Dr. Shervin Naderi explains the key difference between deep-plane and SMAS facelifts. Both use the same incision, but SMAS lifts create a larger skin flap while deep-plane lifts dissect minimally and release facial ligaments more extensively, allowing greater lift of the neck, midface, and cheeks.
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Deep plane facelift versus SMAS lift. There's a lot of information out there, a lot of it is wrong, there's a lot of misconceptions. Let's clarify it quickly within 2 minutes. Let's set it straight. All right, what is it? Deep plane, is it deeper? No, it's farther. What does that mean? During the SMAS lift, the same incision is made. The incision is the same, the scar is the same down here, here, no difference. What's the difference? In a SMAS lift, the skin is dissected much more. The skin is lifted, that is layers 1 and 2, skin and the subcutaneous fat. Those 2 layers are lifted way more, further out, larger skin flap. In the deep plane, much less. Those 2 layers, layers 1 and 2, skin and subcutaneous fat, the little layer of fat under it, are dissected Much less. That's the number one difference. Number two, you identify SMAS. SMAS S M A S. That is layer three. You identify it in both procedures. In a SMAS lift, you do a little bit of dissection freeing up the SMAS and you lift it up. It's great for the jowls. In a deep plane, you do a much more thorough, much more forward dissection of that layer. Same exact layer. It's the SMAS, but you just keep going and going and going until you get closer to the mouth. Why? Because there are ligaments that must be released. By doing so, you get much more lift. Improves the neck more, improves the midface and cheek more, has much more lift. That's the difference. Deep plane versus SMAS. They're both lifting skin. Deep plane lifts the skin by itself a little bit. Smoss by itself lifts the skin a lot more. Smoss lift— the smoss gets lifted a little bit during a deep plane. That same exact smoss gets penetrated, dissected, freed up much more forward anteriorly. There are areas of the face where the smoss kind of peters out. There's just no real smoss down here. The smoss basically becomes apothysma. Doesn't matter, it's still layer 3. So you are going to layer 4, which is underneath that smoss, That's the dissection plane in both procedures, whether it's SMAS lift or deep plane facelift, doesn't make a difference. You're in layer 4, but you keep going and going and going during a deep plane. You get a much more complete release, and then you can suspend things much nicer. That's it. So when somebody goes SMAS lift versus deep plane, now you know what it is.
