Deep Plane Facelift vs High Lateral SMAS Facelift

One of the most common questions I hear during consultation is: “What’s the real difference between a deep plane facelift and a high lateral SMAS facelift?”

Both deep plane and high lateral SMAS techniques are incredible techniques for facial rejuvenation.  Deep plane and high lateral SMAS each have unique properties that need to be matched to the appropriate patient to reach their aesthetic goals and specific needs.  Every patient has unique anatomy that provides challenges and opportunities for an incredbiel transformation.  The question is not which technique is better, but which procedure is going to optimize your specific results based on your goals.  

Austin Plastic Surgeon provides a variety of facelift options for our patients tailored to their specific needs.  

Facelift Techniques

• Deep plane facelift: lifts the midface + jawline by working in a deeper tissue plane the SMAS and extending into the neck, releasing key retaining ligaments while keeping skin and deeper tissues moving more as a unit. It also uses an oblique entry point the bypasses the fixed SMAS over the parotid gland.  This allows easier access to the retaining ligements and thus mobilization of the lower and midface. 
• High lateral SMAS facelift: lifts by repositioning the SMAS layer (the strong structural layer under the skin), often with more classic separation between skin and SMAS, and excellent control for reshaping cheek/jowl support. It lifts the lower face while augmenting the midface.  This allows for malar enhancement.  High lateral SMAS facelift can also release the retaining ligaments though it take further dissection. 
• Both techniques are based on repositioning the underlying structures and supporting the facelift from within.  These techniques take the tension of the skin while lifting and supporting the underlying tissues.  Facial rejuvenation is more than just removing skin, it is repositioning, rejuvenating and restoring.   The goal of modern facelift techniques is support and repositioning of the deeper structures for a natural but rejuvenated result. 

What is the SMAS?

The SMAS (Superficial Musculoaponeurotic System) is the strong, supportive layer beneath the skin that helps define the cheeks, jawline, and lower face.  It is about lifting the fat pads, releasing the retaining ligaments and rejuvenating the face.  

Modern facelifts and facial rejuvenation isn’t about pulling the skin as tight as possible.  It is about youthful regenerative restoration. The goal is to: 

1. Support deeper structures
2. Release tethering/retaining ligaments
3. Redrape the skin smoothly with minimal tension.
4. Targeted volume enhancement
5. Skin Rejuvenation

The foundation has to be set in your facial rejuvenation, then work from the inside out.  

Deep Plane Facelift

A deep plane facelift works in a deeper facial plane to mobilize the midface and lower face more effectively in certain patients. The concept is to release key ligament attachments and lift the deeper soft tissues in a way that can create a very natural, cohesive rejuvenation.

Why It has become so popular

Deep plane has become very popular, due to the hype on social media, but also because of the  the phenomenal results that patients have achieved  

The benefit of deep plane facelift

Deep plane facelift directly targets the deeper tissues, release the ligaments and repositions the fat pads.  This approach can produce several results that lead to a natural but incredible facial rejuvenation. 

High Lateral SMAS Facelift: What it is

A high lateral SMAS facelift also focuses on the SMAS layer, but the entry point of the SMAS is different and the smas lift direction is different. It often involves more defined work on the SMAS layer and less continueation into the neck.  The ability to reposition it in a way that can add support and structure to the cheek area and improve jowls and jawline definition.

Is the High Lateral SMAS still a good option for your Facelift? 

High lateral SMAS is an incredibly effective, versatile facelift when you want:

• Strong jawline and lower face improvement
• Excellent control and cheek support and contour. 
• Malar Enhancement
• A reliable, customizable lift plan based on anatomy

The High Lateral SMAS technique can allow very intentional improvement in the malar area of the SMAS to enhance facial structures. High lateral SMAS is an incredible option when patient benefits from added midface support and volumization of the upper midface.  

Similarities between High Lateral SMAS and Deep Plane Facelift

Both techniques share the same modern facelift principles and concepts. 

• Lift  and repositiong the deeper structures of the face, not just the skin. 
• Release the retaining ligaments in the face when appropriate to allow mobilization of the face. 
• Redraping the skin that is supported by the underlying structures
• Creating a rejuvenated appearance to the face. 

The neck matters! For most patients, it’s the #1 concern they have when they come for facial rejuvenation.

A facelift conversation and facial rejuvenation has to include conversation about improving the appearance of the neck.  

In most of our patients, we address the neck through a small incision under the chin to access and tighten the platysma muscle that causes banding and visible wrinkling of the neck.   The neck plication helps in several areas: 

• Tightens the neck bands, by plicating the muscle. 
• Sharpens the jawline by tightening these muscles. 
• Improve the cervicomental angle (that clean neck-to-chin contour)

Fat transfer – Regenerative Restoration

It is more than just pulling and lifting, Modern facelifts are built around lifting and supporting the underlying structures while restoring the youthful appearance of the fat with fat transfer, regenerative restoration. 
That’s why many facelifts whether deep plane or high lateral SMAS techniques are combined with fat transfer to restore soft, natural structure. 

Fat Transfer during a deep plane or high Lateral SMAS facelift can injected in a variety of areas depending on your specific needs: 

• Temples
• Cheeks
• Jawline
• Lips
• Nasolabial Fold
• Marionette lines
• Under eyes

For patients who don’t have available fat, which has become more common in the world of GLP-1 medications there have been some new fat products that have become available.  Shelf-stable fat products such as Lipoderma, Dermaclae and Alloclae can be used for facial augmentation in select situations or in patients that have had a facelift previously and subsequently lost weight.  These new processed fat products have created opportunities without surgery.  

Recovery and results from Deep Plane and High Lateral SMAS Facelifts

Patients are pleasantly surprised that modern facelifts techniques can make such a dramatic  change, but have a rapid recovery.  Most patients can be back to social events in two weeks with a little cover-up make-up.  However the swelling will take time and the results will continue to improve for months

How I choose which facelift is right for me? 

This is where your board certified plastic surgeon can help guide you on the correct facial rejuvenation plan.  It is typically a much broader journey than just the surgery. The surgery is the cornerstone of your transformation, but it is so much more than just that to get the best results possible.  

Longevity of Deep Plane and High Lateral SMAS Facelifts

A facelift is a big decision in your life and something that should have serious consideration and thought. Not only in the surgery iteself, but in creating a plan for maintaning your results!  

• Stable weight. – Fluctuations in weight is probably the thing that will most rapidlby dimish your results from your facelift.  It is important to be a good stable weight and maintain it. 
• Skincare routine: It is critical to take care of your skin prior to and after your facelift.
  • Moisturizer
  • Sunscreen 
  • Cleanser
• Collagen Stimulation.  No question as we age we lose collagen and elastin.  Often treatments such as Sofwave and AVAVA are great supplements your to your facial rejuvenation journey. 
• Consider maintenance options (skin tightening, lasers, injectables) if appropriate
  

FAQ

If you’re considering a facelift in Austin and want a plan that looks refreshed, natural, and you, that’s exactly what we focus on every day.

— Dr. Johnny Franco, Austin Plastic Surgeon
Because confidence is the best contour.