By Dr Scott J Turner, Specialist Plastic Surgeon (FRACS) | Bondi Junction, Sydney
Two terms dominate every facelift conversation right now — deep plane and SMAS. You’ll find them on clinic websites, in patient forums, across Instagram reels. And depending on who you ask, one is apparently far superior to the other. The reality? Not that simple.
Both are proven surgical approaches. Both go after the deeper structural layers responsible for facial ageing — not just skin. Where they part ways is how they handle those structures, and that distinction matters when it comes to your face, your concerns, and what recovery timeline works for you. If you’re considering facelift surgery in Sydney — particularly around Bondi Junction and the Eastern Suburbs — getting clear on this difference before you book a consultation is worth your time.
Dr Scott J Turner performs both deep plane and SMAS facelifts at FacePlus Aesthetics in Bondi Junction. This article breaks down what each technique actually involves, where they genuinely differ, and what published research says — so you walk into your consultation with sharper questions already in mind.
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A Bit of Anatomy First
You can’t make sense of this comparison without understanding one structure: the SMAS. That stands for superficial musculoaponeurotic system — a fibrous muscular layer sitting between your skin and the deeper facial structures. Think of it as scaffolding. It connects to the muscles you use to smile and frown, and it’s pinned to bone by tough bands called retaining ligaments.
In your twenties and thirties, this system keeps everything where it belongs. Then gravity and time get to work. The SMAS stretches. Ligaments loosen. Fat pads slip downward. What you end up seeing — deeper nasolabial folds, jowls forming along the jaw, a neck losing its angle — that’s not really a skin problem. It’s structural.
Which is exactly why old-fashioned skin-only facelifts didn’t hold up. They smoothed the surface but left the scaffolding sagging underneath. Both the SMAS and deep plane techniques go after that scaffolding. They just do it differently.
The SMAS Facelift — How It Works
SMAS facelifts have been around since the mid-1970s. They’re the backbone of modern facial surgery, and for good reason — they work.
The basic idea: your surgeon lifts the skin off the SMAS beneath it. Now there are two separate layers to deal with. The SMAS gets tightened — either by folding it on itself (plication), cutting a strip out and suturing the edges (SMASectomy), or extending the dissection across the cheek in a High or Extended SMAS approach. Once repositioned, skin gets redraped and trimmed.
Where it excels. Jowls, jawline definition, and early neck banding — the SMAS technique handles these well. A 2025 meta-analysis in Aesthetic Plastic Surgery covering 2,896 patients put satisfaction at 87.8%. And a High SMAS facelift has shown durability past the 10-year mark in published follow-up data.
Where it runs into trouble. The midface. Standard SMAS techniques don’t release the retaining ligaments — the zygomatic and masseteric ones specifically — so the lift doesn’t travel effectively into the cheek area. Deep nasolabial folds, descended cheek volume — harder to fix with this approach. Your skin also carries more of the tension, and over time, that can sometimes show up as visible scarring or a slightly pulled look.
The Deep Plane Facelift — How It Works
The deep plane facelift came along as an evolution of SMAS work. Different approach entirely to how tissue gets handled.
Rather than peeling skin off the SMAS and treating the two layers separately, the deep plane technique lifts skin, fat, and SMAS together — all in one block. Your surgeon drops beneath the SMAS into the sub-SMAS space and releases those retaining ligaments holding deeper tissues down. Once freed, the whole composite flap gets repositioned vertically. Because the deeper structures do the heavy lifting, the skin just drapes over the top. No pulling. No tension on the closure.
This is the approach Dr Turner performs most frequently at FacePlus Aesthetics. Every operation gets planned around the individual — which ligaments need releasing, how far to extend, what vectors make sense. That assessment happens during your consultation at the Bondi Junction clinic.
Where it excels. Midface correction is the standout. Releasing the zygomatic ligaments lets the surgeon reposition descended cheek volume and soften deep nasolabial folds — something standard SMAS work struggles with. The lack of skin tension means a very low risk of looking “done.” Published studies report longevity in the 10 to 15-year range, though individual outcomes vary.
On safety — and this matters because the myth persists — a meta-analysis in the Aesthetic Surgery Journal covering over 41,000 patients found a temporary nerve injury rate of 0.69% for deep plane. Identical to SMAS plication. No permanent injuries in either group.
Satisfaction rates hit 94.4% in the same 2025 Aesthetic Plastic Surgery review that covered SMAS outcomes.
The trade-offs. It’s a longer operation — 4 to 6 hours typically. More swelling afterwards, and research shows that oedema can hang around 15 to 30 days longer than with SMAS techniques. Cost runs higher because of the operative time and technical demands involved.
Comparing the Two — What Actually Differs
| Feature | Deep Plane | SMAS |
|---|---|---|
| Where the surgeon works | Beneath the SMAS | On or above the SMAS |
| Tissue handling | Skin, fat, SMAS lifted as one flap | Skin and SMAS separated, repositioned independently |
| Retaining ligaments released? | Yes | Generally no |
| Midface correction | Strong | Limited (improved with High/Extended SMAS) |
| Lower face and jawline | Excellent | Excellent |
| Skin tension | Minimal | Moderate |
| Typical longevity | 10–15 years | 7–12 years |
| Time in theatre | 4–6 hours | 3–4 hours |
| Back to social life | 2–3 weeks | 1–2 weeks |
| Patient satisfaction | 94.4% | 87.8% |
| Temporary nerve injury | 0.69% | 0.69% (plication); up to 1.85% (High Lateral SMAS) |
Patients often search for “deep plane facelift vs SMAS facelift Sydney” or “which facelift lasts longer.” The honest answer is that structural anatomy — not a universal ranking of techniques — determines which approach gives you the better outcome. That’s true whether you’re having a first procedure or looking into a revision facelift after previous surgery elsewhere.
So Which One Do You Actually Need?
It depends. That’s not the definitive answer you’re after, but it’s the honest one.
Deep plane tends to be the better fit when there’s moderate to significant ageing across the midface, lower face, and neck. Noticeably dropped cheeks, nasolabial folds past what fillers can manage, established jowls, loss of neck definition — that combination points toward deep plane.
SMAS may be the smarter choice when your primary concerns sit in the lower face and neck — jowling, jawline softening — without much midface involvement. Shorter procedure, slightly quicker recovery, and for the right patient it delivers an excellent result.
And sometimes neither is the right call. Early jowling, mild laxity — you probably don’t need a full facelift. A short scar facelift or ponytail facelift might get you there with smaller incisions and less downtime. Dr Turner won’t recommend a bigger operation than your anatomy calls for.
Cost Considerations
Deep plane procedures involve longer operative time, which means higher theatre and anaesthetic fees compared to SMAS techniques. Final pricing depends on the extent of surgery and whether you’re combining additional procedures — a deep neck lift, blepharoplasty, or facial fat grafting all add to the total. Dr Turner provides a detailed quote after your consultation.
What Recovery Looks Like
You’d expect a huge gap between these two recoveries. In practice, they overlap more than you’d think — though the deep plane does need a bit longer in that early phase.
Deep plane: Swelling peaks around day two or three. Bruising tends to track down the neck in the first week. Numbness across the cheeks and jaw? Completely normal. Most people are back at a desk by week two or three. By week four, things sharpen up nicely. Six months is when you’re seeing the final picture.
SMAS: Similar pattern, just dialled down. Less swelling, quicker bruise resolution. Socially presentable by about week two for most patients. Normal routine by weeks three to four.
Either way — sun protection isn’t optional. SPF 30+ and a hat every time you step outside. And nicotine has to stop completely. At least six weeks either side of surgery. No exceptions on that one. Post-operative care is coordinated through the Bondi Junction clinic, with regular follow-up appointments during those first few weeks. More details on the facelift recovery page.
A Word About Marketing vs Reality
This needs saying. Plenty of clinics now slap “deep plane” on everything they offer because the term sells. But a genuine deep plane facelift means entering the sub-SMAS space and physically releasing retaining ligaments. It’s not just aggressive SMAS tightening with a trendy label.
If you’re comparing surgeons, ask bluntly: do you release retaining ligaments? What plane are you working in? A surgeon who performs both approaches and chooses based on what your face needs — rather than what their marketing says — is worth talking to.
Frequently Asked Questions
Next Steps
If you’re considering facelift surgery in Sydney and want clarity on which technique suits your anatomy, book a consultation at FacePlus Aesthetics in Bondi Junction. Dr Turner will examine your face, explain what he’d recommend and why, and answer whatever questions you’ve got. No pressure — just an honest assessment.
Patients come from across Sydney, interstate, and overseas. If you’re travelling from outside the Eastern Suburbs, check the out of town patients page.
Contact FacePlus Aesthetics to book a consultation.
