What are the differences and the pros and cons of an SMAS facelift and a deep plane facelift? Are results more natural or long lasting with one over the other?
The terms you are referring to are not standardized, but I will answer the question with the traditional thoughts. The face has layers which consist of skin, fat, then SMAS, then fascia, then nerves and muscle and bone. A SMAS facelift refers to a facelift in which the skin is elevated and then the SMAS is elevated off the deeper structures and used to suspend the face. Many different degrees of SMAS elevation may be carried out from just incising the SMAS to elevating it for a great distance. The only difference between an aggressive SMAS lift and a deep plane lift is that in the deep plane lift the skin is only elevated for a short distance and left mostly attached to the SMAS and the dissection is carried out over the cheek and down one of the facial muscles to attempt to elevate the cheek and smile line. Studies have shown the smile line improvement does not last from this technique.
We perform a wide variety of facelifts that are all SMAS in nature. In patients without a great degree of aging we might to a mini-lift or limited incision facelift with very little SMAS work. In patient with a greater degree of aging we will perform a more extensive SMAS lift even bordering on the traditional deep plane lift. The results from any of these can be great and they should be matched to the individual patient. They can each last the same length of time if they are utilized correctly.
Posted by Dr. Buckingham