Deep plane vs SMAS:
what really changes
in your facelift

If you are researching a facelift, you have probably run into two words that sound like operating-room jargon: SMAS and deep plane. Some people present them as "the old technique" and "the new one". The reality is more interesting, and more useful to you.

First, what is the SMAS?

Picture your face as a coat: the skin is the outer fabric and the SMAS is the lining that gives it shape. It is a thin layer of fibrous and muscular tissue that wraps the muscles of facial expression and continues into the neck, where it joins the platysma muscle.³ Over the years that "lining" loosens and descends, and with it the cheeks drop, the jawline softens and neck bands appear.

That is why modern facelifts don't just pull the skin: they work on this layer, because moving it changes the skin, fat and muscles together.³

Two ways to reposition the support

• SMAS facelift (plication or excision). The skin stays attached to the SMAS and the surgeon tightens that layer with stitches, by folding it or removing a strip and closing it.^3,5 Think of tailoring the coat's lining.
• Deep plane facelift. The surgeon works beneath the SMAS, releases the ligaments that hold the cheek area and repositions the tissues upward as one unit.⁵ It was described in 1990 to better correct that area.⁵ In the neck it can be extended to lift skin and muscle together.⁶

What the studies say, in plain English

• Both work. A review of 21 studies and almost 2,900 patients found very satisfied patients and lasting results with both techniques.²
• Safety is similar. Another review, with 47 studies and more than 10,000 patients, found comparable complication rates and nerve injuries that were almost always temporary.⁷
• No official winner. Some studies see an advantage for the deep plane in the cheeks; others find no difference, and a 2025 review concluded it has not been shown to improve that area more or to last longer.^8,5
• Better studies are needed. The authors themselves call for research that compares the techniques directly, with the same measurements.^1,7

So what decides which one suits you?

Your anatomy, not a trend. At the evaluation the surgeon reviews how much the cheeks, jawline and neck have descended; your skin quality and thickness; the shape of your face; your age and previous surgery; your health and, very importantly, what you hope to achieve. Dr. Chung performs facelift and neck lift surgery with the deep plane technique and explains at your evaluation whether it is right for you.

The risks, straight

Every facelift is surgery and carries risks: hematoma (blood collecting under the skin), temporary changes in sensation, scars, asymmetry and, because the surgeon works close to the facial nerves, the possibility of temporary weakness of a facial muscle.

How often does the nerve issue happen? An analysis of 45 studies and more than 10,000 deep plane patients found no permanent injuries and estimated temporary ones at about 1.2%.¹ On the other hand, a survey of 150 US facial plastic surgeons reported temporary injuries in 1% to 5% of cases, more often with the deep plane.⁹ Figures vary between studies and with the surgeon's experience, and none is a promise for your case. Dr. Chung explains the risks in writing before surgery.

What to expect with Dr. Chung

• Surgery of 5 to 6 hours, under general anesthesia or deep sedation, with one night in hospital.
• Back to your activities in 2 to 3 weeks, once swelling and bruising have settled.
• Traveling from another city or country: stay 7 to 10 days after surgery; the days before surgery do not count.
• The first step commits you to nothing: a free photo evaluation on WhatsApp. If you decide to continue, the consultation with Dr. Chung costs $1,000 MXN, in person in Zapopan or by video call.