Deep Plane Facelift vs SMAS in Turkey

A SMAS facelift tightens the supporting layer beneath the skin, called the SMAS, and then redrapes the skin. A deep plane facelift works beneath that layer and releases the ligaments that hold the tissues down, so the skin and the deeper tissue lift together as one unit. Both are established techniques and both can look natural. Which one suits you depends on where your face has aged and on the surgeon's experience with the technique, more than on the name.

If you are researching a deep plane facelift in Turkey, you have probably noticed deepening folds around the mouth, heaviness in the lower face, jowls that blur the jawline or a neck that no longer looks defined. This article compares the two approaches without hype: what each one lifts, how natural it tends to look, recovery, risks and how long results last. It also explains what clinics mean by "spacelifting". For the wider picture of techniques, recovery and planning, see our overview of facelift surgery. Plastic Surgery Turkey Group (PSTG) coordinates the practical side of treatment, and the treating surgeon at a contracted healthcare institution in Istanbul or Antalya chooses the technique after examining you.

Deep plane vs SMAS at a glance#

The table shows how the two are usually described. Surgeons adapt both techniques, so treat it as a starting point for your consultation rather than a fixed rule.

A short history: from skin-only lifts to deeper layers#

Early facelifts were mostly skin-only. Surgeons tightened and trimmed the skin, but it became clear that relying on skin tension alone could look unnatural and did not hold as well. The SMAS facelift became a major step in the 1970s: instead of pulling only the skin, surgeons began lifting and supporting the deeper layer beneath it.

The deep plane facelift followed as surgeons refined their understanding of facial anatomy and ageing. It reflects the idea that ageing is not only loose skin but also the descent of deeper tissues and changes in volume. Deep plane techniques aim to reposition those deeper structures more directly. Today both approaches are in wide use, and many surgeons adapt elements of each to the face in front of them.

Retaining ligaments, simply explained#

To understand the difference between SMAS and deep plane, it helps to know one concept: retaining ligaments.

The face is made of layers of soft tissue (skin, fat, fascia and muscle) held in place by internal anchors. These anchors, the retaining ligaments, keep the tissues where they belong. With time the tissues become heavier, collagen changes and gravity works on them. The result is a slow shift downward:

• the cheeks can descend, making the mid-face look flatter or heavier;
• the jawline loses its clean edge;
• jowls form as tissue gathers at the sides of the mouth;
• the neck can show laxity or bands.

Facelift techniques differ in how they deal with these ligaments and how much they free and reposition the deeper tissues. A simple analogy makes the difference easier to picture.

SMAS facelift: tightening the bedsheet#

Imagine your face is a bed. The skin is the bedsheet and the SMAS is a structured layer beneath it. In many SMAS approaches the surgeon lifts the skin, tightens or folds the SMAS, and then redrapes the skin. This was a big improvement over skin-only lifts, because it moves much of the work from the skin to the deeper supporting layer.

Performed well, a SMAS facelift can:

• improve jowls and jawline definition;
• refresh the lower face;
• give a natural-looking lift without excessive skin tension;
• give a result that lasts for some years while the face keeps ageing.

The result can depend more on skin redraping than with deep plane techniques. That does not mean a SMAS lift looks pulled; a skilled surgeon can create very natural results with it. It does mean the outcome is more sensitive to how tightly the skin is closed and in which direction it is pulled.

SMAS lifts often suit people with moderate laxity of the lower face and neck who want a reliable, well-established approach, and people whose cheeks have not descended much.

Deep plane facelift: moving the whole mattress#

Now imagine the surgeon does not just pull the bedsheet but repositions the whole mattress. That is the idea behind the deep plane facelift. Rather than relying on skin tension, the surgeon works beneath the SMAS, releases the key ligaments and moves the deeper tissues as one unit, so the skin can sit naturally over the new shape.

The deep plane approach is often associated with:

• a stronger effect on the cheeks and mid-face;
• softening of deep folds without obvious signs of tight skin;
• a smoother transition from the lower eyelid to the cheek and down to the jawline;
• less of a pulled-back look when done well.

It is often considered for people with heavier tissues, deeper folds or noticeable descent of the cheeks, and for those whose main fear is looking operated on. It is not automatically the right choice. It is a more demanding operation, and the surgeon's training and regular experience with it matter a great deal.

The wind-tunnel look and how natural each looks#

A common fear before a facelift is the operated look: cheeks that seem swept back, corners of the mouth that look tight, and skin that appears stretched rather than refreshed. This is often called the wind-tunnel effect.

One reason patients ask about deep plane techniques is that the lift comes from repositioning deeper tissue rather than from pulling the skin tight. When deeper tissues sit in a more youthful position, the skin can be closed with less tension, which helps the face look natural when you talk and smile.

Technique is only part of it. The wind-tunnel look usually comes from too much skin tension or a pull in the wrong direction, and that can happen with any technique. A natural result depends on the surgeon's judgement, proportion and a plan that matches your anatomy.

How long the results last#

You may see figures online claiming that one technique lasts several years longer than the other. The evidence comparing them is limited. With either technique the face continues to age afterwards, and your surgeon will advise how long to expect the result to last for your face.

How long your own result lasts depends heavily on:

• skin quality and genetics;
• sun exposure and skin care;
• smoking history;
• weight changes after surgery;
• your overall health and how you heal.

No facelift stops time, and some people choose further treatment years later. Ask the surgeon what they expect for your face rather than relying on a general figure.

Recovery and risks compared#

The overall recovery timeline is broadly similar for both techniques, although the swelling can feel different. Swelling and bruising usually peak in the first two or three days, stitches are removed in stages within one to two weeks, and many people prefer to avoid social situations for about two weeks. Swelling along the jaw and under the chin settles over several months, and the result can be judged fairly at around six months to a year. Because a deep plane lift involves deeper work, ask the surgeon how the swelling is likely to feel and settle in your case.

The main risks are the same for both:

• haematoma, a collection of blood under the skin, which may need a return to theatre;
• facial nerve injury causing weakness of part of the face, usually temporary;
• numbness around the cheeks and ears, which generally improves over months;
• skin healing problems, particularly in smokers;
• visible or widened scars, hairline changes and asymmetry;
• infection, blood clots and the general risks of anaesthesia.

In a deep plane lift the dissection runs closer to branches of the facial nerve, which is one reason the surgeon's experience with the technique matters. Either operation is usually not advised if you smoke and cannot stop, have uncontrolled high blood pressure or a bleeding disorder, take blood thinners that cannot safely be paused, or have a condition that makes a longer general anaesthetic unsafe.

What is spacelifting?#

"Spacelifting", sometimes written "space lift", is a name some surgeons and clinics use for a facelift that works within the soft-tissue spaces of the face. These spaces are natural gaps between the retaining ligaments, beneath the SMAS. Opening them lets the surgeon release and reposition the deeper tissues of the cheek and jawline with less tension on the skin.

This is the same anatomical idea that underlies deep plane techniques. Spacelifting is therefore more accurately understood as a description of a deep-layer approach, not as a separate, standardised operation with its own body of evidence. What it treats is similar to a deep plane lift: jowls, a softened jawline, descent of the mid-face and loss of definition.

Some descriptions present spacelifting as minimally invasive, nearly scarless or longer-lasting than other facelifts. Treat those claims with caution. A lift of the deeper layers still needs incisions around the ear and into the hairline, a recovery comparable to other facelifts, and carries the same risks. If a plan uses this name, ask:

• which layer will be lifted, and which ligaments will be released;
• where the incisions will run and what the scars will look like;
• whether the neck is included, and whether fat grafting is planned;
• how often the surgeon performs this exact technique.

Where Vertical Restore fits#

Vertical Restore is another name you will meet. It describes a deep-layer lift carried out in a more vertical direction, often combined with fat grafting to replace lost volume in the cheeks or temples. Our comparison of Vertical Restore and the traditional facelift sets out how it differs from a classic lift, and the complete Vertical Restore guide covers candidacy and questions to ask.

Deep plane or SMAS in Turkey: what to compare#

Many patients weighing a facelift abroad are balancing three things: a natural result, how long it lasts, and a plan that does not cut corners on safety. The technique name answers none of these on its own. What matters is who will operate, how often they perform the technique you are offered, which institution is used and how the aftercare is organised. Our article comparing a facelift in Turkey with the UK and US looks at aftercare and follow-up in more detail.

Ask the provider to state in writing which technique is planned, whether the neck, eyelids or fat grafting are included, who the surgeon and institution are, and how follow-up works after you fly home. A deep plane lift with neck work usually means more operating time than a limited SMAS lift, and that is reflected in the plan, so only compare quotes that describe the same scope. Our article on facelift packages, quotes and reviews explains how a quote is built and how to read reviews critically.

How to decide: questions that matter most#

Rather than choosing by label, a good consultation should help you answer these questions.

• Where has your face aged most? A deep plane lift is often considered when the cheeks and mid-face have clearly descended. A SMAS lift may suit a pattern centred on the lower face and jawline.
• Do you need tissue repositioned, volume replaced, or both? Some faces mainly need lifting, others also need fat grafting, and some do well with a SMAS lift plus careful contouring.
• What matters most to you? Weigh the extent of the operation, recovery time and your expectations, and say plainly what look you do not want.
• What does your surgeon do most often? A surgeon who performs a technique regularly is usually better able to get a natural result with it. Ask to see photos of faces similar to yours, taken at least several months after surgery.

The surgeon may also suggest something smaller, such as a mini facelift or a neck lift alone, or advise against surgery for now. That is part of a good assessment, not a refusal. You can look at examples in our facelift before and after gallery, remembering that each photo shows one patient.

If you would like a surgeon's view on which approach fits your face, you are welcome to send your photos for a free, no-obligation assessment through our contact page. This article is general information, and the technique is always decided at your examination.