The deep plane facelift represents a fundamental evolution in facelift technique. Rather than simply tightening skin — the approach of earlier facelifts that produced the telltale “pulled” look — the deep plane releases and repositions the structural layer beneath the muscle, restoring facial anatomy to where it was years before. The extended deep plane takes this further, addressing the midface and nasolabial folds in a way that no other facelift technique can.
What the Deep Plane Actually Does
The face ages in layers. The SMAS (superficial musculoaponeurotic system) is the fibromuscular layer beneath the skin that descends with gravity over time, creating jowls, neck banding, and midface descent. A standard SMAS facelift plicates or imbricated this layer without fully releasing the retaining ligaments that tether the descended tissues. The deep plane releases these ligaments, allowing the SMAS-skin composite to be repositioned as a single unit — restoring volume to the midface, eliminating jowls, and rejuvenating the neck simultaneously.
The Extended Addition
The extended deep plane additionally releases the zygomatic cutaneous ligaments, allowing mobilization of the malar fat pad — the volume of the cheek that descends to create nasolabial folds and a hollowed midface. Repositioning the malar fat pad restores youthful cheek contour without the unnatural roundness that can result from injectable fillers placed in a descended malar complex.
Why the Results Look More Natural
Because the deep plane repositions tissue rather than stretching skin, tension on the skin closure is minimal. This means the incisions heal with less distortion, hairlines are preserved, and the result moves naturally with facial expression. The “done” look of older facelift techniques is fundamentally a product of skin tension. Eliminating skin tension eliminates that appearance.
Candidacy and Longevity
The extended deep plane is appropriate for patients with moderate to significant facial aging, particularly those with jowling, nasolabial folds, neck laxity, and midface descent. Results are consistently longer-lasting than SMAS or skin-only techniques because the deep ligamentous release addresses the root cause of descent rather than compensating for it superficially. Most patients enjoy their results for 10–15 years.