Most patients can expect about two weeks of downtime after either a deep plane or an SMAS facelift, with swelling easing and comfort returning over the following weeks. Between these two facelift techniques, the better fit depends on the extent of sagging and how soon the patient needs to return to work.
Philip Robb, Jr., MD, FACS, is a double board-certified facial plastic surgeon who performs facelift surgery in Atlanta from his Alpharetta practice and works exclusively on the face and neck. This facelift comparison explains how each procedure heals and which patients each suits.
How Do Deep Plane and SMAS Facelift Techniques Differ?
The two techniques differ in how deeply they work. The SMAS is a layer of supportive tissue beneath the skin and fat of the face and neck, and each facelift procedure repositions it differently.
- Deep plane facelift: Lifts the skin and the deeper tissue together as one unit, which may give a more natural, longer-lasting lift to the midface and neck. Dr. Robb specializes in the deep plane facelift.
- SMAS facelift: Tightens or lifts the SMAS layer, then lays the skin back over it.
- Skin handling: Dr. Robb's deep plane approach involves minimal separation of the skin from the tissue beneath, which may help lower downtime for many patients.
Either technique can be combined with a neck lift or eyelid surgery as part of facial rejuvenation surgery. Adding procedures can lengthen recovery.
Deep Plane vs SMAS Facelift Recovery Timeline
Recovery typically follows a similar pattern with either technique. Bruising and swelling usually peak around days 3 and 4, and many patients feel ready to return to work by the end of week 2. The society also notes that minor swelling and tightness can last up to a year, though usually only the patient notices. Most people recover within four to six weeks.
For ROBB REFRESH™ patients, whose surgery is built on a deep plane facelift, Dr. Robb describes recovery in four stages:
- 1 to 2 weeks: Social downtime, the period before most patients feel comfortable being seen in public.
- 3 to 4 weeks: More comfort, as remaining swelling and tightness continue to ease.
- 3 months: Refined healing, as the face continues to settle into its final shape.
- 1 year: Final skin and tissue renewal, when even minor swelling and tightness have typically resolved.
What Factors Affect Facelift Downtime?
Several things influence how long recovery takes. A deep plane facelift combined with a neck lift or eyelid surgery involves more healing than a lift alone, so Dr. Robb builds each plan around the patient's anatomy and schedule.
Downtime is ADJUSTABLE depending on your anatomy, goals, and schedule.
Anesthesia may also affect early recovery. At the AAAASF-accredited North Point Surgery Center, Dr. Robb works with board-certified anesthesiologists he selected himself, and the team uses anesthesia intended to ease recovery and reduce nausea.
Who Is a Good Candidate for a Deep Plane or SMAS Facelift?
Good candidates for either facelift procedure are healthy adults with realistic goals and visible sagging in the lower face or neck. Dr. Robb chooses the technique after a detailed facial analysis.
A deep plane facelift may suit patients with more pronounced jowls or neck sagging, since it repositions deeper tissue. An SMAS facelift may suit patients with milder sagging who prefer a more limited approach.
Patients who want a quick fix or cannot set aside time to recover may not be ideal candidates. This is still surgery that requires time to recover. Dr. Robb's team can review any untreated medical conditions at the consultation.
Is a Deep Plane Facelift Riskier Than an SMAS Facelift?
Current research suggests both procedures have comparable safety profiles, though few studies compare them directly. A systematic review and meta-analysis of 47 studies and 10,766 patients found hematoma rates, meaning a collection of blood under the skin, of 3 percent for deep technique facelifts, a group that includes deep plane, and 2 percent for SMAS facelifts. It reports that only one study compared aesthetic results directly, and it found better midface rejuvenation with deep technique facelifts. The authors conclude that technique selection should be individualized.
Surgeon experience matters when comparing facelift techniques. Dr. Robb has performed thousands of facial procedures. All facelift surgery carries risks, including bleeding and nerve injury, which are worth discussing at a consultation. We also know that repetition leads to quality and this is Dr. Robb’s most common surgery and is often performed 3 times per week!
How Does Dr. Robb Support Facelift Recovery in Atlanta?
Robb Refresh patients receive VIP access to the medical spa for our specialized ROBB RAPID RECOVERY Program. This is customizsed to each patients but can include hyperbaric oxygen therapy, IV fluid rehydration with medication infusion as well as lymphatic, all aimed at supporting healing and comfort.
The Concierge Care Program adds privacy on request, with an on-call nurse available around the clock for dressing changes at home or a hotel. Dr. Robb follows up with patients personally, and Robb Refresh patients receive his cell phone number.
FAQs
Can a facelift be combined with other procedures?
Yes. Robb Refresh plans can combine a deep plane facelift with a deep neck lift, eyelid surgery, brow lift, lip lift, fat transfer, or laser resurfacing, depending on the patient's goals and anatomy.
Will people notice I had a facelift?
By weeks 3 and 4, many patients can resume exercise and daily activities with few outward signs of surgery, according to the American Society of Plastic Surgeons. Incision lines may look pinkish-red at first and fade with time.
Can out-of-town patients have a facelift with Dr. Robb?
Yes. About 56 percent of Robb Facial Plastic Surgery patients travel from out of town, and Dr. Robb offers virtual consultations by FaceTime or Zoom so patients can begin planning from home.
Questions About Facelift Techniques? Dr. Robb Is Here to Help
Choosing between a deep plane and an SMAS facelift depends on the patient's anatomy and goals, and a one-on-one assessment is the best way to decide.
Dr. Robb, a Castle Connolly Top Doctor from 2024 to 2026 and a Best of Georgia 2025 honoree, welcomes patients considering a facelift in Atlanta for an in-person or virtual consultation. Schedule a consultation with Robb Facial Plastic Surgery in Alpharetta to discuss which approach fits your goals and timeline.
This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.
Sources
- American Society of Plastic Surgeons, Your Facelift Recovery Explained From Day 1 to Day 30
- Kaiser Permanente, Face-Lift: What to Expect at Home
- Vayalapra et al., Comparing the Safety and Efficacy of SMAS and Deep Plane Facelift Techniques: A Systematic Review and Meta-Analysis
