Blog Kerolus Facial Plastic Surgery

Facelift terminology has gotten competitive. Deep plane is treated as the new standard, and SMAS gets filed under traditional.

But faces are more complex than these labels suggest.

Both deep plane and SMAS facelifts work on the deeper layers beneath the skin. They both move underlying tissues to help with jowls, sagging skin, and a less defined jawline. The main difference is in how the surgeon accesses and moves these tissues. These details affect which areas of the face change, how much improvement is possible, and what risks to consider.

If you are looking at facial rejuvenation options in Atlanta, it is important to choose a procedure that matches your unique features and gives your surgeon the right amount of access and control.

The central difference between a deep plane facelift and an SMAS facelift is the level and extent of surgical release. A SMAS facelift reshapes or repositions the superficial musculoaponeurotic system through several methods. The deep plane approach enters beneath the SMAS layer and releases facial retaining ligaments, so connected facial tissues can be repositioned together.

Factors like your neck structure, skin quality, deeper fat, bone shape, and any previous cosmetic surgery all play a role in planning. The surgeon will choose the facelift technique that best fits you.

First, What Is the SMAS?

The SMAS is the connective tissue layer beneath facial fat and skin. Some sources call it the superficial muscular aponeurotic system; the accepted term is superficial musculoaponeurotic system. Treating this layer can create deeper support than pulling the skin alone.

“SMAS facelift” describes a family of techniques rather than one fixed operation. A surgeon may fold the SMAS, remove a small section and close it under tension, elevate it as a flap, or work beneath it. The direction and extent of movement also vary.

Modern SMAS surgery can create significant improvements. That is why the surgeon’s specific approach matters more than just the name of the technique.

Where the Deep Plane Begins

The deep plane facelift technique works in a surgical plane beneath the SMAS in parts of the face. The surgeon releases retaining ligaments that tether the soft tissue to deeper structures, then moves the skin, fat, and SMAS together as a connected unit.

By releasing these ligaments, the surgeon can move the cheek and lower face more freely. This method is helpful when issues like sagging cheeks, jowls, and deep folds near the mouth happen together.

Dr. Julia Kerolus performs deep plane facelift surgery with a face-and-neck focus. Her facial plastic surgery training informs how she evaluates movement, tissue position, scars, and the relationship between the jawline and neck.

What Is an Extended Deep Plane Facelift?

“Extended deep plane facelift” describes a broader ligament release into the midface or lower face. Definitions vary: some surgeons use it for a release reaching the cheek and deep nasolabial folds, while others mean a specific pattern of deep dissection.

An extended deep plane facelift can help lift sagging cheeks even more. During this surgery, the surgeon must carefully work around deeper muscles, nerves, and connective tissue, which requires a strong understanding of facial anatomy.

Deep Plane vs SMAS Side by Side

The main difference between these techniques is where the surgeon works and how much of the face they can reach.

Technique names cannot predict results. Deep plane releases and SMAS operations vary in direction, depth, and reach. Consultation drawings and a clear explanation reveal far more than the label.

What the Research Says

Two 2025 systematic reviews found strong outcomes with both techniques. One review included 47 studies and 10,766 people, reporting low infection rates, similar nerve-injury rates, and improvement with both approaches. A single study compared aesthetic outcomes and favored the deep technique for midface improvement. Limited head-to-head data prevented a definitive verdict.

A separate review of 21 studies found high satisfaction with both operations. Pooled figures favored the deep plane for satisfaction, while the reported complication rate was higher. The studies were not randomized comparisons, so technique alone cannot explain either difference.

A 2026 review reported low pooled complication rates for deep plane facelifts but called for stronger research and long-term follow-up.

Both types of surgery can give good results. What matters most is the surgeon’s experience, your anatomy, the details of the operation, and how you care for yourself afterward.

Comparing Deep Plane and SMAS Facelift Results

Deep plane facelift results may include cheek elevation, softer nasolabial folds, jowl correction, and a youthful contour. SMAS facelift results can address the same concerns. Vertical lift, ligament release, tissue condition, and neck treatment influence the visible difference.

No matter which procedure you choose, facial aging will continue. Your skin and deeper tissues will still change over time due to aging, sun, weight changes, and genetics. How your scars heal and how you care for your face after surgery also affect your long-term results.

Why “Traditional Facelift” Gets Messy

People searching for deep plane facelift vs. traditional facelift results may picture a simple contest between deep support and stretched skin. That comparison belongs to an earlier era of facelift surgery.

A skin-only facelift pulls just the surface. Modern SMAS techniques work on the supportive layer under the skin. Deep plane surgery is part of this group of structural facelifts. Labeling all SMAS procedures as 'traditional' misses the important differences between them.

A good consultation focuses on the details, like which ligaments will be released, how the cheeks and neck will be treated, how tension is managed, and where incisions will be placed. These specifics show what the surgery will really involve.

Why Atlanta Is Asking About Structure

Atlanta is known for its beauty culture, but most people want practical results from facial surgery. They want to fix heaviness without looking pulled, have a defined jawline, cheeks in their natural position, and a neck that matches the lower face. The results should also look good in everyday life, whether talking, laughing, or out in the sun.

Structural facial surgery helps with these goals by adjusting the position of tissues. Skin quality and facial volume are still important, as are the brows, eyelids, chin, and neck. No facelift can fix everything, and working on the wrong layer can lead to less satisfying results.

People searching for information are often just curious, not necessarily set on deep plane surgery. In Atlanta, many want to know about anatomy, how long results last, and how surgery is planned before they decide on a facelift.

The Natural Appearance Question

Natural-looking results in someone’s 50s begin with the same principle that applies at 45 or 68: preserve the face while correcting structures that have moved. Age gives the surgeon context. Tissue quality, underlying bone structure, volume, prior procedures, and the degree of descent shape the plan.

A good facelift keeps your natural facial movement. Your mouth should move easily, your earlobe should not look pulled, and your sideburns and temple hair should be carefully planned. The cheek, jawline, and neck should all look balanced together.

Both techniques can help you look younger if they are right for you. The most natural results come from matching the surgery to your features, expressions, proportions, and age.

Who May Benefit From Each Approach?

A deep plane facelift may suit someone with sagging cheeks, jowls, deep folds, and advanced facial aging that involves several connected areas. The deep plane facelift lifts a composite unit after selected facial ligaments are released. That mobility can help when the cheek and lower face need coordinated repositioning.

A SMAS lift may suit mild to substantial lower-face laxity, depending on the specific SMAS facelift procedure. Plication can tighten the layer by folding it. A SMASectomy removes a strip before closure. Flap techniques elevate a section of the entire SMAS layer or selected portions. These are distinct operations with different reach.

Some younger people ask about deep plane lifts if they notice early jowls or want to act before their skin gets too loose. Age alone does not decide if you are a good candidate. If you only need a small change, a less extensive facelift or even nonsurgical options might be better, especially if your skin is still firm.

The initial examination should include facial structure, tissue thickness, scars, hairline, facial muscles, neck bands, fat distribution, and medical history. A person with significant sun damage may also need skin resurfacing because lifting deeper tissues will not correct pigment or rough skin texture.

Recovery Is Still Recovery

Some ads make deep plane surgery sound like recovery is easy, but it still involves cuts, anesthesia, working with tissues, swelling, bruising, and some time when you need to take it easy.

Early recovery can include tightness, numbness, and uneven swelling. Many people plan to be away from public-facing work for around two weeks, though residual swelling can remain. Exercise returns in stages after the surgeon confirms that healing is progressing. The face continues to soften over several months, and scars mature for a year or longer.

How long recovery takes depends on how much surgery you have, whether your neck is involved, your health, any past surgeries, if you use nicotine, and how your body heals. It is better to have a plan for what is normal than to expect a specific recovery date.

Choosing the Surgeon Before the Technique

People searching for the best facial plastic surgeon in Atlanta for a deep plane lift should question the phrase “deep plane specialist.” Ask how the surgeon chooses a technique. Review before-and-after photos of similar anatomy. Ask how the midface and neck will be treated, where incisions will sit, and how the plan may change during surgery.

People searching for a board-certified plastic surgeon should check the boards. Dr. Kerolus is certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery. She devotes her practice to aesthetic and reconstructive procedures of the face and neck and remains involved from consultation through postoperative care.

Her approach focuses on the face first, which means you might be a candidate for a mini facelift, a neck lift, another treatment, or even waiting before having any surgery.

Common Questions About Facelift Techniques

Does a Deep Plane Facelift Procedure Work Better Than an SMAS Facelift?

Studies show that both techniques can work well. Deep plane surgery might be better for certain midface issues, but there is not a lot of direct comparison. SMAS facelifts can also give good results. The best choice depends on your facial structure, which areas need treatment, any previous surgeries, and how skilled your surgeon is with the chosen method.

Does the Deep Plane Technique Cause Less Skin Tension?

The deep plane technique places the lifting force in deeper tissues after ligament release, allowing the skin to be redraped rather than used as the main source of support. Modern SMAS techniques also aim to avoid pulling skin tight with too much tension. Incision placement, closure, blood supply, and healing still influence scar quality.

Is a Deep Plane Procedure More Invasive?

This technique works deeper under the SMAS in certain areas, so it goes further than just tightening the layer. Calling it 'more invasive' does not really explain what recovery or risks will be like. Things like how much is done, if the neck is involved, past surgeries, anesthesia time, and your health all matter more.

Can Either Facelift Correct Deep Wrinkles?

Both procedures can soften deep folds linked to tissue descent, including some nasolabial folds. Neither erases every wrinkle. Fine lines, etched creases, pigment, and surface damage may respond better to laser resurfacing, chemical peels, injectables, or a separate skin treatment.

How Long Do Deep Plane Facelift Results Last?

A deep plane facelift can give long-lasting results, but it will not stop aging. Many people see good changes for ten years or more. How long results last depends on the type of surgery, your facial tissues, skin quality, weight changes, nicotine use, sun exposure, and genetics.

The Better Facelift Conversation

Both deep plane and SMAS facelifts aim to lift sagging tissues and improve facial shape without relying only on the skin. While there are real differences, online discussions often turn these into a ranking, but the research does not clearly support one as better than the other.

A more helpful discussion focuses on the details: which layer is treated, what areas need improvement, what the surgery can and cannot do, and why the surgeon recommends a certain plan. The technique is important, but the surgeon’s judgment is key.

If you are thinking about a facelift in Atlanta, meeting with Dr. Kerolus lets you compare options based on your own features, not just marketing claims. This makes the process more personal, practical, and easier to understand.