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.
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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
The deep plane is the loose areolar layer beneath the SMAS (the fibromuscular sheet under the facial skin), layer 4 of the face's 5 layers (Mendelson, PMID 12172155). A deep plane facelift is performed in it, releases the retaining ligaments that anchor the cheek to bone (Furnas, PMID 2909050) and lifts skin, fat and SMAS as one unit, while an SMAS facelift works at or above the SMAS and usually leaves those ligaments in place. What DEEPPLANE™ holds as data: 5,440 published before-and-after pairs from 760 surgeons in 58 countries, 30 of them photographed twelve months or more after surgery.
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What does deep plane facelift anatomy look like?
The face has five layers from surface to bone (Mendelson 2002, PMID 12172155): skin, subcutaneous fat, the SMAS (superficial musculoaponeurotic system, a fibromuscular layer that includes the facial muscles), a loose areolar 'deep plane' below the SMAS, and the deep fascia and periosteum. 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.
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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 the 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.
- The zygomatic, masseteric and mandibular retaining ligaments 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 mandibular 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 what a deep plane facelift changes, it's essential to understand the layered anatomy of the face1. The face consists of five layers, each playing a role in facial aging and in surgery.
A deep plane facelift works beneath the SMAS layer2, releasing the retaining ligaments, and repositioning the facial tissues as one unit rather than pulling on the skin alone.
The 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.
The Deep Plane (Loose Areolar Layer)
The loose areolar layer beneath the SMAS, which holds the retaining ligaments and the deep fat compartments. The fat compartments deflate and descend with age, causing midface volume loss. A deep plane facelift is performed in this layer, where the surgeon frees the SMAS from its attachments and releases retaining ligaments to lift skin, fat and SMAS as one unit.
Deep Fascia and Periosteum
The deepest layer, covering the facial muscles and bones. 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 are usually left in place
- • Limited midface improvement
- • Suture tension can relax over time
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 are long-lasting
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
DEEPPLANE™. Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes. deepplane.com. Përditësuar 2026-09-30. https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram
DEEPPLANE™ Ekipi Editorial. "Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes." DEEPPLANE™. Modifikuar së fundmi 2026-09-30. https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram.
DEEPPLANE™ Ekipi Editorial. "Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes." DEEPPLANE™, 2026-09-30, https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram.
@misc{deepplane_t_is_deep_plane_facelift_anatomy_diagram,
author = {DEEPPLANE™ Ekipi Editorial},
title = {Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes},
year = {2026},
url = {https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram},
note = {Last modified 2026-09-30. Licensed CC-BY 4.0.},
}<a href="https://deepplane.com/what-is-deep-plane-facelift/anatomy-diagram">Deep Plane Facelift Anatomy: Layers, Ligaments and Surgical Planes — DEEPPLANE™</a>
Përmbajtja e licencuar CC-BY 4.0. E lirë për t'u shpërndarë me atribuim te DEEPPLANE™.
FAQ
What is the SMAS layer?
Why are retaining ligaments important?
Is working in the deep plane more dangerous?
How many layers of tissue does the face have?
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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