Does a Deep Plane Facelift Move or Reposition the Muscles of the Face?

February 22, 2026 | Facelift

In short… no and yes.

The question of whether a deep plane facelift actually moves the muscles of the face is
one that I frequently hear from patients. The same might be true for a SMAS facelift. For
the purpose of this blog, the information I discuss about a deep plane facelift in most
circumstances could be applied to a SMAS or high SMAS facelift. Not only do I hear
questions from patients about the movement of muscles with these facelifts, but
sometimes I hear from patients that other surgeons have told them that the muscles are
moved.

Before I move on to discuss the answer to the question of whether muscles are moved
with a deep plane facelift, we need to define some terms.
Before we define terms, we need to discuss a fundamental truth of facelifts. There are
more similarities than there are dissimilarities between deep plane facelifts and SMAS
facelifts. In fact, from my observation of journal articles, social media posts, and
scientific lectures, I would say that to some degree the two procedures are actually
merging with regard to how they are performed and the quality of the results. I’m going
to have a separate blog about the convergence of the two types of facelifts in the future.
For the time being, I will briefly touch upon the similarities and the differences. The
similarities between a deep plane facelift and a SMAS facelift are that both derive their
significant lifting power from entering a space called the sub-SMAS plane. This is an
anatomic space beneath the SMAS, and readers will have a better understanding of
that when I later describe the SMAS. Another similarity between deep plane facelifts
and SMAS facelifts is that in traditional variations, incisions are placed near the
sideburn, in front of the ear, and behind the ear. The final similarity I’m going to discuss
is that in both deep plane facelifts and SMAS facelifts, some of the skin has to be
separated from the deeper tissues to perform the surgery.

Let’s go on to discuss the differences between a deep plane facelift and a SMAS
facelift. In a deep plane facelift, a limited amount of skin is elevated until the surgeon
reaches the locations at which the sub-SMAS plane is entered. The locations in which
those spaces are entered in the classical description of the procedure are near the
cheekbone and near the back of the jawbone. These anatomic landmarks are
scientifically known as the malar prominence of the zygomatic bone and the gonial
angle of the mandible, respectively. In a SMAS facelift, the skin is elevated more
extensively, traveling from the side of the face toward the center of the face, but
conversely, the sub-SMAS plane is entered closer to the ear and sideburn in
comparison to a deep plane facelift. Therefore, in a deep plane facelift, the cheek tissue
— which is primarily comprised of the malar fat pad — is left joined with the overlying skin and the underlying SMAS. This composite tissue is repositioned in a vertical or
vertical oblique vector altogether. In a SMAS facelift, there is more separation of the
skin from the SMAS, and the skin and SMAS are repositioned in slightly different
vectors or directions; the repositioning occurs less as a composite flap.

Now that we have established that both a deep plane facelift and a SMAS facelift work
beneath the SMAS tissue, let’s define what SMAS is. That acronym stands for the
Subcutaneous Musculo Aponeurotic System. This is basically a dense netting of
collagen in the central portion of the face that lies beneath and supports the fat, or
adipose tissue, beneath the skin, and lies above the muscles of the central face — in
particular those responsible for smiling. It is for this reason that many patients and even
surgeons say that with a deep plane facelift, and even a SMAS facelift, muscles are
moved. In the central part of the face — the cheek in particular — muscles are not
moved. So this is where we get the partial “no” answer. To summarize in a sentence: if
we take the narrow definition of a facelift to mean a procedure that rejuvenates only the
central part of the face, then the answer is no, because the tissue that’s relocated in the
central part of the face is the SMAS, which is not a muscle.

Now this is where things get interesting and the plot thickens. The SMAS is connected
to muscles in the upper part of the face — in particular the orbicularis oculi, which are the
eyelid muscles, and the frontalis muscle in the forehead, which is the muscle that raises
the eyebrows. In the lower part of the face, the SMAS is connected to the platysma
muscle, which is the muscle beneath the skin starting approximately at the jawline and
extending into the neck all the way down to the clavicle, or collarbones. When I say
“connected,” what I really mean is contiguous — there is a smooth transition from the
SMAS to the orbicularis oculi and frontalis muscles in the upper part of the face, and
again a smooth continuation of the SMAS with the platysma muscle in the neck. It’s
worth pointing out that all three of those muscles — frontalis, orbicularis oculi, and
platysma — are thin, flat muscles that lie beneath the subcutaneous fat and the skin
itself, just as is true for the SMAS.

Here is where we get to the “yes” part of the answer about whether muscles in the
face are moved with a face and neck lift. As I have discussed on social media, on my website’s facelift page, and in other blogs, it is rare that someone undergoes an isolated facelift of the central part of the face. In fact, it’s almost never. Generally, a facelift is performed in conjunction with eyelid
surgery and a brow reset or brow lift, also known as an upper third facelift. Furthermore,
patients undergoing a facelift almost always undergo a neck lift as well. One of the main
techniques by which the brows are lifted involves dissection beneath the frontalis
muscle. That muscle, along with the overlying skin and the forehead soft tissue in
general, is released and repositioned — therefore muscle is moved. This also has an
impact on the eyelid muscles, which are precisely repositioned. Finally, when a patient
undergoes a neck lift — in particular a deep plane neck lift, which is the most common
type to accompany a deep plane facelift and a SMAS lift — the platysma muscle is
modified, precisely repositioned, and tightened, and therefore that muscle is moved.

So again, the answer to whether muscles are moved in a deep plane facelift — and for
that matter a SMAS lift — depends specifically on what you’re talking about. The
answer can be no, and the answer can be yes. The answer is no if we are talking only
about the central face, the cheek in particular, because in that area it’s only the SMAS
that is moved, and the SMAS is not a muscle. But facelifts almost never deal only with
the central part of the face. They almost always are combined with a neck lift and with a
brow lift or upper third facelift, in which case muscles are moved — so if we are talking
about comprehensive facial rejuvenation, then the answer is yes: muscles are released
and precisely repositioned to lift and shape the face.

Five Fast FAQs

Are muscles moved in a deep plane facelift? Not really in the central part of the
facelift, but definitely in the forehead portion and the neck portion of a facelift.

What is the sub-SMAS plane? This is the anatomic space that is entered in a deep
plane facelift to create the profound and natural movement of tissues. It’s also the space
that is entered for a SMAS facelift.

What’s the difference between a SMAS facelift and a high SMAS facelift? These
are actually very similar procedures. In a SMAS facelift, the dissection of the SMAS
starts below the zygomatic arch. In a high SMAS facelift, the dissection starts over the
zygomatic arch or even above it.

When someone uses the term SMAS facelift, are they talking about a facelift with
SMAS plication? This is where terminology breaks down a little, because the terms
that have started to be used on social media and in marketing are inconsistent, and
even some of the terminology in the scientific literature can be confusing. For the
purpose of this article — and generally from what I’ve been able to gather from social
media — when I am talking about a SMAS facelift, or when we hear others talking about
it, for the most part they are referring to a facelift in which the sub-SMAS space is
entered in a dissection that is deeper than just the skin. In a SMAS plication facelift, the
sub-SMAS space is not entered; instead the skin is elevated off of the SMAS, and then
the SMAS is sutured to itself to elevate the tissues in the central and lower parts of the
face.

Are deep plane facelifts and SMAS facelifts the same? No, but there are more
similarities than there are dissimilarities.

Author
Adam Bryce Weinfeld, MD
Located in Austin, Texas
Top Residency and Double Fellowship Trained
Board certified plastic surgeon, focusing on facial aesthetic plastic surgery

For a consultation, visit the contact page at drweinfeld.com.