# DEEPPLANE™ — /research

> Machine-readable markdown summary. Full article: https://deepplane.com/research
> Last built: 2026-10-26 · Editorial standard: DEEPPLANE™ Review Council.
> License: CC BY 4.0 — Source: DEEPPLANE™

## Frequently asked questions

### How many peer-reviewed studies support deep plane facelift?

DEEPPLANE™ cites over 65 peer-reviewed journal articles and clinical studies covering anatomy, technique, safety, outcomes, and comparisons. All include PubMed or DOI links for independent verification. The evidence base spans randomised controlled trials, systematic reviews, large-cohort safety studies, and anatomical cadaveric research.

*Topics: evidence, research, citations, peer-reviewed*

### What is the strongest clinical evidence for deep plane facelift?

The strongest evidence comes from Jacono & Rousso (2012), a randomised controlled trial comparing deep plane versus SMAS plication on opposite sides of the same patient — a gold-standard design eliminating confounders. Deep plane showed significantly greater soft-tissue mobilisation and longevity. A 2020 systematic review in Facial Plastic Surgery confirmed superiority across multiple studies.

*Topics: evidence, rct, jacono, longevity*

### What is the complication rate for deep plane facelift according to the literature?

In a prospective database of 11,300 facelifts, 1.8% had a major complication, most often hematoma (1.1%) and infection (0.3%) (Gupta 2016, PMID 26578747). A 183-study meta-analysis found major hematoma in 1.22% of deep plane facelifts, higher than with SMAS plication, and no difference among techniques in permanent facial nerve injury (Jacono 2019, PMID 30768122). Facial nerve injury was reported in 0.5-5% across studies, with about 70% fully recovered within six months (Arianpour 2025, PMID 41273502). Counting every recorded adverse event (severity not graded), a 2025 pooled review recorded 17.2% for deep plane vs 10.3% for SMAS (Khoury 2025, PMID 40801931).

*Topics: complications, safety, evidence, nerve*

### Who first described the deep plane facelift in the medical literature?

Sam T. Hamra, MD, introduced the deep plane rhytidectomy in his landmark 1990 paper in Plastic and Reconstructive Surgery (86(1):53-61). The technique dissected below the SMAS and orbicularis oculi to release retaining ligaments and reposition facial soft tissues as a composite unit, enabling more natural and durable results than surface-plane methods.

*Topics: history, hamra, technique, anatomy*

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