If you've started researching facelifts, you've likely seen two names come up again and again: the deep plane facelift and the SMAS facelift. Both address the muscle layer beneath the skin. The deep plane technique goes one step further, releasing the ligaments that hold the cheeks down so the entire midface can be lifted back to where it once began. For many women, that difference is what separates a result that looks refreshed from one that looks tight.
Dr. Philip K. Robb Jr. is a double board-certified facial plastic surgeon who has made deep plane facelift surgery the foundation of his practice. As the creator of the Robb Refresh™, Dr. Robb has performed thousands of facial procedures and operates from a private accredited and certified surgical center in Alpharetta, Georgia. The sections below look at how each technique approaches natural facial rejuvenation and who tends to benefit, then cover recovery and why surgeon expertise shapes your results.
What Is the Difference Between a Deep Plane and SMAS Facelift?
A deep plane facelift and an SMAS facelift differ in how deeply the surgeon works and how the tissue moves once it's lifted. SMAS stands for superficial musculoaponeurotic system, the thin layer of muscle and connective tissue that supports the lower two-thirds of the face and the neck. Nearly every modern facelift addresses it in some way.
In a deep plane vs SMAS facelift comparison, the key distinctions look like this:
- SMAS facelift: The skin is lifted first, then the SMAS is tightened with stitches or by trimming a small strip. The two layers are treated separately. EXTENSIVE skin lifting.
- Deep plane facelift: The surgeon works beneath the SMAS and releases the retaining ligaments around the cheek and jowl, so skin, fat, and muscle rise together as one unit. DOES NOT lift skin - the skin MAINTAINS the connection with it’s blood supply.
- Tension placement: The deep plane approach removes the tension as the anchors are lifted, so the skin can rest naturally instead of being pulled toward the ears.
Dr. Sam Hamra first described the deep plane approach in 1990, and surgeons have continued refining it ever since, according to a 2026 meta-analysis in Aesthetic Plastic Surgery.
Why Midface Rejuvenation Matters in a Facelift
Midface rejuvenation is often the missing piece for women who feel their face is "melting." As we age, the fat pads that give the cheeks their soft fullness slowly slide downward. That descent deepens the folds around the nose and mouth and adds weight to the jowls.
A deep plane facelift is designed to reach this area directly. Once the cheek ligaments are released and lifted, Dr. Robb can gently reposition that tissue over the cheekbone, which may soften nasolabial folds and restore the gentle curve you remember in your upper cheeks.
SMAS techniques vary widely. Traditional versions concentrate on the jawline and jowls, while extended or high SMAS variations reach farther into the cheek. Published comparisons are still limited: a 2025 systematic review in Annals of Plastic Surgery found that both techniques improved appearance, with one included study reporting better midface rejuvenation after a deep plane facelift.
Which Technique Creates the Most Natural Results?
Natural results come from lifting the structures that actually fell in a tension free manner, then letting the skin settle on its own. When skin carries most of the tension, it can look stretched, shiny, or swept to the side. In Dr. Robb's deep plane technique, the skin stays attached to the SMAS and moves with it. Keeping that connection helps preserve blood supply, sensation, and natural shine, so the result may simply look like a more rested version of you. This is CRITICAL and results in natural and more beautiful results!
Facelift before-and-after results are the best place to see this for yourself. As you compare facial plastic surgeons, look closely for:
- Smooth cheeks that still look soft when the patient smiles
- A defined jawline that flows naturally into the neck
- Earlobes and hairlines that keep their original shape
- Incisions tucked discreetly into the natural creases around the ear
Real patients in Dr. Robb's Robb Refresh gallery show how a deep plane facelift can be thoughtfully paired with a deep neck lift, eyelid surgery, fat transfer, or laser resurfacing for a complete, balanced refresh.
Should I Consider Deep Plane Facelift Surgery?
If you've noticed changes in both your midface and lower face. Women who choose this approach often mention:
- Sagging jowls or a softened jawline
- Deepening folds between the nose and mouth
- Flattened cheeks or visible volume loss
- Loose skin, bands, or fullness under the chin
- A previous facelift that didn't hold up or look natural
An SMAS facelift may be enough for someone with mild laxity along the jawline and very little cheek descent. Interest in lifting procedures continues to grow nationwide. According to the ASPS 2025 Procedural Statistics Report, facelifts rose 13% and neck lifts rose 21% compared with the previous year.
Beyond anatomy, Dr. Robb looks for patients who want to look like themselves, only refreshed. Good candidates are in stable health and avoid nicotine. A commitment to quality skincare afterward also helps protect the investment. The best way to know is a one-on-one consultation, available in person or through a virtual consultation.
Which Recovery Is Easier: Deep Plane Facelift vs. SMAS Facelift?
When comparing recovery experiences, in our experience, deep plane facelift offers a significantly easier, smoother recovery than a traditional SMAS facelift.
Because the skin envelope experiences significantly less trauma and no skin tension, patients typically report less overall discomfort, minimal bruising, and a quicker return to daily life.
Here is what you can expect during recovery from a deep plane facelift with Dr. Robb:
- First Few Days: Swelling peaks around day four. You will rest at home with your head elevated and use cold packs to keep swelling manageable.
- 1 to 2 Weeks: Most patients can apply makeup, resume driving, and return to work comfortably.
- 1 Month: You will feel confident and comfortable attending larger social gatherings and events.
- 4 to 6 Weeks: You will receive clearance for vigorous exercise following your follow-up visit.
To make recovery even more seamless, every surgical patient receives Dr. Robb's personal cell phone number and access to the Robb Rapid Recovery Program. This includes hyperbaric oxygen therapy to speed healing and minimize swelling, as well as VIP med spa care featuring lymphatic drainage massage and medical-grade skincare.
For added privacy, the Concierge Care Program can arrange a skilled nurse on call around the clock to handle dressing changes at your home or hotel, so you never need to go out in public while healing.
Is a Deep Plane Facelift Safe?
Both deep plane and SMAS facelifts have strong safety records in experienced hands. Our patients have all done extremely well. Recent research published in 2025 and 2026 includes:
- A 2026 meta-analysis of 10,784 deep plane patients reported an overall complication rate of 6.6%, temporary facial nerve weakness in 1.2%, and no cases of permanent facial nerve injury.
- The 2025 Annals of Plastic Surgery review of 10,766 patients concluded that both techniques are safe, with low infection rates and nerve symptoms that were mostly temporary.
- A 2025 meta-analysis in Aesthetic Plastic Surgery found that both deep plane and SMAS facelifts deliver robust, long-term outcomes with high patient satisfaction.
Since the deep plane technique works closer to the facial nerve branches, training makes a real difference. Dr. Robb completed his residency in Otolaryngology-Head and Neck Surgery, a specialty grounded in detailed knowledge of facial nerve anatomy. Furthermore, the repetition of high quality facial lifting procedures leads to excellent and consistent results.
How to Choose the Best Facelift Clinic in the US?
With so many facelift clinics in the US advertising the deep plane technique, it helps to know what to ask. Before booking surgery, consider:
- Is the surgeon board-certified, and does their practice focus on the face and neck? Your face is not an afterthought or an ‘add on’ procedure.
- How often do they perform deep plane facelifts?
- Can you see before-and-after results from patients with features similar to yours?
- Is the surgical facility accredited, such as by the AAAASF?
- Will the surgeon personally perform every step of your procedure?
- What support will you have during recovery?
Distance rarely stands in the way. About 56% of Dr. Robb's patients come from out of town, and the team helps arrange hotels near the office and black car service from Hartsfield-Jackson Atlanta International Airport.
Dr. Robb is a double board-certified plastic surgeon who dedicates his practice exclusively to facial plastic surgery, with a particular focus on the deep plane facelift. A second-generation facial surgeon raised in Alpharetta, he attended the Medical College of Georgia, completed residency at the University of Arkansas for Medical Sciences, and then spent an intensive fellowship year training with Dr. Achih Chen, one of the country's most well-known facial plastic surgeons.
He has been named a Castle Connolly Top Doctor from 2019 to 2026 and Best of Georgia 2020-2025, and more than 700 patients have left five-star Google reviews. Dr. Robb performs each surgery himself alongside the same dedicated team and hand-picked, board-certified anesthesiologists.
Your procedure takes place at the North Point Surgery Center, an AAAASF-accredited facility with its own private entrance and exit, away from the main waiting room and out of view from the street.
FAQs
Does a deep plane facelift last longer than an SMAS facelift?
Deep plane results may last longer because the deeper structures carry the lift and then tension is released. In Dr. Robb's experience, results can last over a decade, and daily sun protection with medical-grade skincare may help you enjoy them longer. Natural aging continues, so individual results vary.
Can a deep plane facelift improve a previous facelift?
Yes. Dr. Robb regularly performs revision face and neck lifts for women who were unhappy with an earlier procedure elsewhere.
Is a neck lift included with a deep plane facelift?
A deep neck lift is often paired with the deep plane facelift to sculpt the jawline and address bands or fullness. Whether you need one depends on your facial analysis.
How much does a deep plane facelift cost?
Your final investment depends on your surgical plan and any combined procedures, which Dr. Robb reviews during consultation. Cost will be discussed in the telephone calls leading up to the consult - well before the in person or virtual consult with Dr. Robb. The practice accepts checks, ACH, cash, credit cards, and CareCredit financing.
What is the best age for a facelift?
Candidacy depends more on skin quality and facial structure than on age alone. Dr. Robb can help you decide whether now is the right time.
Considering a Deep Plane Facelift? Dr. Robb Is Here to Help
This information is provided for educational purposes only and does not replace a consultation with a board-certified facial plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.
Sources
- American Society of Plastic Surgeons. How Much Does a Facelift Cost?
- American Society of Plastic Surgeons. Lift Procedures Led Growth as Demand for Restoration Drove Plastic Surgery in 2025, New ASPS Report Reveals. September 1, 2026.
- Deep Plane Facelifts: A Systematic Review and Meta-Analysis of Outcomes. Aesthetic Plastic Surgery, 2026.
- Comparing the Safety and Efficacy of Superficial Musculoaponeurotic System and Deep Plane Facelift Techniques: A Systematic Review and Meta-analysis. Annals of Plastic Surgery, 2025.
- The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis. Aesthetic Plastic Surgery, 2025.
