Deep Plane Facelift Anatomy: Deep plane facelift anatomy involves the SMAS (Superficial Musculoaponeurotic System), facial retaining ligaments, and deep facial fat compartments. Understanding these structures is essential for achieving natural-looking results through proper tissue repositioning.
— DEEPPLANE™ Editorial Board
Deep Plane Facelift Anatomy: Quick Facts
- SMAS Layer
- Key structure targeted
- Facial Nerves
- Carefully preserved
- Retaining Ligaments
- Released for mobility
- Dissection Depth
- Below SMAS layer
- Blood Supply
- Preserved for healing
- Technique
- Anatomically precise
Burimi: Medical Literature & Expert Consensus
Deep Plane Facelift Anatomy
Përgjigje e Shpejtë
What does deep plane facelift anatomy look like?
The face has six layers from surface to bone: skin, subcutaneous fat, SMAS (superficial musculoaponeurotic system, a fibromuscular sheet wrapping the facial muscles), a loose areolar 'deep plane' below the SMAS, facial muscles, and facial skeleton. Deep plane facelift operates in the fourth layer — a normally bloodless plane that lets the surgeon release the zygomatic, masseteric, and mandibular retaining ligaments and lift skin, fat, and SMAS as one composite unit without tension. Working below the SMAS preserves the sub-dermal blood supply the skin needs to heal, which is why skin-necrosis rates are lower than with skin-only or SMAS facelifts.
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What anatomy is involved in a deep plane facelift?
A deep plane facelift operates at the level of the SMAS (superficial musculoaponeurotic system) — the fibromuscular layer beneath the skin. Key anatomical structures: (1) SMAS — the layer that is dissected beneath and repositioned. (2) Retaining ligaments — zygomatic, masseteric, and mandibular ligaments are released to free the SMAS-fat composite. (3) Malar fat pad — repositioned superiorly for cheek restoration. (4) Platysma — addressed via neck component for neck contour. (5) Facial nerve branches — identified and preserved throughout the dissection. The deep plane's advantage over SMAS techniques is ligament release, which allows composite repositioning rather than just plication.
Cross-section of facial layers targeted in deep plane facelift surgery
A deep plane facelift works by dissecting below the SMAS (Superficial Musculoaponeurotic System) layer, releasing four key retaining ligaments to reposition facial tissues. This technique, which preserves the skin's blood supply, allows for more significant and natural-looking rejuvenation of the midface and jawline compared to traditional facelifts.
- The dissection plane is located *below* the SMAS layer, not above it.
- Four key retaining ligaments (zygomatic, masseteric, mandibular, cervical) are released.
- The facial nerve (cranial nerve VII) is carefully preserved throughout the dissection.
Deep plane facelift anatomy involves dissecting beneath the SMAS layer into the sub-SMAS space, where the surgeon releases the zygomatic, masseteric, and cervical retaining ligaments[1,3]. This deeper dissection plane allows the entire SMAS-fat pad complex to be repositioned as a single unit, producing more natural and longer-lasting results than techniques that work above this layer[5].
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A detailed visual guide to the facial layers and anatomical structures involved in deep plane facelift surgery.
Understanding Facial Anatomy
To understand why deep plane facelift produces superior results, it's essential to understand the layered anatomy of the face1. The face consists of multiple distinct layers, each playing a crucial role in facial aging and rejuvenation.
The key to deep plane facelift's effectiveness lies in working beneath the SMAS layer2, releasing the retaining ligaments, and repositioning the entire facial structure as a unified unit—rather than simply pulling on the skin.
The Five Layers of the Face
Skin (Epidermis & Dermis)
The outermost layer, consisting of the epidermis and dermis. Traditional facelifts often work primarily at this level, which is why results can appear "pulled" or unnatural.
Subcutaneous Fat
A layer of fat beneath the skin that provides facial volume and contour. This layer thins with age, contributing to a gaunt appearance.
SMAS (Superficial Musculoaponeurotic System)
The key layer in facelift surgery. The SMAS is a fibromuscular layer that connects the facial muscles to the skin. Deep plane facelift works beneath this layer, while SMAS facelifts work above it.
Deep Fat Compartments
Distinct pockets of fat beneath the SMAS that provide structural support. These compartments deflate and descend with age, causing midface volume loss.
Deep Fascia & Periosteum
The deepest layer, covering the facial bones and muscles. The retaining ligaments anchor the overlying tissues to this layer.
Retaining Ligaments
Retaining ligaments are fibrous structures that anchor the facial soft tissues to the underlying bone4. In deep plane facelift, these ligaments are released to allow the face to be repositioned without tension on the skin.
Zygomatic Ligaments
Located over the cheekbone, these ligaments hold the midface in position. Releasing them allows the cheek fat to be lifted and repositioned.
Masseteric Ligaments
Anchor the lower face to the masseter muscle. Releasing these ligaments is essential for addressing jowls and the lower face.
Mandibular Ligaments
Located along the jawline, these ligaments contribute to jowl formation when they weaken with age.
Platysma-Auricular Ligaments
Connect the neck muscle (platysma) to the ear area. Important for neck rejuvenation in extended deep plane procedures.
Deep Plane vs. SMAS: Anatomical Difference
SMAS Facelift
- • Works above the SMAS layer
- • Skin is separated from SMAS
- • SMAS is tightened (plication or SMASectomy)
- • Retaining ligaments remain intact
- • Limited midface improvement
- • Results last 5-7 years
Deep Plane Facelift
- • Works beneath the SMAS layer
- • Skin stays attached to SMAS
- • SMAS is released and repositioned
- • Retaining ligaments are released
- • Comprehensive midface rejuvenation
- • Results last 10-15 years
Deep plane vs SMAS facelift — anatomical comparison
| Dimensioni anatomik | Facelift deep plane | Facelift SMAS |
|---|---|---|
| Dissection plane | Sub-SMAS plane (fourth facial layer, beneath the SMAS) | At the SMAS surface — plication or imbrication of the layer itself [burimi] |
| Retaining ligaments | Released, so the whole soft-tissue block repositions | Largely left intact; lift is achieved by tightening the SMAS [burimi] |
| Skin blood supply | Preserved — skin and SMAS travel as one composite flap | A separate thin skin flap is raised, with its own perfusion limits [burimi] |
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Key Studies Behind Deep Plane Facelift Anatomy (1989–2019)
Peer-reviewed studies already cited on this page — full citations appear in the references list below.
| Study | First author | Year | Journal | What it found |
|---|---|---|---|---|
| The retaining ligaments of the cheek | Furnas DW | 1989 | Plast Reconstr Surg | Identified the retaining ligaments of the cheek — the fibrous structures that anchor facial soft tissue to the underlying bone. |
| Surgical anatomy of the midcheek and malar mounds | Mendelson BC | 2002 | Plast Reconstr Surg | Mapped the surgical anatomy of the midcheek and malar mounds — the layered midface anatomy described on this page. |
| Restoring facial shape in face lifting: the role of skeletal support in facial analysis and midface soft-tissue repositioning | Stuzin JM | 2007 | Plast Reconstr Surg | Analyzed the role of skeletal support in facial analysis and midface soft-tissue repositioning during face lifting. |
| High SMAS facelift: combined single flap lifting of the jawline, cheek, and midface | Marten TJ | 2008 | Clin Plast Surg | Described the high SMAS facelift, lifting the jawline, cheek and midface with a combined single flap. |
| A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization | Jacono AA | 2019 | Aesthet Surg J | Described a novel extended deep plane facelift technique for jawline rejuvenation and volumization. |
Citoni këtë faqeCC-BY 4.0
DEEPPLANE™ Ekipi Editorial (2026). Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes. DEEPPLANE™. Marrë nga https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram
Përmbajtja e licencuar CC-BY 4.0. E lirë për t'u shpërndarë me atribuim te DEEPPLANE™.
FAQ
What is the SMAS layer?
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Which facial nerves are at risk during deep plane facelift?
Medical References
- 01Mendelson BC, et al. Surgical anatomy of the midcheek and malar mounds. Plast Reconstr Surg. 2002;110(3):885-896(hapet në një skedë të re)(Artikull Reviste)Aksessuar: 2026-08-05DOI: 10.1097/00006534-200209010-00026
- 02
- 03Furnas DW. The retaining ligaments of the cheek. Plast Reconstr Surg. 1989;83(1):11-16(hapet në një skedë të re)(Artikull Reviste)Aksessuar: 2026-03-21DOI: 10.1097/00006534-198901000-00003
- 04
- 05
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Find a SurgeonCommon Misconceptions
Myth: The SMAS is a single uniform layer
Fact: The SMAS varies in thickness across the face and has different characteristics in different regions. Surgeons must understand these variations for optimal results.
Myth: Facial ligaments should be preserved during facelift
Fact: Deep plane technique specifically releases retaining ligaments to allow natural tissue repositioning. This is key to achieving long-lasting, natural results.
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