What is a Deep Plane Facelift?

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A deep plane facelift achieves tighter skin, defines the facial features, and reduces elasticity in the neck. Out of the different types of facelifts, the deep plane facelift is the most effective – yielding results that make patients look 12-15 years younger.

Deep plane facelift surgery is a facial surgery where the SMAS, a layer of connective tissue underneath the facial skin, is lifted to tighten the cheekbones, jawline, and neck.

It also restores the cheek area back to its original position and improves the hollowness in the lower eyelid.

A true deep plane facelift is very technically challenging, which is why many surgeons do not perform the procedure. Dr. Williams has created a specific approach to the deep plane facelift, which he has perfected over the years and has shared with other surgeons in the United States and internationally.

Where will I see results of a deep plane facelift? 

The jowls, excess neck skin, and midface soft tissues are areas that see the most improvement after a deep plane facelift. When patients undergo deep plane facelifts, they also see improvements in their lower eyelids. These deep plane facelift results leave patients looking, on average, 12-15 years younger. 

Results of a deep plane facelift performed by Dr. Edwin Williams at The Williams Center

How a deep plane facelift is performed

The deep plane facelift is most commonly performed under general anesthesia. This means that our patients are put “to sleep” by our experienced anesthesia team. 

The procedure involves dissecting multiple layers of tissues in the face as well as the neck. 

The first step of the surgery is to make an incision in the face and neck, typically within the hairline and skin crease just in front of the ear. This incision is designed to “hide” or minimize facial scars. The facial and neck skin is then separated from deeper tissues, allowing your surgeon to visualize the “SMAS.”

The superficial musculoaponeurotic system (SMAS) is a tissue layer made up of elastin, collagen, and fat cells, that normally drapes over our facial muscles and facial organs. The SMAS extends from the neck to the forehead, and it is this structure that gets “lifted” in a deep plane facelift. 

Once the SMAS is identified, your surgeon will then work on separating the SMAS from deeper tissues. The region underneath the SMAS is referred to as the deep plane. The SMAS layer is carefully lifted up, and multiple stitches are placed to anchor the SMAS in different regions of the face and neck. Suturing the SMAS allows us to directly pull on common areas of aging, such as sagging of the cheek, jowls, and sagging of neck. 

At the end of the surgery, your surgeon will perform meticulous suturing to close all the incisions. 

Cost of a deep plane facelift

When taking into account the surgeon’s fee, anesthesia fee, and operating room and facility fee, patients at The Williams Center can expect to pay approximately in the range of $18,000 to $40,000 for their deep plane facelift surgery.

The final cost of a deep plane facelift can be adjusted depending on the extent of the facelift, the amount of general anesthesia needed, and the addition of any adjunctive facelift procedures.

When compared nationally, facelift costs can range anywhere from $40,000 to upwards of $100,000.

Recovery after deep plane facelift surgery

Recovering after a deep plane facelift surgery can take seven to 14 days, depending on the procedure.

Most patients do not complain of discomfort during recovery, but often describe it as being sore or having a tightness in their face.

Low energy levels are common following surgery, and it’s important to minimize all activities for several days, as unnecessary activity will encourage swelling, discomfort, and bleeding.

Healing after surgery takes time, but following the post-operative instructions is the best way to ensure a smooth recovery.

Watch to see a patient’s day by day recovery after a deep plane facelift surgery.

Deep plane facelift vs. facelift technique

Originally, facelifts were performed by just lifting up the skin and pulling it tight; this resulted in an unnatural “windblown” look. The technique then evolved to what many people around the country currently use: the imbrication technique. 

The imbrication technique is when the skin is lifted, and the SMAS layer (or superficial musculoaponeurotic system) is cut into and pulled tight. The problem with the imbrication technique is that there are ligaments (or areas of attachment) that cannot be smoothed out by just pulling that tissue. 

A true deep plane facelift, then, is taking this one step further. We not only make an incision in that deeper SMAS layer, but we also dissect underneath that layer to free up those ligaments. 

This dissection improves the neck and results in a nice, crisp jawline. 

Why choose a deep plane facelift over a SMAS facelift

Because deep tissues are pulled up during a deep plane facelift, there will be greater definition to the cheekbones, jawline, and neck. 

Patients tend to look more natural rather than a “pulled” look. The deep plane facelift can also restore volume to the mid-face and under-eye areas to give patients fuller cheeks and a more youthful appearance. 

Some experts also argue that the results of a deep plane facelift lasts longer than many of the other traditional facelift techniques. 

Will my scars be visible?

At The Williams Center, our expert plastic surgeons create the incision so that hair can grow through it — meaning that months later, the facelift incision scars are not visible. Instead, the incisions are hidden around the ears and within the hairline.

When we see our patients one year after they undergo facelift surgery, the incisions are virtually undetectable.

How long do the results of a deep plane facelift last?

Many experts believe that the results of a deep plane facelift should last anywhere between 7 to 12 years. 

Individual factors, such as genetics, cumulative sun damage, and skin quality, all play a role in aging and can affect the longevity of surgery. We recommend practicing a good anti-aging skincare regimen after surgery to ensure that the effect of a facelift lasts as long as possible. 

Typically, the most noticeable areas of improvement after a deep plane facelift are the cheekbones and jawline. However, an individual who has undergone a deep plane facelift will continue to experience aging even after surgery. As time goes on, some people may notice the sagging of the skin on their face and neck. 

This is a side by side view photos of a woman's face before and after Deep Plane Lower Face and Neck Lift and Bilateral Upper Lid Sliver Blepharoplasty procedure. Before photo shows a loose-fitting skin on her cheeks that covers her jawline while after photo shows more solid skin which makes her jawline more vissible. | Albany, Latham, Saratoga NY, Plastic Surgery

Patient showcasing their results after undergoing an extended deep plane facelift at The Williams Center.

How to find an experienced deep plane facelift surgeon

It’s important to find a surgeon who is experienced in the procedure you’re looking to have, has all relevant certifications, and comes highly recommended by previous patients.

To find the right plastic surgeon for you, consider asking them the following questions:

  1. Does your doctor go below or elevate the platysma muscle in the neck along the jawline to get a more effective release?
  2. Do they release the zygomatic cutaneous ligaments in the area of the cheekbone and elevate the SMAS or muscle in the deep plane all the way out to the smile line and along the jawline?
  3. How long have they been performing the deep plane facelift surgery?
  4. Do they release in the deep plane in the middle part of the face and continue down into the neck below the muscle?
  5. Can the surgeon remove the buccal fat pads through the deep plane approach?

Thoroughly researching a surgeon’s qualifications is key, but don’t forget to follow your instincts as you search for the right plastic surgeon for you.

Schedule a deep plane facelift consultation.

Dr. Edwin Williams has spent many years perfecting his deep plane facelift technique and has shared it with other surgeons in the United States and internationally. 

To get more information about how the deep plane facelift procedure can give you the results you’re looking for, schedule a consultation today

Female patient showcasing results of deep plane facelift

About the Author: Dr. Edwin Williams

Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.

Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.

Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.