What Is a Deep Plane Facelift?
A deep plane facelift is an advanced facial rejuvenation procedure that targets the structural foundations of the face. Unlike traditional facelifts that tighten the skin or reposition the superficial muscular layer (SMAS) separately, the deep plane technique lifts the skin and SMAS as a single unit. This allows the surgeon to reposition the descended midface fat pads, release key retaining ligaments, and restore youthful volume to the cheeks and jawline without tension on the skin.
While often compared to the SMAS facelift, it’s important to understand that the deep plane technique is actually a subtype of SMAS lift—differing primarily in how the layers are elevated. This deeper, composite dissection allows for a more natural, longer-lasting result, particularly in the midface and nasolabial folds.
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Why Women Choose the Deep Plane Approach
As we age, facial changes go beyond the surface. Volume shifts downward, cheek fat pads descend, and ligaments that once held everything in place begin to weaken. For many women, fillers and non-surgical treatments no longer provide the desired effect.
The deep plane facelift offers a structural reset. By lifting the soft tissues from their foundational layer, it restores natural contours and avoids the pulled or artificial look associated with skin-only lifts. Women often choose this technique because it rejuvenates without changing their identity. The face appears refreshed, rested, and more harmonious—without looking tight or altered.
How It Works: Technique and Surgical Experience
Your surgeon will begin by making discreet incisions around the ears, sometimes extending into the hairline. Through these openings, they’ll enter the deep plane—beneath the SMAS layer—where they can safely release anchoring ligaments and mobilize deeper facial structures.
The surgeon lifts the cheek fat pads and jowls together as a unit, repositions them to their original location, and secures the tissue with deep sutures. Because the skin remains attached to the underlying layers during elevation, it preserves blood flow, minimizes trauma, and supports a more natural healing process.
Depending on your anatomy and goals, the procedure may also include neck tightening, platysma muscle repair, or facial fat grafting. Many surgeons also recommend combining this with skin-resurfacing procedures—like laser treatments or chemical peels—to address superficial skin quality.
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How to Prepare for Surgery
Preparing for a deep plane facelift is an essential part of the process. Your surgeon will provide a custom plan, but key steps usually include:
- Stop smoking at least 4–6 weeks in advance. Nicotine severely impacts circulation and healing.
- Discontinue blood-thinning medications and supplements like aspirin, vitamin E, or ginkgo as instructed.
- Make sure your blood pressure is under control. Unmanaged hypertension increases the risk of hematoma.
- Arrange for someone to accompany you on surgery day and assist for the first 24–48 hours.
- Set up a quiet recovery area with soft foods, button-up clothing, and any prescriptions or wound care items.
- Plan for 2–3 weeks off work, and avoid any strenuous activity for 4–6 weeks post-op.
Recovery: What to Expect
Recovery from a deep plane facelift is more involved than a mini or skin-only lift, but also more rewarding.
In the first few days, your face will be wrapped in compression bandages, and you may have small drains to prevent fluid buildup. Swelling and bruising typically peak around day 3 or 4, then begin to subside. Sutures and drains are usually removed during the first 7–10 days.
By week two, most patients feel well enough to resume gentle activity, though some visible swelling may persist. Around weeks three and four, many women feel comfortable returning to social life. Some tightness, numbness, or mild asymmetry may linger for a few more weeks.
Complete healing is gradual. While you'll see noticeable improvement within the first month, final results typically settle in between three and six months. It's worth the patience—because this type of lift changes the underlying structure, not just the skin.
What It Does—and Doesn’t—Fix
A deep plane facelift can significantly improve sagging cheeks, jowls, deep nasolabial folds, and loss of jawline definition. It repositions volume and restores youthful contours more effectively than SMAS or mini-lifts.
However, it does not correct:
- Fine lines, crepey skin, or enlarged pores
- Sun damage or pigmentation
- Loss of elasticity in the skin envelope
This is why many patients pair their facelift with procedures that resurface or regenerate the skin—such as RF microneedling, CO2 laser, or chemical peels. These address skin tone and texture, complementing the structural lift provided by surgery.
Is It Right for You?
The deep plane facelift is best suited for individuals in their 40s to 60s with moderate to severe facial sagging, particularly in the midface and jawline. Ideal candidates are in good health, non-smokers (or willing to stop), and have realistic expectations about the healing process and results.
It's not the right choice for patients with minimal aging or those seeking only subtle enhancement. In these cases, a SMAS facelift or mini lift might be more appropriate.
How Long Do Results Last?
One of the strongest advantages of the deep plane approach is its durability. Results often last 10–15 years, depending on genetics, lifestyle, and skin care.
But longevity is only part of the story. Because the tissues are repositioned—rather than stretched—the aesthetic outcome tends to age more gracefully. The face appears supported and naturally contoured, rather than deflated or tight, even as time passes.
Risks and Safety Considerations
When performed by an experienced facial plastic surgeon, the deep plane facelift is considered safe. However, it’s a complex procedure, and potential risks should be taken seriously. These may include:
- Hematoma (blood accumulation under the skin)
- Infection
- Temporary or, rarely, prolonged facial nerve weakness
- Prolonged swelling or numbness
- Poor wound healing or scarring (especially in smokers)
Surgeon experience matters greatly. You should feel comfortable asking how often your surgeon performs deep plane facelifts, what complication rates they’ve encountered, and how they manage unexpected outcomes.
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Comparing Deep Plane and SMAS Techniques
While often presented as opposites, the deep plane facelift is a variation of the SMAS technique. In a standard SMAS lift, the skin is separated from the muscle layer and both are lifted individually. In a deep plane lift, the skin and SMAS are lifted together as one unit, allowing the surgeon to release ligaments and reposition volume more effectively.
The deeper dissection used in the deep plane lift allows for better midface elevation and avoids excessive skin tension, which can lead to a more natural appearance and smoother recovery.
Choosing a Surgeon: What to Know
The term "deep plane" is gaining popularity and is sometimes used loosely. Some clinics may label a procedure as deep plane even when no ligament release or composite flap elevation is performed.
Always verify that your surgeon performs true deep plane dissections, not just modified SMAS techniques. Request before-and-after photos, ask detailed questions, and make sure the surgeon is board-certified and experienced specifically in facial surgery.
The deep plane technique is complex — make sure your surgeon performs true deep dissections, not shortcuts. Ask for before/after photos. Prioritize board-certified facial surgeons.
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What Does It Cost in Belgium?
In Belgium, a deep plane facelift typically starts at around €8,500 to €13,500 when performed as a standalone procedure. However, it’s often combined with:
- Neck lift or platysmaplasty
- Eyelid surgery (blepharoplasty)
- Fat grafting
- Laser resurfacing or chemical peels
With these additions, total costs can easily exceed €18,000 to €22,000. Prices vary depending on the clinic, surgeon reputation, and whether overnight recovery is included.
This is a significant investment—but one that reflects the complexity and artistry of the procedure. In the right hands, it offers results that can rival or exceed any non-surgical option in both quality and longevity.
