Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
If you’ve reached the point in your facelift research where you’re comparing deep plane facelift to Vertical Restore, you’re already past the initial decision of whether to address the SMAS layer or just the skin. Both techniques work beneath the SMAS. Both release retaining ligaments. Both are considered comprehensive approaches. The differences come down to scope, vector of lift, and how much of the face is addressed in a single operation. This guide covers what each technique is for, how they compare across the factors that actually affect your decision, and which patient profile each one suits.
I’m Dr Scott J Turner, a Specialist Plastic Surgeon (FRACS) at our Bondi Junction and Manly clinics in Sydney. I perform both deep plane and Vertical Restore facelift techniques. The choice between them is rarely about one being universally better. It’s about which approach matches your individual pattern of ageing.
The Anatomy Both Techniques Work With
Both deep plane and Vertical Restore facelift are built on the same anatomical foundation. Understanding it briefly helps the rest of the comparison make sense.
Beneath the skin sits a fibromuscular layer called the SMAS (Superficial Musculoaponeurotic System). It supports the cheek, jawline, and upper neck, and it’s continuous with the platysma muscle in the neck. Beneath the SMAS, fibrous bands called retaining ligaments anchor the deeper soft tissues to the underlying facial skeleton. With age, these ligaments stretch and weaken, allowing the tissues they were holding in place to descend.
Both techniques operate beneath the SMAS in the deep plane and release these retaining ligaments. That’s the shared territory. The differences begin in how far the dissection extends, what vector of lift is used, and which additional facial zones are addressed.
How Each Technique Works
Deep Plane Facelift
A deep plane facelift dissects beneath the SMAS into a deeper anatomical plane and directly releases three retaining ligament groups: the zygomatic ligaments at the cheekbone, the masseteric ligaments along the jaw muscle, and the mandibular ligaments along the jawline. Once released, the entire composite of skin, fat, and SMAS can be repositioned as a single unit.
The technique typically focuses on the lower two-thirds of the face: the midface (cheek descent and nasolabial folds), the lower face (jowls and jawline), and the upper neck. It can be extended into the neck through release of the cervical retaining ligaments where comprehensive face-and-neck correction is needed. Fat grafting is sometimes incorporated to address volume loss but is not a standard part of every deep plane operation.
The vector of lift in deep plane surgery can be horizontal, oblique, or vertical depending on the surgeon’s approach and the patient’s pattern of ageing. Modern deep plane technique has moved increasingly toward vertical or oblique vectors as understanding of facial ageing has improved.
Vertical Restore Facelift
The Vertical Restore Facelift uses deep plane dissection as a core component but extends the operation in two important ways.
First, the vector of lift is specifically vertical. Tissues are repositioned upward against the direction of gravitational descent rather than pulled laterally toward the ears or obliquely. This vertical vector is the defining feature the technique is named for. The anatomical reasoning is that the face ages predominantly in a downward direction, so the most direct correction is one that moves tissues back upward toward where they originated.
Second, the scope is broader. A standard deep plane facelift addresses the lower two-thirds of the face. The Vertical Restore addresses the full face: upper face (lateral brow and temple), midface (cheek and nasolabial fold), lower face (jowls and jawline), and neck (skin, platysma, submental fullness). It also typically incorporates fat grafting as a standard component to address age-related volume loss in the temples, midface, and undereye region. Where indicated, eyelid surgery and lip lift can be integrated into the same operation.
For the full procedure detail on each, see the Deep Plane Facelift page or the Vertical Restore Facelift page.
What Each Approach Addresses
The clearest way to understand the practical difference is to look at which facial zones each technique routinely addresses.
Deep plane facelift typically addresses: the midface (cheek descent, nasolabial folds), lower face (jowls, jawline definition), upper neck (where included), and marionette lines via the lower face component. It does not routinely address the brow, eyelids, upper lip, or comprehensive neck unless additional procedures are added.
Vertical Restore facelift addresses: all of the above, plus the upper face (lateral brow descent, temple hollowing), eyelids (where blepharoplasty is included), the upper lip (where lip lift is included), the full neck (skin, platysma, submental fat), and volume loss across the face via standard-included fat grafting.
For patients whose ageing is concentrated in the lower two-thirds of the face, a deep plane facelift produces appropriate correction without the additional scope (and additional recovery, additional cost) of a Vertical Restore. For patients whose changes extend to the brow, eyelids, full neck, or who have notable volume loss, a Vertical Restore addresses all of those concerns in a single operation rather than requiring multiple separate procedures over time.
Recovery: How They Compare
Recovery for both techniques is more substantial than for SMAS or mini facelift approaches. The differences between deep plane and Vertical Restore are smaller than the differences between either of these and a less extensive facelift, but they are real.
Deep plane facelift. Hospital stay is typically one night. Most patients can return to desk-based work around two to three weeks post-surgery, although bruising may still be visible. Social activities resume from three to four weeks. Light exercise from four weeks, demanding activity from six weeks. Subtle deeper swelling continues to settle over three to six months.
Vertical Restore facelift. Hospital stay is typically one to two nights, depending on the components included. The recovery profile is broadly similar to a deep plane facelift but tends to run a few days longer for patients having the full multi-component operation. Bruising can extend higher into the upper face when brow and eyelid components are included. Most patients return to desk-based work at two to three weeks, social activities at three to four weeks, demanding activity at six weeks. Final settling continues over three to six months with full results visible at twelve months.
The practical recovery difference is typically less than a week. The trade-off for that additional recovery is a single comprehensive operation rather than separate procedures spaced months or years apart.
Longevity: How Long Does Each Last?
Published clinical experience suggests both techniques produce durable structural change. The numbers are similar enough that longevity should not be the deciding factor between them.
Deep plane facelift. Some published series suggest twelve to fifteen years for deep plane techniques, particularly when combined with vertical or oblique vector repositioning.
Vertical Restore facelift. Similar published longevity range of approximately twelve to fifteen years for the structural component. The eyelid, brow, and lip components have their own separate longevity considerations.
Both techniques produce the kind of structural repositioning that lasts because the deep tissue change is substantial rather than tightening alone. What both share: the face continues to age after surgery. No facelift stops the ageing process. Stable weight, sun protection, non-smoking status, and good general health all influence how long either result remains visible.
Individual outcomes vary considerably based on starting anatomy, skin quality, bone structure, genetics, and lifestyle factors after surgery.
Risk: How Do They Compare?
Both techniques are performed by Specialist Plastic Surgeons under general anaesthesia in accredited hospitals. The technical complexity is similar (both involve deep plane dissection in proximity to facial nerve branches), and the published risk profiles are broadly comparable.
Common to both. Swelling, bruising, temporary numbness, sensation of tightness, haematoma risk, infection (uncommon with current protocols), unfavourable scarring, prolonged altered sensation, asymmetry, hair loss around incisions, and rare risks of any major surgery including deep vein thrombosis.
Where Vertical Restore carries a higher cumulative risk profile. Because the scope is larger, the operating time is longer, the anaesthesia exposure is greater, and the total surgical territory is wider. This is not a difference in technique safety; it is a difference in operative scope. A single comprehensive operation always carries a higher cumulative risk than a more limited operation, even when both techniques are well-performed.
Facial nerve risk. Both techniques involve dissection near the facial nerve branches. In experienced hands, the risk profiles are comparable. Published series report temporary facial nerve weakness in approximately 1 percent of cases for both deep plane and comprehensive facelift approaches, with permanent injury very rare.
Revision rates. Published revision rates for facelift surgery vary from approximately 5 to 15 percent depending on technique, follow-up length, and definition of revision used. Both deep plane and Vertical Restore sit within this range.
Cost: Vertical Restore vs Deep Plane in Australia
Cost reflects the scope and complexity of the operation. In the Australian market, Vertical Restore Facelift typically costs more than a standard deep plane facelift because the operation incorporates additional components: brow work, eyelid surgery, fat grafting, and full neck correction integrated into a single procedure.
For patients who would otherwise require separate operations to address brow, eyelid, midface, lower face, and neck concerns, the Vertical Restore consolidates those into a single recovery period. The total cost across all components is often comparable to (or less than) the cumulative cost of staged separate procedures, particularly when hospital and anaesthetic fees for multiple operations are factored in.
Specific costs are provided after consultation when the surgical plan has been confirmed. Costs typically include the surgeon’s fee, anaesthetist’s fee, hospital accommodation, and post-operative care. Medicare rebates do not apply to cosmetic facelift surgery, and private health insurance typically does not cover cosmetic procedures.
For procedure-specific cost detail, see the Deep Plane Facelift page or the Vertical Restore Facelift page.
Which Is Right for You? A Decision Framework
The choice between deep plane and Vertical Restore is rarely about one being universally better. It comes down to where your ageing concerns are concentrated and what scope of intervention fits your situation.
A deep plane facelift may be appropriate if:
Your ageing concerns are concentrated in the midface, lower face, and upper neck. Your brow position, eyelids, and forehead are still in reasonable position. You don’t have significant volume loss requiring fat grafting. You prefer a more focused operation that addresses your primary concerns without expanding into additional zones. You may want to address brow or eyelid changes separately at a later stage.
A Vertical Restore facelift may be appropriate if:
Your ageing changes extend across multiple facial zones (brow, midface, lower face, neck). Volume loss is part of what you want addressed (temples, midface, undereye). You have eyelid concerns alongside facial concerns and would prefer to address them in a single recovery period. You want the most comprehensive correction available in one operation. You’re comfortable with the additional recovery scope that comes with a more extensive operation.
A different technique may be more appropriate if:
Your changes are mild to moderate and primarily in the lower face (consider an SMAS Facelift, mini facelift, or lower facelift). You have very early changes concentrated in the upper face (consider a ponytail facelift). You’ve had previous facelift surgery and revision is needed (often a SMAS approach is preferred). Non-surgical options haven’t yet been explored and may be sufficient for your stage of ageing.
The right answer depends on your individual anatomy, assessed during consultation. For an overview of all facelift techniques Dr Turner performs, see the main facelift page.
Frequently Asked Questions
What is the difference between deep plane and Vertical Restore facelift? Both techniques work beneath the SMAS layer and release retaining ligaments to reposition deeper facial tissues. The differences are in scope and lift vector. A deep plane facelift typically addresses the lower two-thirds of the face (midface, lower face, upper neck) using horizontal, oblique, or vertical lift vectors depending on the surgeon. A Vertical Restore Facelift uses deep plane dissection but applies a specifically vertical vector of lift and addresses the full face (upper face, brow, eyelids, midface, lower face, and full neck) with fat grafting included as standard. The Vertical Restore is broader in scope; the deep plane is more focused.
How long does a Vertical Restore Facelift last? Published clinical experience suggests structural improvements from a Vertical Restore Facelift may last approximately twelve to fifteen years, depending on the technique specifics, individual patient factors, and lifestyle. Maintaining a stable weight, sun protection, non-smoking status, and good general health all contribute to how long the result remains visible. The face continues to age after surgery, so the result is a reset of the timeline rather than a permanent stop to ageing. Individual outcomes vary considerably.
Is a Vertical Restore Facelift a deep plane facelift? Yes, in the sense that the Vertical Restore uses deep plane dissection as a core surgical component. All Vertical Restore Facelifts are performed in the deep plane. The reverse is not true: not all deep plane facelifts are Vertical Restore facelifts. The term “Vertical Restore” specifically refers to the combination of deep plane dissection, vertical lift vector, and full-face scope including upper face, eyelids, lip, and integrated fat grafting. A standard deep plane facelift is more focused on the lower two-thirds of the face and may use any vector of lift.
Which costs more, deep plane or Vertical Restore facelift? In the Australian market, the Vertical Restore Facelift typically costs more than a standard deep plane facelift because it incorporates additional components: brow work, eyelid surgery, full neck correction, and fat grafting integrated into a single operation. For patients who would otherwise need separate operations to address all of these zones, the Vertical Restore can be comparable in total cost when hospital and anaesthetic fees for multiple separate procedures are factored in. Specific costs are provided after consultation.
Is recovery from Vertical Restore harder than deep plane facelift? Recovery profiles are broadly similar but Vertical Restore tends to run a few days longer because the scope of the operation is larger. Hospital stay is typically one night for deep plane and one to two nights for Vertical Restore. Most patients return to desk-based work at two to three weeks for either operation. The visible bruising distribution differs because the Vertical Restore extends into the upper face when brow and eyelid components are included. Demanding activity is typically cleared at six weeks for both. Final settling continues over three to six months with full results at twelve months.
Book a Consultation
If you’re comparing comprehensive facelift options and want an honest assessment of which approach fits your situation, book a consultation with me at our Bondi Junction or Manly clinic in Sydney. I also consult at clinics in Brisbane, Canberra, and Newcastle.
Please obtain a GP referral before your appointment. The consultation includes a detailed facial anatomy assessment, discussion of all facelift technique options (not only deep plane or Vertical Restore), realistic information about recovery and outcomes, and the mandatory two-consultation cooling-off process required under Australian cosmetic surgery law.
Contact our clinic on 1300 437 758 or email [email protected].
General information only, not medical advice. All surgery carries risk. Outcomes vary considerably between patients based on anatomy, skin quality, health factors, and individual response to surgery. Any decision about facelift surgery requires individual clinical assessment by a qualified health practitioner.
