A deep plane facelift is a surgical procedure that corrects age-related change in the midface, jawline and neck by repositioning the deeper layers of facial tissue rather than pulling on the skin alone. The operation works in the plane beneath the superficial musculoaponeurotic system (SMAS), where the retaining ligaments that anchor the facial soft tissue are released so that skin, muscle and fat can be lifted and repositioned as a single composite flap. Because the skin is not stretched to carry the lift, the technique avoids much of the tight, windblown appearance associated with skin-only facelifts.
Rivonia patients can arrange an in-person assessment or begin with the practice’s online consultation and photo review form. The information below is general in nature, and a personal consultation is required before any surgical recommendation can be made.
What is a deep plane facelift?
Facial ageing involves more than skin laxity. The fat compartments of the midface descend, the SMAS layer loses tone, and the retaining ligaments of the cheek and jawline allow tissue to shift downward. The visible result is flattening of the cheek, deepening of the nasolabial folds, heaviness along the jawline and loose skin in the neck.
A deep plane facelift addresses these layers directly. After the incisions are made, the skin is raised only far enough to reach the deeper plane, and the zygomatic and mandibular retaining ligaments are released. The composite flap of skin, SMAS and midface fat is then repositioned as a unit, restoring cheek fullness, softening the nasolabial folds and redefining the jawline. Neck improvement usually includes work on the platysma muscle in the same operation.
Because the lift is carried by the deeper tissue rather than by tension on the skin, the incisions tend to heal with less stretching, and the result moves with normal facial expression.
How it differs from a SMAS facelift
A conventional SMAS facelift tightens the SMAS layer by folding it (plication) or removing a strip of it, leaving the retaining ligaments intact. This works well for jowls and neck laxity but has a limited effect on the descended midface. A deep plane facelift releases those ligaments and moves the composite flap as a whole, which is why the technique is generally reserved for patients with moderate to advanced ageing changes who want the midface corrected along with the jawline and neck.
Who is a good candidate?
There is no fixed age for the procedure. Most patients are between 45 and 70, and the pattern of ageing and general health matter more than the number on the birth certificate. Candidates typically have:
- descent of the midface, with flattening of the cheeks and deepening nasolabial folds
- jowls and loss of definition along the jawline
- loose neck skin or visible banding in the platysma
- good general health, with no uncontrolled medical conditions
- non-smoker status, or a commitment to stop smoking well before and after surgery
- realistic expectations about scarring, recovery time and the degree of change surgery can achieve
Patients with early, limited change are often better served by a mini facelift, and those whose main problem is volume loss may be advised to combine surgery with fat grafting rather than rely on lifting alone.
How the deep plane technique compares
The table below sets out how the deep plane facelift compares with the mini and SMAS techniques. Individual recommendations depend on examination, so these figures are a general guide rather than a surgical plan.
| Technique | What is addressed | Typically suits | Theatre time | Time off work | Results commonly last |
|---|---|---|---|---|---|
| Mini facelift | Skin and limited SMAS tightening through shorter incisions | Early jowls in the 40s to early 50s | 1.5–2.5 hours | About 1 week | About 5–7 years |
| SMAS facelift | Plication or partial removal of the SMAS layer | Jowls and neck laxity in the 50s and 60s | 2–3 hours | 1–2 weeks | Around 7–10 years |
| Deep plane facelift | Release of the retaining ligaments and repositioning of skin, SMAS and midface fat as one flap | Moderate to advanced change across the midface, jawline and neck | 3–5 hours | 2–3 weeks | Commonly a decade or more |
What the surgery involves
Deep plane facelift surgery is performed under general anaesthesia and takes roughly 3–5 hours, longer when it is combined with eyelid surgery, a brow lift or fat grafting. The incision begins in the hairline at the temple, runs in front of the ear, curves around the earlobe and finishes behind the ear. In most cases it can be concealed within the natural contours of the ear and the hairline.
Once the composite flap is repositioned and secured, the skin is redraped without tension and the excess is removed. Fine sutures close the incision. Most patients go home the same day or stay one night, and a review appointment is booked within the first week for suture removal and wound checks.
Recovery: what to expect
Swelling and bruising are part of normal healing and are usually at their most noticeable in the first 72 hours. Most patients feel presentable again within two to three weeks, and the final result becomes apparent over the following months as residual swelling settles.
| Phase | What to expect |
|---|---|
| Days 1–7 | Rest with the head raised. Tightness, numbness of the cheeks and ears, bruising and swelling. Sutures are removed at 7–10 days. |
| Weeks 2–3 | Bruising largely settles. Return to office work and driving is common from about week two. Camouflage make-up can be used once the incisions have healed. |
| Weeks 4–6 | Light exercise resumes. Swelling continues to fade, particularly along the jawline. |
| Months 3–6 | Residual swelling resolves, scars soften and fade, and the final contour becomes visible. |
Risks and complications
Every facelift carries risk, and the decision to operate should rest on understanding the complications as much as on the expected benefit. Complications reported for facelift surgery include:
- haematoma, a collection of blood under the flap, the most common significant complication, reported in the region of 1–3% of cases in published series, which sometimes requires a return to theatre
- temporary weakness of branches of the facial nerve, which usually recovers over weeks to months; permanent nerve injury is rare
- infection and separation of the wound edges
- skin loss or delayed healing, which is markedly more likely in smokers
- widened or raised scars, and permanently visible scarring in a small number of patients
- asymmetry between the two sides
- prolonged swelling, firmness and numbness, which can take several months to settle
- the general risks associated with general anaesthesia
Smoking, certain medications and uncontrolled medical conditions all raise surgical risk. Patients are usually asked to stop smoking at least four to six weeks before surgery and to pause blood-thinning medication for the period advised at consultation.
Consultations for Rivonia patients
Rivonia sits in northern Sandton, with straightforward access from Rivonia Road and the N1 Western Bypass, so travel to appointments and post-operative reviews is manageable for most patients. At consultation, Dr Deon takes a full medical history, examines the face and neck, reviews photographs with you, and sets out which technique, or combination of techniques, fits your anatomy and goals. A written quotation is provided after the consultation, once the surgical plan is clear.
Patients who prefer to start remotely can complete the online consultation and photo review form, which allows a preliminary assessment before an in-person visit is arranged. As with any surgeon, you can verify registration with the Health Professions Council of South Africa before booking.
Frequently asked questions
What is a deep plane facelift?
A deep plane facelift lifts the deeper structures of the face. The surgeon releases the retaining ligaments and repositions skin, SMAS and midface fat as one composite flap, addressing sagging in the midface, jawline and neck rather than skin laxity alone.
How long does recovery take?
Recovery varies, but most patients have noticeable swelling and bruising for 1–2 weeks, return to work around two to three weeks, and see the final result within three to six months as the face settles.
How long do deep plane facelift results last?
Deep plane facelift results are commonly described as lasting a decade or longer. The face continues to age after surgery, and maintenance treatments can support the outcome, but the surgical correction itself is long-lasting.
Is the procedure painful?
The surgery is performed under general anaesthesia. Discomfort afterwards is usually described as tightness rather than sharp pain and is managed with prescribed analgesia in the first days.
Will there be visible scars?
Incisions follow the hairline and the natural creases around the ear, so they are well concealed. Scars fade over the first months, though a small number of patients form thicker scars.
How much does a deep plane facelift cost?
Cost depends on the technique used, theatre time, anaesthesia, whether other procedures are combined, and the facility. A written quote is provided after consultation, because no two surgical plans are identical.
To discuss whether a deep plane facelift suits you, phone 011 875 1694 and book a consultation with Dr Deon, or complete the online consultation and photo review form and the practice will respond with the next step.
Also Read:
- DEEP PLANE FACELIFT
- Natural Results Deep Plane Facelift Surgeon in Rosebank
- Premier Deep Plane Facelift Surgeon In Illovo
This information is general in nature and is not a substitute for personal medical advice. Surgical outcomes, recovery times and risks differ from patient to patient. Speak to a qualified medical practitioner about your own circumstances before making any treatment decision.
