Deep Plane Facelift
Also known as rhytidectomy, SMAS facelift, facelift
The definitive treatment for midface and jawline laxity. Nothing non-surgical is a substitute once real descent has occurred.
US $20,000–60,000 with a well-regarded surgeon; often more in major markets.
How it works
The surgeon releases the retaining ligaments and lifts the SMAS layer and overlying tissue as a single composite unit in a plane deep to the muscle, repositioning the midface vertically. Because tension sits on the deep layer rather than the skin, the result avoids the pulled, wind-tunnel look of older skin-only techniques.
How it's used
Choose a surgeon who performs deep plane work routinely and can show you results at one and five years, not just six weeks. Usually combined with a neck lift. Stop nicotine entirely for at least a month either side — smoking dramatically raises the risk of skin necrosis.
Trade-offs
In favour
- The only genuine correction for significant facial laxity
- Long-lasting — typically 10–15 years
- Repositions rather than merely tightening, so it looks natural
- Simultaneously improves jawline and neck
Against
- Major surgery with a real recovery
- Expensive
- Does not improve skin quality, pigmentation or fine lines
- Ageing continues from the new baseline
Risks and side effects
- Facial nerve injury causing weakness — usually temporary, rarely permanent
- Haematoma requiring urgent drainage, the most common early complication
- Skin necrosis, sharply elevated in smokers
- Visible or hypertrophic scarring
- Hairline distortion and earlobe deformity
- Prolonged numbness
- Asymmetry
Recovery
Week 1: significant swelling and bruising, drains possibly in place, head elevated. Week 2: sutures out, bruising fading, still visibly swollen. Weeks 3–4: presentable in public, makeup usable. Weeks 6–12: swelling resolves and numbness improves. Months 6–12: scars mature and the final contour settles.
How good is the evidence?
Extensive surgical literature supporting durability and outcomes; deep plane technique has strong anatomical and clinical support.
Sources
Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.