This guide walks through the recovery timeline in clinical detail, drawing on the published literature on deep plane face lifts and the practice’s postoperative protocol. It also explains the trade-offs of a deep plane lift versus a SMAS plication or skin-only face lift, so you can decide whether the deeper dissection is right for your anatomy and your downtime tolerance.

What is a Deep Plane Facelift and How Does It Differ from Other Face Lift Techniques?

A deep plane facelift is a face lift technique in which the surgeon enters a plane beneath the SMAS and releases the facial retaining ligaments. By freeing these ligaments, the deeper tissues can be repositioned as a single unit, which is what gives the lift a more natural appearance at the midface, jawline, and neck compared with skin-only or SMAS plication techniques. The skin is then re-draped without tension, which also tends to produce a more durable result.

Other common face lift approaches include:

Skin-only face lift. Tension is placed on the skin alone. Recovery is the shortest, but the result tends to relapse sooner and the skin can look pulled.
SMAS plication or SMASectomy. The SMAS is folded or trimmed and sutured. This tightens the deeper layer without a sub-SMAS dissection. Downtime is shorter than a deep plane lift but the lift at the midface and neck is generally less pronounced.
Extended SMAS or high SMAS. The dissection stays just above the deep plane and addresses a longer flap. It is a middle-ground option between SMAS plication and a true deep plane release.
Deep plane facelift. The dissection enters the sub-SMAS plane and the retaining ligaments are released. The lift is carried by the deeper tissues, not the skin, which is the main reason recovery is slightly longer and the result is more durable.

Because the deep plane lift releases structures that other techniques leave intact, patients should expect more early swelling and a longer period before the final contour is visible. The benefit is that the lift, particularly at the nasolabial fold, jowls, and neck, tends to last well into the second decade after surgery.

Deep Plane Facelift Recovery Timeline at a Glance

The table below summarises the typical recovery milestones after a deep plane facelift. Times are approximate and vary with age, skin quality, smoking status, and whether adjunct procedures (blepharoplasty, brow lift, fat grafting, chemical peel) were performed at the same time.

Time after surgery	What is happening	What you can usually do
Day 1 to 3	Drains in place, swelling and bruising peak at 48 to 72 hours, mild to moderate discomfort controlled with prescribed analgesia.	Rest at home, walk short distances, head elevated, soft diet.
Day 5 to 7	Drains removed, sutures or staples reviewed, bruising begins to fade.	Light indoor activity, no bending or lifting.
Week 2	Most visible bruising has settled, residual swelling around cheeks and neck.	Return to desk-based work, light social outings with makeup.
Week 3 to 4	Swelling continues to reduce, incisions begin to mature.	Light cardiovascular exercise, scar care starts.
Week 6	About 70 to 80 percent of swelling has resolved.	Most exercise resumed, no-contact sport.
3 months	Final contour is visible, scars mature and flatten.	Unrestricted activity, scar protection with sunscreen.
6 to 12 months	Incisions fully mature, sensation normalises.	Long-term review and photography comparison.

Day 1 to 7: The First Week of Deep Plane Facelift Recovery

Immediately After Surgery

A deep plane facelift is performed under general anaesthesia administered by a specialist anaesthetist, so you are asleep throughout the procedure. In most cases it is done as a day case or with one overnight stay at the facility. On waking you will have a soft dressing around the face, small drains exiting behind the ear, and swelling that is already noticeable at the cheeks, jawline, and neck.

Drains are usually removed at day 1 to 3, once output is below about 30 ml per 24 hours. You will be discharged with:

Prescribed analgesia and a short course of antibiotics.
A compression garment or chin strap to wear as directed.
Written wound care instructions.
A follow-up appointment within the first week.

Swelling and Bruising in the First 48 to 72 Hours

Swelling and bruising are expected after a deep plane lift and are usually most visible at 48 to 72 hours. They tend to settle in the order: cheeks first, then periorbital area, then neck. Cold compresses applied for 20 minutes on and 20 minutes off during the first 48 hours, sleeping with the head at roughly 30 degrees elevation, and avoiding bending or straining all help to keep swelling within the expected range.

Pain is typically mild to moderate in the first week. Most patients describe a tight, full sensation rather than sharp pain, and this is usually well controlled with the prescribed analgesia. If pain increases after day 3 rather than decreasing, contact the practice, as this can be a sign of haematoma (around 1 to 3 percent in published series) or infection.

Incision and Wound Care

Incisions for a deep plane facelift are placed in front of and behind the ear, sometimes extending into the temporal hairline and into the posterior hairline at the neck. They are closed in layers with fine sutures and, in some areas, surgical glue or staples. You will be shown how to clean the incisions, when to apply ointment, and what signs to look for (increasing redness, discharge, or wound separation).

Keep incisions dry for the first 48 hours, then clean gently as directed. Avoid hair dye or harsh chemical treatments on the scalp for at least 4 weeks, and avoid pulling clothing over the head for the first 2 weeks to protect the preauricular incisions.

Week 2 to 4: Continued Healing and Return to Normal Activities

Reduction in Swelling and Bruising

By the end of the second week most visible bruising has faded and the swelling has settled enough that close friends and colleagues tend not to comment. Residual firmness and fullness are still present, particularly at the jawline and neck, and will continue to refine over the next 6 to 12 weeks. Numbness around the cheeks, ears, and neck is common in this phase and usually improves steadily over 3 to 6 months as the sensory nerves regenerate.

Returning to Work and Light Activity

Most patients return to desk-based work at 10 to 14 days. You can usually drive once you are off strong analgesia and can move your neck comfortably, typically at the end of week 2. Light cardiovascular exercise (walking, stationary cycling) is generally allowed from week 3, with a gradual increase from week 4. Heavy lifting and high-impact exercise are deferred until about week 6.

Scar care begins once the incisions are fully closed and any scabs have lifted. This usually means:

Silicone-based scar gel or sheeting from week 3 to 4 for 12 hours a day.
Daily sunscreen (SPF 50+) on all incisions for at least 12 months.
Avoiding direct sun exposure to the scars in the first 3 months.

Week 6 to 12: Final Stages of Deep Plane Facelift Recovery

When the Final Result Becomes Visible

At 6 weeks roughly 70 to 80 percent of the swelling has resolved and most patients feel comfortable in public without explanation. The lift at the midface, jowls, and neck is clearly visible. By 3 months the result is close to final, although subtle changes continue for up to 12 months as the deeper tissues fully settle.

Resuming Full Exercise and Physical Activity

Most patients return to full exercise at 6 weeks, including running, gym work, and swimming. Contact sport and activities with a risk of facial impact (rugby, squash, martial arts) are usually deferred for 3 months. Saunas, steam rooms, and very hot yoga should be avoided for the first 4 to 6 weeks to limit swelling.

If you have had an adjunct procedure, recovery times are adjusted accordingly:

Blepharoplasty. Add roughly 1 to 2 weeks for periorbital bruising to settle.
Brow lift. Forehead numbness can take 3 to 6 months to normalise.
Fat grafting. The grafted areas can look fuller for 6 to 8 weeks before settling.
Chemical peel or laser resurfacing. Plan for 2 to 3 weeks of visible skin recovery on top of the face lift recovery.

Long-Term Considerations After a Deep Plane Facelift

A deep plane facelift does not stop the clock. Most patients can expect the result to look refreshed for 10 to 15 years, after which the natural ageing process continues. Factors that influence how long the result lasts include skin quality, sun exposure history, smoking status, weight stability, and genetics.

Long-term care focuses on:

Daily sunscreen. UVA and UVB protection on the face, ears, and neck every day.
Skincare. A retinoid, vitamin C, and moisturiser routine, tailored to your skin type.
Lifestyle. Avoiding smoking, limiting alcohol, and maintaining a stable weight.
Non-surgical maintenance. Injectables, skin boosters, and energy-based devices can be used from 3 months onward to support the surgical result.

You can see representative before and after photographs in the practice’s deep plane facelift gallery and the deep plane facelift procedure overview.

Risks and Complications of Deep Plane Facelift Surgery

Any surgical procedure carries risk. The risks specific to a deep plane facelift are well documented in the published literature and include:

Haematoma. A collection of blood under the skin, reported in roughly 1 to 3 percent of face lifts. It is more common in men and in patients on anticoagulants. Small haematomas are managed conservatively; larger ones may need to be drained in theatre.
Nerve injury. The marginal mandibular and temporal branches of the facial nerve run close to the dissection plane. Temporary weakness is reported in roughly 1 to 2 percent of cases and usually recovers over weeks to months. Permanent facial nerve injury is rare, in the order of 0.1 to 0.5 percent.
Skin necrosis. Compromised skin healing, most often behind the ear in smokers. Stopping smoking at least 4 weeks before and after surgery reduces this risk significantly.
Infection. Reported in under 1 percent of face lifts. It usually presents at day 5 to 10 and is treated with antibiotics and, where needed, local wound care.
Hypertrophic or wide scars. Scars are placed in hidden areas, but individual healing varies. Silicone therapy, steroid injections, or scar revision can be considered once the scar has matured at 12 months.
Asymmetry, contour irregularity, and prolonged numbness. Most settle with time. Persistent contour issues can be addressed with revision at 12 months.

The practice’s deep plane facelift Cape Town page explains how Dr Deon mitigates these risks, including preoperative medical optimisation, intraoperative nerve monitoring where appropriate, and a structured follow-up schedule.

How to Prepare for Deep Plane Facelift Surgery

Preparation has a direct effect on recovery. The standard pre-op checklist is:

Stop smoking. Ideally 6 to 8 weeks before surgery and 4 weeks after. Nicotine impairs blood flow and increases the risk of skin necrosis.
Review medications. Aspirin, clopidogrel, NSAIDs, and certain supplements (fish oil, garlic, ginkgo, vitamin E in high doses) increase bleeding risk and are usually stopped 7 to 10 days before surgery, under your prescribing doctor’s guidance.
Optimise nutrition. Protein, vitamin C, and zinc support wound healing. Good hydration in the week before surgery also helps with anaesthetic recovery.
Plan your environment. A recliner or extra pillows for sleeping upright, easy-to-prepare meals, and help at home for the first 5 to 7 days.
Pre-op investigations. Routine bloods and, depending on age and medical history, an ECG or further workup. The practice will provide a list in advance.

When to Contact the Practice During Recovery

Routine swelling, bruising, and numbness are expected. You should contact the practice on 011 875 1694 if you experience any of the following:

Sudden increase in swelling or pain after day 3.
Heavy bleeding from an incision.
Fever above 38 degrees Celsius.
Spreading redness, warmth, or pus at an incision.
New facial weakness or asymmetry.

If you are unsure, contact the practice rather than waiting. Early review is the rule for any face lift patient.

Booking a Deep Plane Facelift Consultation

A consultation with Dr Deon is the first step. It includes a full facial analysis, review of your medical history, photography, and a discussion of the technique best suited to your anatomy, whether that is a deep plane lift, an extended SMAS lift, or a non-surgical alternative. The consultation can be done in person in Century City or remotely via the online consultation and photo review.

You will receive a written quote after the consultation, which includes the surgical fee, anaesthetic fee, facility fee, and follow-up visits. Dr Deon is registered with the Health Professions Council of South Africa (HPCSA) as a specialist plastic surgeon.

Frequently Asked Questions About Deep Plane Facelift Recovery

FAQ

How long does swelling last after a deep plane facelift?

Most visible swelling has resolved by 2 to 3 weeks. Roughly 70 to 80 percent is gone by 6 weeks, and the final contour is close to settled at 3 months. Subtle refinement continues for up to 12 months.

When can I return to work after a deep plane facelift?

Most patients return to desk-based work at 10 to 14 days. If your work is physically demanding or involves public-facing contact, plan for 3 weeks.

When can I exercise after a deep plane facelift?

Light cardio is usually allowed from week 3. Heavy lifting, running, and gym work resume at around week 6. Contact sport is deferred for 3 months.

How painful is a deep plane facelift?

Pain is usually mild to moderate in the first week and is well controlled with prescribed analgesia. Most patients describe a tight, full sensation rather than sharp pain.

When will I see the final result?

You will look presentable at 2 to 3 weeks and see a clear improvement at 6 weeks. The result is close to final at 3 months and fully settled by 12 months.

How long does a deep plane facelift last?

Published data and the practice’s experience suggest a deep plane lift looks refreshed for 10 to 15 years. Lifestyle, skin quality, and genetics all influence this.

Is a deep plane facelift safe?

When performed by a specialist plastic surgeon registered with the HPCSA, a deep plane facelift is a well-established procedure. The risks (haematoma, nerve injury, skin necrosis, infection) are well described and managed with a structured pre-op and post-op protocol.

Can I have other procedures at the same time?

Yes. Blepharoplasty, brow lift, fat grafting, and skin resurfacing are commonly combined with a deep plane facelift. Recovery is staged, and the practice will outline the additional downtime in advance.

Do I need to stay in hospital?

Most deep plane face lifts are done as a day case or with one overnight stay. Longer stays are arranged if you live far from Cape Town or have additional medical considerations.

Where is the surgery performed?

The procedure is performed at an accredited day-case facility in Century City, Cape Town, under general anaesthesia administered by a specialist anaesthetist.

Also Read:

This article is for general information only and does not substitute for a medical consultation. Surgical outcomes and recovery vary between patients. Book a consultation with Dr Deon, registered with the HPCSA, to discuss your individual case.

Talk to Dr Deon

Deep Plane Facelift Recovery in South Africa: Timeline and What to Expect