The preservation facelift or preservation deep plane facelift is a modern approach to facial rejuvenation that aims to maintain the natural facial anatomy while delivering aesthetic improvements. Traditional facelifts often involve more extensive dissection and repositioning of tissues, which can sometimes result in a less natural appearance. The preservation facelift, in contrast, is based on the principle of minimising the skin undermining and primarily working in a deeper plane to lift the face. By preserving the skin integrity, the technique achieves a youthful appearance while minimizing swelling and avoiding too much tension on the skin. This method also reduces trauma, which may contribute to quicker recovery times and a lower risk of complications.

What is the SMAS Layer?

The SMAS, or Superficial Musculoaponeurotic System, is a thin but strong fibromuscular layer located beneath the skin and subcutaneous fat of the face. It extends from the neck to the forehead, covering the muscles of facial expression, and is a key structure in facelift surgery. The SMAS connects to deeper facial tissues, creating a framework that supports the skin and soft tissues of the face. This layer plays a critical role in facial ageing, as it begins to sag and descend over time, contributing to jowls, deep nasolabial folds, and loss of cheek volume. Because it is tightly interwoven with facial ligaments and muscles, altering the SMAS can have a significant impact on facial contour and expression, making it a central target for various facelift techniques.

What is a SMAS Lift Facelift?

A SMAS lift facelift is a surgical technique that specifically targets the SMAS layer to rejuvenate the face. In a traditional SMAS facelift, the surgeon makes an incision in front of the ear, lifting the skin and underlying SMAS layer separately. The SMAS layer is then either folded, excised, or repositioned, depending on the surgeon’s preferred technique and the patient’s anatomy. By manipulating the SMAS, this technique can tighten the facial framework and restore a more youthful contour to the jawline, cheeks, and neck. This approach offers a balance between effectiveness and safety, making it a popular choice for facial rejuvenation.

What is a Deep Plane Facelift?

A deep plane facelift goes a step further than a traditional SMAS lift by releasing deeper attachments within the facial structure. In a deep plane facelift, the skin, SMAS, and deeper facial layers are lifted together as a single unit, rather than separating the skin from the SMAS layer. This unified approach allows for greater repositioning of the midface and cheeks, addressing more severe signs of ageing, such as deep nasolabial folds and cheek sagging. Because it provides a more comprehensive lift, the deep plane technique can achieve more dramatic and longer-lasting results. However, it is also more technically demanding and carries a slightly higher risk profile compared to simpler facelift methods.

What is the Difference Between a Deep Plane and SMAS Facelift?

The primary difference between a deep plane facelift and a SMAS lift lies in the depth of tissue manipulation:

• SMAS Facelift: Focuses on lifting and tightening the SMAS layer without disrupting deeper facial attachments. This technique is less invasive and suitable for patients with moderate facial sagging.
• Deep Plane Facelift: Lifts both the SMAS and deeper structures, such as the malar fat pad and retaining ligaments, as a single unit. This technique is ideal for patients with more pronounced midface sagging and jowling, as it allows for repositioning of deeper facial structures.

In general, the deep plane facelift can produce a more natural look, particularly in the midface and cheek region, while the SMAS lift is effective for targeting the jawline and neck.

What is the Preservation Deep Plane Facelift?

The Preservation Deep Plane Facelift is a refinement of the traditional deep plane facelift. It is designed to offer the same benefits—such as lifting and repositioning the deeper layers of the face—while minimizing the skin dissection. Traditional deep plane facelifts involve an extensive skin dissection which can result in reduced circulation to the skin, increased skin tension, higher risks of skin necrosis or swelling, need for drains and longer recovery.

The preservation deep plane technique, as the name suggests, focuses on minimizing the skin dissection. By preserving the skin integrity, this technique maintains a natural facial appearance and minimizes the risk of complications like unnatural contours, swelling, skin necrosis or need for drains.

Who Published the Paper on the Preservation Deep Plane Facelift?

The deep plane facelift technique was pioneered and described by Dr. Andrew Jacono, a prominent facial plastic surgeon based in the United States. Dr. Jacono has published several papers on this technique, highlighting its benefits and outcomes compared to traditional facelift approaches. His work has been influential in shaping contemporary facelift practices and has been featured in several prestigious journals and conferences. The preservation deep plane facelift was described and published by a group of well known plastic surgeons which includes Dr Ben Talei, Dr Mike Nayak and Dr Dominic Bray.

Why is the Preservation Deep Plane Facelift Better Than a Normal Deep Plane Facelift?

The Preservation Deep Plane Facelift offers several potential advantages over the traditional deep plane facelift:

1. Natural Results: By preserving some of the skin and minimizing it’s undermining, this technique helps maintain the natural facial harmony, minimizing the risk of an “overdone” or pulled look. It also helps reduce swelling and avoid the need for drains.
2. Reduced Trauma: Less disruption to the skin can result in lower trauma to the facial structure, which may contribute to quicker recovery times.
3. Improved Safety Profile: Preservation of blood supply to the skin can reduce the risks of skin necrosis.
4. Enhanced Longevity: While both techniques can achieve long-lasting results, the preservation deep plane facelift may offer improved support to the lifted tissues, potentially enhancing the durability of the results. This may be helpful for the mid face or marionette or nasolabial fold areas.

The decision between a traditional deep plane facelift and a preservation deep plane facelift depends on the patient’s anatomy, degree of facial ageing, and desired outcomes. Book your consultation with Mr Reza Nassab to find out more about this technique. Mr Nassab has had the privilege of working with Dr Mike Nayak and Dr Dominic Bray and observing their refinements in Deep Plane Facelifts.