removed.

The aim of this approach is not to ‘pull the face as much as possible’. The main goal is to bring tissues that have shifted downwards with age into a more anatomically balanced position.

What is the Main Difference Between Deep Plane and Classic Facelift?

Since ‘classic facelift’ can refer to different operations in everyday use, caution is needed in this comparison. Today, under the name of classic facelift, not only skin tightening but also SMAS plication, SMASectomy, or various SMAS techniques can be applied.

Therefore, the difference between deep plane and ‘classic facelift’ is not always as simple as ‘one is done deeply, the other superficially’.

One of the fundamental anatomical differences is that in the deep plane approach, the anatomical plane beneath the SMAS is entered in certain areas, and some retaining ligaments that stabilize the face are controllably released.

In other SMAS-based facelift techniques, the SMAS tissue can be folded, tightened, partially removed, or repositioned using different methods.

Therefore, what matters more than the technical name is which anatomical problem of the patient is corrected with which surgical maneuver.

Why are Tissues Released in Deep Plane Facelift?

It is not correct to think of facial tissues as a tent fabric. The skin and soft tissues are attached to the facial skeleton by various anatomical connections.

While some of these connections hold tissues firm at specific points despite aging, the surrounding tissues can shift downwards. As a result, changes such as the accentuation of nasolabial folds, the descent of the cheeks, or an irregular jawline may occur.

In deep plane surgery, the release of specific retaining ligaments can allow tissues to be moved as a larger soft tissue unit instead of just being pulled from the outside.

This anatomical approach is one of the fundamental characteristics that distinguishes the deep plane facelift from some other facelift methods.

Does Deep Plane Facelift Affect the Midface?

One of the most discussed features of the deep plane facelift is its effect on the midface region.

With aging, the soft tissues around the cheekbones and in the cheek area can shift downwards. This change can lead to the cheeks appearing flatter, the nasolabial fold between the nose and mouth becoming more pronounced, and a reduction in the characteristic midface fullness of a youthful face.

The deep plane approach can allow for the mobilization of midface tissues in suitable patients. Therefore, it is a method that addresses not only laxity in the lower face but also signs of aging in the cheeks and midface.

Regarding the anatomical approach to midface rejuvenation, the study Deep Plane Face Lifting for Midface Rejuvenation published on PubMed can be reviewed.

Does Deep Plane Facelift Define the Jawline?

For a significant portion of individuals researching facelift surgery, one of the primary complaints is the loss of the jawline’s youthful definition.

The downward displacement of the lower cheek tissues over time can create a prominent or sagging appearance along the jawline, referred to as “jowl.”

Deep plane facelift, by repositioning the lower facial tissues, can contribute to a more defined and regular appearance of the jawline in suitable patients.

However, the appearance of the jawline is not solely determined by the facial tissues. Aging in the submental (double chin) area, the condition of the platysma muscle, the projection of the jawbone, and excess skin in the neck can also affect the outcome.

Therefore, while a facelift alone may be sufficient for some patients, others may require planning that includes neck lift surgery or additional procedures targeting the neck area.

Does Deep Plane Facelift Also Lift the Neck?

Although deep plane facelift and neck lift are closely related, they are not technically the same procedure.

In one patient, there might be sagging in the mid and lower face without significant laxity in the neck. In another patient, changes in the jawline might be accompanied by severe neck sagging, submental (double chin) aging, or platysma bands.

Therefore, planning the surgery solely based on the question “will it be deep plane?” is not correct. The face and neck should be considered as a single aesthetic unit.

In patients with significant excess skin and muscle laxity in the neck, surgically addressing the neck area along with the facelift can create a more balanced profile.

Does Deep Plane Facelift Look More Natural?

One of the most frequently encountered phrases in deep plane facelift research is the concept of a “more natural facelift.”

Naturalness alone is not a guarantee of a surgical technique. The outcome of a natural-looking facelift is a result of surgical planning, proper patient selection, the direction in which tissues are repositioned, the tension applied to the skin, the preservation of the face’s own anatomy, and the surgeon’s experience, all playing a combined role.

In the deep plane approach, repositioning deeper soft tissues as a whole and attempting to prevent excessive skin tension when closing the skin can form the anatomical basis for the goal of a natural appearance.

However, similarly natural results can also be achieved with well-planned modern SMAS facelift techniques. Therefore, the generalization that “deep plane looks natural, all other methods look artificial” is not correct.

Does the Face Look Overly Stretched with a Deep Plane Facelift?

One of the common concerns expressed by patients hesitant about facelift surgeries is that their face might appear overly stretched or different after the operation.

The goal of modern facelift surgery is not to maximize horizontal stretching of the face. It is to rearrange the altered tissue positions of the face due to aging in as anatomical and balanced a way as possible.

In the deep plane approach, because deeper tissues are mobilized, the need to keep the facial skin under high tension alone is sought to be reduced.

However, whether the final result is natural or not is not determined solely by the name of the technique used. Surgical planning and execution are extremely important.

Does Deep Plane Facelift Leave Scars?

Deep plane facelift is a surgical facelift procedure and requires incisions. Therefore, the phrase “completely scarless deep plane facelift” is not realistic.

Incisions are usually planned considering the hairline, the front of the ear, and the natural anatomical folds around the ear. If necessary, the incision can extend behind the ear and into the scalp.

The appearance of scars over time may vary depending on the individual’s wound healing characteristics, genetic makeup, smoking habits, skin type, surgical technique, and postoperative care.

In the deep plane technique, the aim is to avoid unnecessary high tension when closing the skin, so the mechanical load on the incision line can be reduced. However, no surgical method can guarantee the complete disappearance of scars.

Who Can Undergo Deep Plane Facelift?

For a deep plane facelift, age is not the only criterion considered. Two people of the same age can have completely different facial aging.

In appropriate patient evaluation, the following findings, in particular, may be considered:

• Downward displacement of mid-face tissues,
• Pronounced sagging in the cheeks,
• Age-related deepening of nasolabial folds,
• Looseness in the lower face,
• Formation of jowls along the jawline,
• Loss of definition in the jawline contour,
• Disruption of the face-neck transition,
• Presence of both excess skin and soft tissue sagging.

However, not every patient may need the deep plane method. For individuals with mild signs of aging, more limited surgical or non-surgical options can be considered.

Is There a Specific Age for a Facelift?

There isn’t a single, numerical answer that fits everyone for the question, “At what age is a deep plane facelift performed?”

The onset and progression rate of facial aging can be affected by many factors such as genetic characteristics, sun exposure, smoking, weight changes, skin structure, and lifestyle.

Therefore, while surgical-level sagging may be observed in a 45-year-old person, another person may have more limited changes even at 55 years old.

The decision for surgery should be based not on the date of birth, but on anatomical need.

Deep Plane or Filler?

Although filler and deep plane facelift may seem like alternatives to each other, they work with completely different mechanisms.

The main task of filler applications is to provide volume support to specific facial areas. Deep plane facelift, on the other hand, aims for the surgical repositioning of downward-displaced tissues.

In individuals with early volume loss and no significant sagging, filler may be a suitable option. However, attempting to correct a face with significant jowl formation, descended cheek tissues, and noticeable skin excess solely by using increasingly larger amounts of filler may not always be the correct approach.

To evaluate this topic in more detail, you can also review the content titled Filler or Facelift for Facial Sagging?

Can Deep Plane Facelift and Eyelid Aesthetics Be Performed Together?

Facial aging does not only occur in the cheek and jawline. Excess skin on the upper and lower eyelids, fat bulges, or signs of aging around the eyes may also be observed simultaneously.

In suitable patients, facelift surgery may be accompanied by blepharoplasty, i.e., eyelid aesthetics. However, whether it is appropriate to perform these procedures together should be determined by evaluating the individual’s anatomy, general health status, and overall surgical plan.

For detailed information about surgical options around the eyes, you can review the Eyelid Aesthetics page.

How Permanent Are the Results of Deep Plane and Classic Facelift?

Facelift surgery does not stop the aging process. With surgery, certain tissues can be moved to a younger anatomical position, but aging continues even after the operation.

Therefore, it is not correct to make a definitive statement such as “deep plane facelift is permanent for life.”

Factors such as the patient’s age, skin quality, genetic characteristics, sun exposure, smoking, weight changes, and the characteristics of the surgical technique play a role in maintaining the result for a long time.

In the current scientific literature, both deep plane and SMAS facelift methods report high patient satisfaction and long-term results. However, since the techniques used and the outcome assessment methods vary among studies, it is not definitively correct to state that one method is more permanent for all patients.

For a current systematic review and meta-analysis evaluating deep plane and SMAS facelift methods, the PubMed – The Deep Plane versus SMAS Facelift publication can be reviewed.

Is Deep Plane Facelift Safe?

Deep plane facelift is an operation that anatomically requires advanced knowledge and surgical experience. The branches of the facial nerve, blood vessels, salivary glands, and other anatomical structures of the face are in close proximity to the surgical area.

As with any facelift surgery, complications such as bleeding, hematoma, infection, fluid accumulation, wound healing problems, altered sensation, asymmetry, changes in the hairline, scarring issues, and temporary or permanent nerve damage may occur after a deep plane facelift.

In a systematic review and meta-analysis published in 2026, evaluating a total of 10,784 deep plane facelift patients across 45 studies, various complication rates were reported to be low. However, it should be noted that scientific research can differ in terms of patient selection, surgical methods, and follow-up periods.

The relevant study can be accessed via PubMed – Deep Plane Facelifts: A Systematic Review and Meta-Analysis of Outcomes.

Is Deep Plane Facelift Better Than Classic Facelift?

On the internet, this question is often asked as “is deep plane better, or SMAS?” However, from a medical perspective, the most appropriate approach is not to evaluate techniques to determine a single winner.

Because the outcome achieved in facelift operations does not depend solely on the name of the technique.

Important factors influencing the outcome include:

• The patient’s facial anatomy,
• Type of aging,
• Condition of the midface,
• Degree of sagging in the jawline,
• Neck anatomy,
• Skin quality,
• Which tissues are mobilized and to what extent,
• The direction in which the tissues are repositioned,
• The surgeon’s technique and experience

are among these.

The deep plane technique can offer significant advantages, especially in some patients where extensive mobilization of midface and lower face tissues is necessary. In other patients, a different SMAS facelift technique might be more suitable.

Therefore, the correct question should not be “Which is the best facelift technique?” but rather “Which technique is more suitable for my facial anatomy and why?”

What is the Recovery Like After Deep Plane Facelift?

The recovery process can vary from person to person. The extent of the surgery and whether additional procedures such as a neck lift or eyelid aesthetics were performed also affect the duration.

In the first few days, swelling, a feeling of tightness, tenderness, and bruising may be observed in the face and neck area. Although swelling begins to decrease after the initial days, it may take longer for the tissues to fully settle.

It is not possible to definitively determine patients’ return time to social life solely by looking at the surgical technique.

After the surgery, it is important not to miss the follow-up appointments recommended by the physician, to perform proper wound care, to stay away from smoking, and to move in a way that protects the face from trauma in the early period.

Does the Face Immediately Take Its Final Form After a Deep Plane Facelift?

No. The appearance immediately after facelift surgery is not the final result.

In the early period, swelling, bruising, and temporary stiffness due to the new position of the tissues may occur. As the swelling subsides, the facial contours gradually become more defined.

Therefore, it is not correct to judge the final outcome of the surgery based on the appearance on the first day or in the first few weeks. It takes time for the tissues to heal and for the facial contours to settle.

What is Examined During the Consultation Before a Deep Plane Facelift?

One of the most crucial stages of a successful facial rejuvenation plan is the pre-operative evaluation.

Instead of just counting wrinkles during the examination, the entire face should be examined.

The main points that can be evaluated are:

• Position of mid-face tissues,
• Cheek volume and cheek sagging,
• Nasolabial folds,
• Corners of the mouth and marionette lines,
• Jowl appearance along the jawline,
• Chin and neck angle,
• Platysma muscle,
• Fat accumulation in the submental (double chin) area,
• Skin quality and elasticity,
• Eye area,
• Overall facial proportions and asymmetries.

At Op. Dr. Şükrü İşler Aesthetic Clinic, the initial examination or first consultation is free of charge. During the first consultation, the suitability of facelift, neck lift, or other facial rejuvenation options can be discussed by evaluating which anatomical structures are responsible for the aging on the person’s face.

You can also get information about the general principles of facelift surgery from the Facelift page.

What are the Advantages of Deep Plane Facelift?

When planned in suitable patients and with correct surgical indications, the potential advantages of the deep plane approach include more comprehensive mobilization of tissues in the mid and lower face, direct release of specific ligaments that fix the face, and achieving rejuvenation through deeper tissues without placing excessive tension on the skin.

This anatomical approach may be preferred in some patients, especially those where the cheek tissue has significantly descended, the nasolabial region has deepened, and sagging has developed along the jawline.

However, it should be remembered that the advantages vary from patient to patient, and the same outcome should not be expected in every facial anatomy.

Are There Disadvantages to Deep Plane Facelift?

Since a deep plane facelift is performed in a deeper anatomical plane, it requires a thorough understanding of facial anatomy.

The scope and difficulty of the operation may vary depending on the patient’s anatomy. Surgical experience is important because the procedure involves anatomical areas close to the branches of the facial nerve.

Furthermore, the designation of the surgery as “deep plane” alone does not guarantee better results or complication-free recovery.

As with any surgical procedure, the benefits and risks must be evaluated on a patient-specific basis.

What Do Scientific Studies Say About Deep Plane Facelift?

Deep plane facelift is a method that has been used in facial rejuvenation surgery since approximately the 1990s and has been developed by different surgeons over time.

In recent years, the number of scientific studies on this method has increased. Research reports high patient satisfaction and successful aesthetic outcomes with the deep plane approach.

However, directly comparing deep plane, SMAS, and other facelift methods is not easy. Technical details used by surgeons, patient selection, follow-up periods, and “success” criteria vary from study to study.

Therefore, while current scientific data supports deep plane facelift as an effective facial rejuvenation method, it is not correct to conclude that it is unequivocally superior to other methods for every patient.

For a 2025 open-access academic publication examining the systematic surgical approach of the deep plane technique, you can access the PMC – Systematic Approach to Deep Plane Facelift resource.

Frequently Asked Questions

What is a Deep Plane facelift?

Deep plane facelift is one of the facelift techniques that aims to release and reposition the facial soft tissues that have shifted downwards, by working on the anatomical planes beneath the SMAS, instead of just tightening the skin of the face.

What is the difference between Deep Plane and traditional facelift?

The main difference is the anatomical plane worked on and the method of mobilizing soft tissues. In the Deep Plane approach, retaining ligaments can be released by advancing under the SMAS in specific areas. In other modern facelift methods, often referred to as traditional, the SMAS can be tightened or repositioned in different ways.

Does a Deep Plane facelift look more natural?

In the Deep Plane technique, the repositioning of deeper tissues and the aim of not creating excessive tension on the skin can support a natural appearance. However, the name of the technique used is not the only factor determining a natural result; proper planning and surgical application are also important.

At what age is a Deep Plane facelift performed?

Instead of a specific age limit, the degree of anatomical aging of the face is evaluated. In individuals with significant sagging in the mid-face and lower face, a surgical evaluation can be performed regardless of age.

Does a Deep Plane facelift correct neck sagging?

Repositioning of the lower face can contribute to the appearance of the jawline-neck transition. However, if there is significant excess neck skin, platysma bands, or a double chin problem, additional surgical procedures targeting the neck area may be required.

Does a Deep Plane facelift leave scars?

Yes. It is an operation that requires a surgical incision. Incisions are usually planned to align with the natural creases around the ears and the hairline, aiming to make the scars as minimally noticeable as possible.

Can the facial nerve be damaged during a Deep Plane facelift?

Facial nerve branches are anatomically related to the surgical field. Therefore, temporary or permanent nerve damage is among the known risks of facelift surgeries. The risk rate depends on factors such as the technique used, patient anatomy, and surgical execution.

Is a Deep Plane facelift permanent?

The operation can provide long-lasting rejuvenation, but it does not stop natural aging. In the years following the surgery, the face and skin continue to age.

Can Deep Plane facelift and eyelid surgery be performed simultaneously?

In suitable patients, a facelift can be combined with upper or lower eyelid aesthetics within the same surgical plan. Its suitability should be determined during the pre-operative examination.

Does a Deep Plane facelift replace fillers?

The purpose of the two procedures is different. While a facelift repositions sagging tissues, fillers create volume in specific areas. Some individuals may only require one, while other patients may benefit from both methods at different times.

Is Deep Plane or SMAS facelift better?

There is no single “best” technique applicable to every patient. Both Deep Plane and SMAS-based facelift techniques can provide successful results with the correct indication. The choice should be made based on the patient’s anatomy, required tissue mobilization, and surgical planning.

Is swelling expected after a Deep Plane facelift?

Yes. A certain amount of edema (swelling) and bruising can be expected after facelift surgery. These will decrease over time during the healing process.

Does the facial expression change after a Deep Plane facelift?

The aim of the surgery is not to transform the person’s face into another face, but to reposition tissues that have shifted downwards with aging. Proper planning aims to preserve the person’s fundamental facial character.

Is the initial consultation for Deep Plane facelift charged?

No. At Op. Dr. Şükrü İşler Aesthetic Clinic, the first examination or initial consultation is free of charge. During the consultation, facial anatomy, mid-face, jawline, neck area, and skin structure can be evaluated to create a personalized plan regarding which facial rejuvenation method might be suitable.

How Should the Decision for Deep Plane Facelift Be Made?

Although Deep Plane facelift has gained popularity in recent years, facelift surgery should not be chosen solely based on the name of a popular surgical technique.

The really important thing is to correctly identify the anatomical changes that make a person’s face look old. While the main problem for one person might be sagging tissue in the mid-face, for another, lower face and neck sagging might be more prominent. In some individuals, the main problem is not tissue sagging but volume loss.

Therefore, in a facial rejuvenation plan, instead of saying “I want a Deep Plane facelift,” one should seek an answer to the question: “Which tissues on my face have changed and why, and which method is needed to correct them?”

Deep Plane facelift is a comprehensive surgical approach that, in the right patient, can enable the anatomical repositioning of mid-face, cheek, and lower face tissues. Modern SMAS facelift methods can also offer effective options for different anatomical needs.

At Op. Dr. Şükrü İşler Aesthetic Clinic, the initial examination or consultation is free. You can benefit from a free initial consultation to learn which anatomical structures are causing the changes in your face and to evaluate the suitability of Deep Plane facelift or other facial rejuvenation methods for you.

This content has been prepared for general informational purposes. It does not substitute for diagnosis or personalized treatment recommendations. Surgical methods, scope of operation, potential benefits, and risks can only be evaluated on a personalized basis after a medical examination by a physician.