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Procedure Safety · Transparency

Is deep plane facelift safe?

No facelift is risk-free, so safe here means that the risks are measured, not absent: in a 2025 systematic review, facial-nerve injury after facelift ranged from 0.5% to 5% (Arianpour et al., PMID 41273502), and in 129,007 cosmetic surgery patients a clinically significant blood clot followed 0.01% of face procedures (Winocour, PMID 28207041). These come from facelifts in general, not from one surgeon, so ask yours for their own rates. What DEEPPLANE™ holds as data: no complication rates of our own, so every rate on this page comes from the cited studies, and 30 of 6,111 published before-and-after pairs photographed twelve months or more after surgery.

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Quick Answer

Is a deep plane facelift safe?

Deep plane facelift is safe when performed by a board-certified surgeon at an accredited facility. Across 11,300 facelifts of all techniques, 1.8% had a major complication within 30 days (hematoma 1.1%, infection 0.3%). A 183-study meta-analysis found major hematoma in 1.22% of deep plane facelifts and no difference between techniques in permanent nerve injury; counting every recorded event, a 2025 meta-analysis pooled 17.2% for deep plane. We hold no study that compares skin-necrosis risk between techniques. Ask how many deep plane facelifts the surgeon performs a year; we hold no study that sets a safe number.

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What are the risks of deep plane facelift?

The main risks of deep plane facelift are: hematoma (blood pooling under the skin), reported as major hematoma in 1.22% of deep plane facelifts across 183 studies; temporary facial nerve weakness, which usually recovers; permanent facial nerve injury, which is rare; infection, 0.3% needing hospital care across 11,300 facelifts; and hypertrophic scarring, which is uncommon. Your surgeon should give you their own rates. We hold no study that compares skin-necrosis risk between techniques. Ask how many deep plane facelifts the surgeon performs a year (we hold no study that sets a safe number), and ask in writing which facility your operation and overnight stay are booked into, since accreditation such as AAAASF or JCI describes that building's systems rather than your surgeon.

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Is Deep Plane Facelift Safe?: Deep plane facelift is safe when performed by experienced, board-certified surgeons in accredited facilities. We hold no study that compares skin necrosis between techniques.

— DEEPPLANE™ Clinical Review

Is Deep Plane Facelift Safe: Quick Facts

Safety Profile
Risks measured, not absent
Major Complications
1.8% of 11,300 facelifts
Nerve Damage
Rare; most recover
Key Factor
Surgeon experience
Recovery
Predictable healing
Satisfaction
94.4% satisfaction

Source: Medical Literature & Expert Consensus

Key Takeaway: Major complications within 30 days: 1.8% of 11,300 facelifts[6]. Major hematoma after deep plane: 1.22% across 183 studies[5]. Most facial-nerve weakness recovers; about 70% of injured patients recover fully within six months[8]. Permanent nerve injury is rare, and its risk did not differ between techniques[5].

Why Understanding This Helps

A deep plane facelift is safe when performed by a specialist: across 11,300 facelifts, 1.8% had a major complication within 30 days, permanent nerve injury is rare, and a 2025 meta-analysis pooled 94.4% patient satisfaction for deep plane. Understanding the key factors that ensure this high safety profile is the first step toward a successful outcome.

  • Rates differ by definition and technique; the figures are below
  • Board-certified surgeons with deep plane experience minimize risks
  • Pre-operative health optimization significantly reduces complications

Deep plane facelift is considered safe when performed by experienced, board-certified facial plastic surgeons, with major complications (an emergency visit, admission or reoperation within 30 days) in 1.8% of 11,300 facelifts of all techniques[6]. Counting every recorded event, a 2025 meta-analysis pooled 17.2% for deep plane and 10.3% for SMAS[4]. The technique provides direct visualization of the facial nerve beneath the SMAS; major hematoma occurred in 1.22% of deep plane facelifts across 183 studies[5]. Patient selection, surgeon expertise, and proper facility accreditation are the three most important safety factors.

Understanding the safety profile, potential risks, and how to minimize complications with proper surgeon selection. A smooth recovery is achievable for most patients.

Safety by the numbers.

Sources: Gupta 2016 (11,300 facelifts) · Jacono 2019 meta-analysis (183 studies) · Khoury 2025 meta-analysis

1.8%

Major complications

Emergency visit, admission or reoperation within 30 days; 11,300 facelifts, all techniques (Gupta 2016)

1.22%

Major hematoma, deep plane

Pooled across 183 studies (Jacono 2019); the most common early complication

17.2%

Any complication, deep plane

Every recorded event counted; the abstract does not grade severity. SMAS 10.3% (Khoury 2025)

94.4%

Patient satisfaction

Pooled for deep plane in a 2025 meta-analysis of 21 studies (Khoury 2025)

Watercolor illustration of an empty operating suite seen from the doorway: an overhead surgical light, a table with a folded sheet, a wall clock and a monitor on a stand. No people are shown.
Illustration: safety is a property of the room, the team and the checks, as much as of the technique.

How Safe Is the Deep Plane Facelift Procedure?

This procedure is a safe procedure when performed by an experienced, board-certified surgeon. Surgeons credit some aspects of the deep plane technique with protecting the skin, but we hold no study that shows it improves safety compared to traditional facelifts[1]:

What Do Surgeons Credit the Deep Plane With?

Preserved Blood Supply

By keeping the skin attached to the SMAS, blood supply to the skin is maintained, which surgeons expect to reduce the risk of skin necrosis; no study we hold measures it.

Less Skin Tension

Lifting the deeper layers means less tension on the skin, which surgeons expect to help wound healing; no study we hold measures it.

Patients Who Smoke

Smoking is never recommended before a facelift, and we hold no study showing the deep plane is safer for patients who have smoked.

What Are the Potential Risks and Complications?

Like any surgical procedure, deep plane facelift carries some risks:

Facial Nerve Injury (uncommon)

Temporary weakness is possible; in a 2025 review about 70% of injured patients recovered fully within six months[8]. Permanent injury is rare with experienced surgeons.

Hematoma (1.22% major, deep plane)

Blood collection under the skin that may require drainage; major hematoma occurred in 1.22% of deep plane facelifts across 183 studies[5]. Male sex was an independent risk factor across 11,300 facelifts[6], and high blood pressure raises the risk.

Infection (0.3% major)

Infection needing an emergency visit, admission or reoperation occurred in 0.3% of 11,300 facelifts[6]. Treated with antibiotics if it occurs.

Scarring

Scars are hidden in natural creases and hairline. Visible scarring is rare but can occur, especially in patients prone to keloids.

How Can You Minimize Deep Plane Facelift Risks?

Choose an Experienced Surgeon

Select a board-certified plastic surgeon or facial plastic surgeon who specializes in deep plane facelift and performs the procedure regularly.

Stop Smoking

Quit smoking at least 4-6 weeks before and after surgery to optimize healing and reduce complications.

Control Blood Pressure

Uncontrolled hypertension increases hematoma risk. Work with your doctor to optimize blood pressure before surgery.

Follow Post-Op Instructions

Carefully follow your surgeon's post-operative instructions regarding activity, medications, and wound care.

What Patients Ask

Is deep plane facelift more dangerous than SMAS facelift?
No. While deep plane facelift requires more surgical expertise and takes longer to perform, it is not inherently more dangerous than a SMAS facelift. A 2019 meta-analysis of 183 studies found that the risk of permanent facial-nerve injury did not differ between facelift techniques; major hematoma was somewhat more frequent after deep plane (1.22%) than after SMAS plication. A 2025 meta-analysis pooled an overall complication rate, counting every recorded event, of 17.2% for deep plane and 10.3% for SMAS. Your surgeon should give you their own rates.
Can you die from a deep plane facelift?
Death after a facelift is very rare, but we have no source we can cite that measures a mortality rate for deep plane facelift specifically, so we do not print one. Blood clots are among the most feared complications; in 129,007 cosmetic surgery patients, a clinically significant blood clot (VTE) followed 0.01% of face procedures (Winocour 2017). Surgeons reduce that risk with intra-operative leg compression and by screening clotting history. Risk is minimized by choosing an accredited facility (JCI / AAAASF / CQC), a board-certified surgeon, and disclosing all medications and clotting history during pre-operative clearance.
What if the facial nerve is damaged?
Temporary facial-nerve weakness — most often involving the marginal mandibular or frontal branches — is uncommon: one surgeon's published deep plane series reported 1.3%. A 2025 systematic review found facial-nerve injury after facelift in 0.5% to 5% of cases; about 70% of those patients recovered fully within six months with conservative treatment, and about 10% had a lasting deficit. Permanent damage is rare and, if it does occur, can often be partially rehabilitated with physical therapy, selective botulinum-toxin injections to the opposite side for symmetry, and in rare cases nerve-graft or cross-face nerve-transfer surgery.
How do I know if my surgeon is experienced enough?
Ask five specific questions: how many deep plane facelifts they perform each year (we hold no study that sets a safe number), what percentage of their practice is deep plane versus other techniques, what their complication rates are (hematoma, nerve injury, infection, revision), where and with whom they trained in the technique, and whether they can show 20+ of their own before/after photo sets. Verify board certification on the ABPS or ABFPRS registry.
Is deep plane facelift safer than traditional facelift?
Deep plane facelift has not been shown to be safer or less safe overall than traditional SMAS and skin-only techniques, and we hold no study that compares them head to head. We hold no study that compares skin necrosis between techniques. In a 183-study meta-analysis, major hematoma occurred in 1.22% of deep plane facelifts, somewhat more often than after SMAS plication, and permanent nerve-injury risk did not differ between techniques. Across 11,300 facelifts of all techniques, 1.8% had a major complication needing an emergency visit, admission or reoperation within 30 days.
What makes a deep plane facelift surgeon safe?
A safe deep plane facelift surgeon combines extensive training in facial anatomy (ideally fellowship-level), active board certification (ABPS, ABFPRS, or recognized international equivalent), high annual case volume specifically in the deep plane technique, operating privileges at an accredited surgical facility with on-site anesthesiology and ICU escalation, written informed-consent and pre-operative evaluation protocols, documented complication tracking, and a willingness to share outcome data openly. Beyond credentials, verify a consistent portfolio of natural-looking results and ask past patients about their post-operative experience.
Are there long-term safety concerns with deep plane facelift?
No delayed complication unique to the deep plane technique has been described. The procedure has been performed since Sam Hamra published the modern description in 1990. The long-term risks — scar hypertrophy, late skin thinning, recurrent laxity — are shared with other facelift techniques, and no study we can cite compares their long-term rates between techniques. The dominant long-term safety factor is the quality of the original surgical technique.
Who should not get a deep plane facelift?
Absolute and relative contraindications include uncontrolled medical conditions (poorly managed hypertension, unstable cardiac disease, untreated diabetes), active smoking within six weeks of surgery, certain bleeding disorders, connective-tissue disorders that impair wound healing, body dysmorphic disorder, and unrealistic expectations. Extensive prior facial surgery is a relative contraindication requiring a more experienced surgeon. A thorough pre-operative consultation identifies these concerns before surgery is scheduled.

Dig Deeper

Medical References

  1. 01
    Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990;86(1):53-61(opens in new tab)(Journal Article)Accessed: 2026-03-21DOI: 10.1097/00006534-199007000-00008
  2. 02
    Baker DC. Complications of cervicofacial rhytidectomy. Clin Plast Surg. 1983;10(3):543-562(opens in new tab)(Journal Article)Accessed: 2026-08-05DOI: 10.1016/S0094-1298(20)31873-3
  3. 03
    International Society of Aesthetic Plastic Surgery (ISAPS) Global Survey 2023(opens in new tab)(Organization)Accessed: 2026-03-21
  4. 04
    Khoury S, Almubarak Z, Khan H, Boldt G, Villemure-Poliquin N, Nichols AC. The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg. 2025;49(21):5895-5903(opens in new tab)(Research Study)Accessed: 2026-08-05DOI: 10.1007/s00266-025-05118-x
  5. 05
    Jacono AA, Alemi AS, Russell JL. A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques. Aesthet Surg J. 2019;39(9):927-942(opens in new tab)(Research Study)Accessed: 2026-09-29DOI: 10.1093/asj/sjz045
  6. 06
    Gupta V, Winocour J, Shi H, Shack RB, Grotting JC, Higdon KK. Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 Patients. Aesthet Surg J. 2016;36(1):1-13(opens in new tab)(Research Study)Accessed: 2026-09-29DOI: 10.1093/asj/sjv162
  7. 07
    Jacono AA, Parikh SS. The minimal access deep plane extended vertical facelift. Aesthet Surg J. 2011;31(8):874-890(opens in new tab)(Research Study)Accessed: 2026-09-29DOI: 10.1177/1090820X11424146
  8. 08
    Arianpour N, Khiabani K, Aberoumand H, Pourhoseini A. Management and outcomes of facial nerve injury following rhytidectomy: a systematic review. Maxillofac Plast Reconstr Surg. 2025;47(1):40(opens in new tab)(Research Study)Accessed: 2026-09-29DOI: 10.1186/s40902-025-00494-5
  9. 09
    Winocour J, Gupta V, Kaoutzanis C, Shi H, Shack RB, Grotting JC, Higdon KK. Venous Thromboembolism in the Cosmetic Patient: Analysis of 129,007 Patients. Aesthet Surg J. 2017;37(3):337-349(opens in new tab)(Research Study)Accessed: 2026-08-05DOI: 10.1093/asj/sjw173
Cite this pageCC-BY 4.0
DEEPPLANE™ Editorial Team (2026). Is Deep Plane Facelift Safe?. DEEPPLANE™. Retrieved from https://deepplane.com/what-is-deep-plane-facelift/safe

Content licensed CC-BY 4.0. Free to share with attribution to DEEPPLANE™.

Key Facts

Facelift major complication rate was 1.8% within 30 days across 11,300 facelifts of all techniques (Gupta 2016)
Major hematoma after deep plane facelift occurred in 1.22% of cases pooled across 183 studies (Jacono 2019)
Permanent facial nerve injury risk did not differ between facelift techniques in a 183-study meta-analysis (Jacono 2019)
Deep plane technique provides better nerve visualization than SMAS technique due to dissection beneath the SMAS layer
Patient safety factors include surgeon experience, facility accreditation, and proper patient selection
Clinically significant VTE after cosmetic face procedures occurred in 0.01% of face procedures among 129,007 cosmetic patients (Winocour 2017)

Risks & Complications

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Common Misconceptions

Myth: Deep plane is more dangerous than other facelifts

Fact: The published rates for the main risks are on this page; we hold no study that shows the deep plane reduces skin complications.

Myth: Facial nerve damage is common

Fact: Permanent nerve damage is rare with experienced surgeons. Most temporary weakness recovers; in a 2025 review about 70% of injured patients recovered fully within six months.

Myth: Older patients cannot safely have deep plane

Fact: Age alone does not determine candidacy. Overall health, not chronological age, determines surgical safety.

Before You Decide

Expert evaluation is essential before any surgical decision

Individual results differ based on anatomy and healing

Budget 2-3 weeks of recovery time from work

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What surgeons say

What are the risks of a facelift? Answered in their own words, quoted exactly from videos and posts they published on their own channels.

  • “Your surgeon will need to evaluate the location of your scar, your anatomy, and your surgical history to determine the safest approach for you.”

    Dr. Philip Wasicek, from the surgeon's own Instagram post, 2026-10-06

  • “Proper storage, maintaining the cold chain, and accurate dosing are all important for safe and predictable results.”

    Dr. Ekrem Keskin, from the surgeon's own Instagram post, 2026-10-04

  • “Your surgical plan should consider the procedure, your individual needs, and the level of monitoring required to keep you safe and comfortable.”

    Dr. Keshav Magge, FACS, from the surgeon's own Instagram post, 2026-09-30

  • “Every surgical plan should be personalized, balanced, and created with patient safety at the center.”

    Dr. Safa Manav, FEBOPRAS, from the surgeon's own YouTube video, 2026-06-18