Which facelift technique gives the best results?
⚠️ Contact your surgeon promptly if you notice warning signs after facelift surgery
After any facelift procedure, contact your surgeon right away if you experience sudden swelling or bruising on one side, weakness or asymmetry of your face, numbness that is worsening, signs of infection such as increasing redness or warmth, or any symptoms that concern you. Some complications require urgent attention.
Short answer
There is no single "best" facelift technique. Research shows that both the SMAS facelift and the deep plane facelift produce high patient satisfaction and long-lasting results. The right choice depends on your individual anatomy, goals, and surgeon expertise.
What the research shows
A 2025 systematic review and meta-analysis directly compared SMAS and deep plane facelifts using data from 21 studies and nearly 2,900 patients. Both techniques performed well: the deep plane had a patient satisfaction rate of about 94%, while the SMAS technique had about 88% satisfaction. [1] Importantly, both provided strong, long-lasting outcomes beyond one year. [1]
The tradeoff is that the deep plane technique, which involves releasing deeper tissue anchors in the face and neck, appears to offer slightly higher satisfaction but also carried a somewhat higher complication rate (about 17%) compared to the SMAS approach (about 10%). [1]
Understanding the techniques
The SMAS (Superficial Musculoaponeurotic System) facelift tightens a layer of tissue just beneath the skin. The deep plane facelift goes deeper, releasing key anchoring ligaments in the face and neck to reposition the underlying tissues more completely, particularly improving the midface, jawline, and neck. [8] Extended versions of the deep plane technique can address even more areas by releasing additional retaining ligaments. [8] Both approaches require thorough knowledge of facial nerve anatomy to be performed safely. [7]
What this means for you
Because both techniques show high satisfaction, the "best" facelift is the one that is well-matched to your specific facial aging concerns and performed by a surgeon experienced in that approach. A deeper technique is not automatically better for everyone. During your consultation, ask your surgeon which technique they recommend for your anatomy and why, what their personal complication rates are, and what long-term results you can realistically expect. [1]
Caveats
The evidence comes from a mix of study types (controlled trials and cohort studies), and patient satisfaction was measured in different ways across studies, which can make direct comparisons imperfect. [1] Individual surgeon skill and experience with a given technique likely plays a large role in outcomes, and this is difficult to capture in research data alone.