SMAS vs. Deep Plane Facelift: Which Technique Gets Better Results?
⚠️ Watch for these warning signs after facelift surgery
Contact your surgeon immediately if you notice sudden or rapidly increasing swelling on one side of the face, severe pain, skin that looks blue or very pale, or any wound that opens or shows signs of infection (redness, warmth, pus, fever). These could signal a hematoma (blood collection) or other complication that needs prompt attention.
Short answer
Both SMAS and deep plane facelifts deliver high patient satisfaction and long-lasting results. The deep plane may have a slight satisfaction edge overall, but it also carries a somewhat higher complication rate. For most patients under 70, SMAS techniques appear to perform at least as well as the deep plane approach.
What the research shows
A 2025 systematic review and meta-analysis that pooled data from 21 studies and nearly 2,900 patients found that both techniques produce strong outcomes. Deep plane facelifts achieved a patient satisfaction rate of about 94%, while SMAS facelifts came in at about 88%. [1] That difference sounds meaningful, but both numbers reflect genuinely high satisfaction in real patients.
However, complications were also more common with the deep plane approach: roughly 17% of deep plane patients experienced some form of adverse event, compared to about 10% for SMAS patients. [1] This is an important trade-off to understand before choosing a technique.
Does age or facial area matter?
A smaller randomized controlled trial compared the two techniques specifically for improving the cheeks, jowls, and nasolabial folds (the lines from your nose to the corners of your mouth). In patients aged 50 to 69, SMAS facelifts actually scored higher than deep plane facelifts when evaluated by experienced surgeons looking at before-and-after photos. Only in the oldest group studied (ages 70 to 80) did the deep plane technique show a slight advantage. [2] This suggests that the deep plane is not automatically the superior choice for every patient.
What this means for you
Neither technique is universally "better." The right choice depends on your age, the specific areas you want to address, your surgeon's expertise, and your personal tolerance for a potentially higher complication risk in exchange for a possible satisfaction benefit. [1][2] A skilled surgeon who is highly experienced in one technique will often achieve better results with that technique than with the other, regardless of which one studies favor on average.
What to ask your surgeon
Consider asking: Which technique do you perform most often and why? How do you tailor your approach to my specific facial anatomy and goals? What is your personal complication rate with each method? What kind of recovery should I expect with each option? These conversations will help you make a decision that is right for your situation, not just based on averages from research studies.