Deep Plane vs SMAS Facelift

At a glance

What the two techniques actually do

A SMAS facelift tightens the sheet of muscle and connective tissue under the skin, then redrapes the skin over it. The lift is real, but it happens mostly at the surface. A deep plane facelift goes one level deeper. It releases the attachments below the SMAS and moves the muscle, fat and skin together as a single flap.

That one difference changes how the face ages afterward. When the layers are lifted as one, the pull is vertical and the face settles into a natural position. When the skin and muscle are moved separately, there is more tension on the skin, which is where a tight or pulled look comes from.

How long each one lasts

A well-performed deep plane lift typically lasts 10 to 15 years. A SMAS lift lasts about 7 to 10. The difference comes down to where the lift happens. The deep plane corrects the descent of the muscle and fat, which is the actual cause of jowls and a heavy lower face. A SMAS lift holds those structures but does not release and re-drape them the same way.

No facelift stops aging. Both results fade gradually, and good skin care, sun protection and a stable weight stretch out whatever lift you choose.

The face shape question

Face shape changes the math. A 2025 review of 78 deep plane procedures found that round and square faces can drop again sooner after a standard deep plane lift, because those faces pull obliquely rather than vertically. For them, Dr. Franco often adjusts the vector of the lift or recommends a high SMAS approach. Oval and gaunt faces tend to get the most out of a deep plane, because the technique puts volume back where the face has lost it.

Which one is right for you

Choose a SMAS lift if your sagging is mild, mostly in the jowls and lower face, and you want a shorter recovery. Choose a deep plane lift if you have significant sagging, heavy jowls, a hollowed midface or deep folds around the mouth, and you want the longest-lasting, most natural result.

What the data says

A 2025 meta-analysis of nearly 2,900 patients found a 94.4 percent satisfaction rate for deep plane lifts, versus 87.8 percent for SMAS lifts. The deep plane carried a slightly higher complication rate, mostly temporary swelling and nerve weakness that resolved. The two techniques have comparable safety when performed by an experienced surgeon, and Dr. Franco's blood pressure and tranexamic acid protocol applies to both.

Recovery

Both procedures bring a week of swelling and bruising. Deep plane patients sometimes bruise less because the skin is not separated as aggressively from the tissue beneath it. Stitches come out around day seven, most people can travel after two weeks, and the final result shows over three to six months.

Cost

In Medellín, a deep plane facelift runs from about $8,000 to $12,000. A SMAS lift costs somewhat less because it is a shorter, less involved operation. Both are a fraction of what the same procedures cost in the United States. Your written quote depends on your face and whether you add a neck lift or eyelid surgery.

Related pages

• Deep plane facelift in detail
• Facelift in Medellín: the full overview
• Mini facelift: a smaller option
• Facelift recovery timeline

Next steps

Send three photos from the front and one from each side. Dr. Franco will tell you which technique fits your face shape and what each one would cost.