At The Aesthetic Meeting 2025 in Austin, we sat down with three top plastic surgeons to dig into one of today’s buzziest aesthetic procedures. While the term deep plane facelift is all over social media and search engines, it quickly became clear that patient perception doesn’t always match surgical reality.
“We hear the buzz term ‘deep plane’ a lot,” said Vero Beach, FL plastic surgeon Alan J. Durkin. MD. “But the one quotient people are really looking for is natural results. People don’t want to look like they’ve had a facelift—they want to hear things like, ‘Did you lose weight?’ or, ‘Did you change your hair?’ That’s the compliment.”
Featured Experts
- Dr. Alan J. Durkin is a board-certified plastic surgeon in Vero Beach, FL
- Dr. Philippe A. Capraro is a board-certified plastic surgeon in Denver
- Dr. George Sanders is a board-certified plastic surgeon in Encino, CA
Denver plastic surgeon Philippe A. Capraro, MD, agreed: “Most of my patients don’t come in asking for a specific plane of dissection. They come in knowing I do deep plane facelifts, but for patients with very thin skin or low volume, I might do a SMAS plication or SMASectomy instead. It’s about what suits that individual best.”
Deep Plane vs. SMAS: What’s the difference?
All three surgeons agreed that technique matters, but not in isolation. “We firmly believe the engine for your outcome is the deeper plane,” said Dr. Durkin. “When you reposition the SMAS, the skin naturally falls into place. That also reduces tension on the skin, which leads to better healing and more natural outcomes.”
However, Encino, CA plastic surgeon George Sanders, MD, who has practiced in Los Angeles for decades, shared a more measured perspective. “You can achieve excellent results with either deep plane or SMAS tightening. It’s not so much the tool, it’s the doctor holding the tool,” he said. “I’ve done both procedures extensively. Over time, I found my results with SMAS tightening were just as good and patients recovered faster with fewer complications.”
He also pointed out a crucial distinction in recovery: “There’s a slightly higher risk of facial nerve injury with the deep plane technique and more swelling. My patients in California want to be back to their routines quickly, so I tend to favor SMAS tightening.”
When’s the right time to get a facelift?
The surgeons also tackled the question nearly every patient asks: “When should I do it?”
“The deep plane doesn’t fail,” said Dr. Durkin. “Your skin does. So, timing has a lot to do with your skin quality. If you’ve maintained your collagen, you can get a good result into your 60s or 70s, but for most people, the sweet spot is between 50 and 60.”
According to Dr. Capraro, the age range can vary widely. “I’ve done lower face and necklifts on patients in their 20s who had neck laxity. I’ve also had 60-year-olds who didn’t need anything. But in general, people are coming in earlier now—mid-40s to early 50s is common.”
Dr. Sanders believes the right time is more about individual goals than a specific age. “If what they want to fix is something surgery can address and they’re healthy, then it’s the right time,” he said. “One of my patients was 100 years old—she had a facelift and went back to chopping wood.”
What procedures pair well with a facelift?
While the facelift focuses on repositioning tissue, the best results often come from combining it with complementary procedures. “Fat transfer is something I do with almost every facelift,” noted Dr. Capraro. “And later, I’ll often do light lasering two to three months after surgery. Also, if we’ve lifted significantly in the midface and jowl, there can be extra skin in the temple area—so I recommend a temporal or brow lift for balance.”
For Dr. Sanders, adding fat grafting and laser resurfacing makes a noticeable difference. “Patients have volume loss and sun damage. These procedures really enhance the final outcome.”
Intraoperative collagen induction therapy is part of Dr. Durkin’s standard facelift protocol. “At this point in my practice, it’s hard not to do some kind of laser during surgery. We’re actually publishing data showing we can safely go to 500 microns intra-op with a hybrid fractionated laser. If I have the chance to improve the skin while I’m there, I’m taking it.”
How to Protect Your Investment
When it comes to maintaining results, all three surgeons agreed: recovery care and long-term skin maintenance are essential. “Quit smoking, use skin care and wear sunscreen,” emphasized Dr. Durkin. “If you’re going to make this kind of investment in yourself, protect it.”
Among Dr. Capraro’s post-op recommendations: avoid neck flexing and use a travel pillow to keep the head in a neutral position. “That helps the swelling go down faster and speeds up recovery.”
One unexpected piece of advice came from Dr. Sanders, who warned against letting pets get too close too soon. “I’ve had too many patients go home and let their dog lick their face or sleep on their pillow. We’ve done all this meticulous work, and the last thing you want is an infection from your furry best friend.”
