SMAS Plication vs Deep Plane
The single most useful distinction in facelift surgery — how the two main families differ, and which might suit you.
Two families of facelift
Almost every facelift technique belongs to one of two families, defined by how the SMAS layer is handled:
- SMAS plication / SMASectomy — the skin and SMAS are separated; the SMAS is folded, stitched or partly removed to tighten it; the skin is redraped over the top.
- Deep plane — the skin and SMAS are kept together as one composite flap; the retaining ligaments beneath are released so the whole unit can be repositioned.
The practical differences
| SMAS plication | Deep plane | |
|---|---|---|
| Skin & SMAS | Handled separately | Moved together |
| Ligament release | Minimal | Yes |
| Midface & folds | Modest improvement | Strong improvement |
| Tension on skin | Some | Very little |
| Technical demand | High | Higher |
| Typical longevity | Long | Tends to be longest |
Which is better?
Neither is universally ‘better’ — the right choice depends on your face and on the surgeon’s expertise. A superbly executed SMAS plication will beat a poorly executed deep plane every time. The deep plane offers more midface correction and tends to last longer, but it is more demanding and not every surgeon is trained in it.
★ Key point
Focus less on winning the technique argument and more on finding a surgeon who is genuinely expert in whichever technique they recommend, and who can explain why it suits your face.