--- title: "What Is an Extended Deep Plane Facelift?" url: https://drturner.com.au/blogs/what-is-an-extended-deep-plane-facelift/ date: 2025-12-26 modified: 2026-07-26 author: "Dr Scott J Turner" description: "Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) Key Takeaways An extended deep plane facelift carries the deep plane dissection beyond the face and into the neck, releasing a..." categories: - "Facelift" tags: - "deep plane facelift" - "Extended Deep Plane Facelift" - "Facelift" - "facelift surgery" image: https://drturner.com.au/wp-content/uploads/2024/04/blogplaceholder-img.svg word_count: 2307 --- # What Is an Extended Deep Plane Facelift? *[Dr Scott J Turner](https://drturner.com.au/dr-scott-turner-sydney-plastic-surgeon/) | Specialist Plastic Surgeon (FRACS)* > **Key Takeaways** An extended deep plane facelift carries the deep plane dissection beyond the face and into the neck, releasing a fourth retaining ligament group so the SMAS of the face and the platysma of the neck move as one continuous sheet. It is not an upgrade on standard deep plane surgery but a match for a particular pattern of ageing: change spanning the lower face and neck together. Where the neck is not significantly involved, the standard operation is the better-matched procedure. Operating time is typically four to six hours, and suitability is assessed individually. The extended deep plane facelift is a technical refinement of standard [deep plane facelift](https://drturner.com.au/procedures/face/deep-plane-facelift/) surgery that takes the dissection further into the neck and addresses an additional retaining ligament group. Queensland patients can read the [Brisbane deep plane facelift](https://drturner.com.au/locations/brisbane/deep-plane-facelift/) page for the equivalent consultation information. The defining anatomical concept is straightforward. The SMAS in the face and the platysma muscle in the neck are addressed as a single continuous tissue sheet rather than as separate zones. For patients whose ageing extends across the lower face, jawline and neck together, this integrated approach can produce a more coherent transition between those zones than addressing them through separate dissections. This guide covers the anatomy, how the extended technique differs from standard deep plane, who it suits, what it does not address, and how recovery compares. The broader range of options sits on the [facelift surgery](https://drturner.com.au/procedures/face/facelift/) page. ## The Anatomy Behind the Technique Beneath the skin sits a fibromuscular layer called the SMAS, the Superficial Musculoaponeurotic System, which supports the cheek, jawline and upper neck. The SMAS transitions into the platysma muscle in the neck, so anatomically the two are continuous, like a single tissue sheet wrapping from the face down into the neck. Older techniques tended to treat them as separate structures; modern technique increasingly recognises them as one unit. Beneath the SMAS, fibrous bands called retaining ligaments anchor the deeper soft tissues to the facial skeleton and cervical fascia. Four groups matter in facelift surgery. The zygomatic ligaments connect the malar fat pad to the cheekbone. The masseteric ligaments run along the front border of the jaw muscle. The mandibular ligaments sit along the lower jaw. The cervical retaining ligaments anchor the platysma at the border of the sternocleidomastoid muscle in the neck. Standard deep plane facelift releases the first three groups. Extended deep plane adds release of the fourth. That single anatomical extension is what defines the technique. ## How Extended Differs From Standard Deep Plane Both techniques share the same principle: dissect beneath the SMAS, release the retaining ligaments, and reposition the composite of skin, fat and SMAS as a single unit. The differences are in scope and continuity. **Three ligaments versus four.** Standard deep plane releases three facial ligament groups and focuses on the lower two-thirds of the face, addressing the neck separately or not at all. Extended deep plane releases the same three plus the cervical retaining ligaments, carrying the dissection from face into neck as one continuous operation. **SMAS and platysma as a single sheet.** Once the cervical ligaments are released, the whole SMAS-platysma sheet mobilises as one unit, so the face and neck no longer need separate vectors. That produces a more continuous transition between jawline and neck than two separate dissections tend to. **Vector of repositioning.** With the cervical ligaments released, the composite flap can be repositioned in whichever direction best opposes the patient's pattern of descent, usually a vertical or slightly oblique vector, with the neck moving alongside the face on the same axis. **Submandibular gland support.** A refinement of the technique is a platysmal hammock that supports a descended submandibular gland from beneath, holding it in better position without removing the gland itself. This is a relatively recent development in deep plane surgery, and it differs meaningfully from older approaches that excised gland tissue. ## How the Procedure Is Performed The operation is performed under general anaesthesia in an accredited private hospital. Operating time is typically four to six hours, with a hospital stay of one or two nights. The standard facelift incision is used, from the temporal hairline, around the ear and into the posterior hairline, along with a small incision under the chin to access the central platysma and deep neck. The extended approach does not require longer incisions than a standard deep plane operation. Through these incisions, the surgeon enters the plane beneath the SMAS, releases the three facial ligament groups, then continues into the neck to release the cervical retaining ligaments at the border of the sternocleidomastoid, which is what allows the SMAS and platysma to move together. Through the chin incision, the central platysma is addressed: platysmaplasty in the midline, creation of the platysmal hammock for gland support, and treatment of subplatysmal fat or the digastric muscles where indicated. Once the four ligament groups are released, the composite of skin, fat, SMAS and platysma is repositioned, redundant skin is trimmed without tension, and the incisions are closed in layers, sometimes with drains for the first 24 to 48 hours. Fat grafting, eyelid surgery, brow procedures or a lip lift can be combined where indicated. ## What It Addresses The technique is designed for ageing that spans both the face and the neck: jowls and loss of jawline definition where descent is moderate to advanced, loss of the cervicomental angle, platysmal banding, upper and mid-neck skin laxity, submandibular gland prominence where soft-tissue support can help, midface descent, deepening nasolabial folds and marionette lines, repositioning these zones in one coordinated movement. ## What It Does Not Address Worth being equally clear about the limits. **The upper face.** The technique does not routinely address the brow, forehead or eyelids. Where ageing extends there, brow lift, blepharoplasty or fat grafting may be combined at the same operation, or those zones addressed separately. **Skin quality.** Ligament release repositions structure. It does not change skin texture, pigmentation, fine surface lines or sun damage, all of which need skin-directed treatment regardless of what happens underneath. **Skeletal limits on neck contour.** Soft tissue sits on a framework the operation does not modify. Hyoid bone position in particular sets a ceiling on the cervicomental angle achievable: a low or forward-set hyoid limits the sharpness of the neck angle no matter how thoroughly the cervical ligaments are released. Chin projection works the same way. Two patients having identical operations can finish with different neck contours for this reason, which is why assessment includes the skeletal landmarks and not only the soft tissue. **The trade-off itself.** The additional dissection is not a free gain. It adds operating time, extends the tissue territory involved and tends to produce more bruising in the neck. Where the neck is not significantly involved, that is cost without corresponding benefit. ## Who May Be Suitable The technique may suit patients whose ageing spans the lower face and neck together, where correcting only one zone would leave a mismatch: significant jowling combined with neck laxity or platysmal banding, loss of the cervicomental angle, or submandibular gland prominence where soft-tissue support could help. Most candidates are in their 50s to 70s, though the pattern of anatomical change matters more than age. Suitability also depends on good general health, cessation of all nicotine products for a minimum of six to eight weeks before surgery and throughout recovery, stable weight and realistic expectations. It may not be the right choice where changes are concentrated in the lower face without significant neck involvement, where ageing is very early, or for patients seeking a shorter recovery. In those situations a standard deep plane operation is the better-matched procedure rather than a lesser one, and choosing the broader operation means accepting additional scope without a corresponding gain. ## Recovery and Longevity Recovery is broadly similar to standard deep plane facelift, with slightly greater operating time and tissue territory. Hospital stay is one or two nights. Most patients return to desk-based work around two to three weeks, though bruising may still be visible in the upper neck and jawline. Social activities typically resume from three to four weeks, light exercise from four weeks and more demanding activity from six weeks. Deeper swelling continues settling over three to six months, with the settled appearance at around twelve months. Bruising tends to be more prominent in the neck than after a standard deep plane operation, because the dissection extends further. On longevity, published clinical experience suggests structural improvements may hold for a number of years, with some series reporting longer durability than more limited techniques. These are reported ranges rather than guarantees. No facelift stops the ageing process, and how long a result remains visible depends on technique specifics, anatomy, skin quality, weight stability, sun exposure, smoking status and general health. The [how long does a facelift last](https://drturner.com.au/blogs/maintain-facelift-results/) guide covers what influences it, and the [recovery after facelift](https://drturner.com.au/blogs/recovery-after-facelift/) guide covers the timeline in more detail. ## Risk Considerations All facelift surgery carries risk. Being more extensive than standard deep plane, the extended approach has a slightly higher cumulative profile in operating time and tissue territory, though published complication rates are broadly similar. Risks common to both include swelling, bruising, temporary numbness, haematoma, infection, unfavourable scarring, prolonged altered sensation, asymmetry, and the rare risks attaching to any major surgery. Both techniques involve dissection near the facial nerve branches. Published series report temporary facial nerve weakness in around one percent of cases for both standard and extended deep plane, with permanent injury very rare. The extended approach adds a consideration around the marginal mandibular and cervical branches near the platysma. Where the platysmal hammock is created, the submandibular gland is repositioned rather than removed, which is an important distinction from older techniques that excised gland tissue. Published facelift revision rates range from approximately 5 to 15 percent, and extended deep plane sits within that range. The [risks and complications after facelift surgery](https://drturner.com.au/blogs/risks-and-complications-after-facelift-surgery/) guide covers the fuller picture. ## How It Compares With Other Options **Versus standard deep plane.** Extended deep plane is the broader operation, releasing four ligament groups instead of three. Where significant neck involvement accompanies facial concerns, it provides integrated correction. Where the concern is facial without significant neck laxity, standard deep plane is the appropriate operation, and the extended version would add scope for no additional benefit. **Versus vertical restore facelift.** Both use deep plane dissection. The [vertical restore facelift](https://drturner.com.au/procedures/face/vertical-facelift/) extends the operation upward into the brow, temple, eyelids and lip with fat grafting as standard, while the extended deep plane extends it downward into the neck. The [deep plane vs vertical restore comparison](https://drturner.com.au/blogs/deep-plane-vs-vertical-restore-facelift/) covers the distinction. **Versus deep neck lift alone.** Patients with neck concerns but limited facial ageing may be better suited to a standalone [deep neck lift](https://drturner.com.au/procedures/face/deep-neck-lift/). Where both need addressing together, the extended deep plane integrates both. **Versus SMAS facelift.** [SMAS facelift](https://drturner.com.au/procedures/face/smas-facelift/) techniques work at the SMAS layer without the same ligament release. For mild to moderate lower-face ageing they may suffice with shorter recovery. The [deep plane vs SMAS comparison](https://drturner.com.au/blogs/difference-between-deep-plane-and-traditional-facelifts/) covers where each fits, and neither approach is universally better. ## Frequently Asked Questions **What is an extended deep plane facelift?** It is a refinement of standard deep plane technique that releases an additional retaining ligament group, the cervical retaining ligaments, and carries the dissection from the face down into the neck as one continuous operation. The defining concept is that the SMAS in the face and the platysma in the neck are addressed as a single continuous tissue sheet rather than as separate zones, which can produce a more coherent transition for patients whose ageing spans both regions. **How is it different from a standard deep plane facelift?** Standard deep plane releases three retaining ligament groups in the face: zygomatic, masseteric and mandibular. Extended deep plane releases those three plus the cervical retaining ligaments, which anchor the platysma in the neck. That fourth release allows the SMAS and platysma to be repositioned together rather than as separate units. It is a broader operation matched to a broader pattern of ageing, not a better version of the same one. **What are the four retaining ligaments released?** The zygomatic ligaments, connecting the malar fat pad to the cheekbone; the masseteric ligaments, along the front border of the jaw muscle; the mandibular ligaments, along the lower jaw; and the cervical retaining ligaments, anchoring the platysma at the border of the sternocleidomastoid muscle. Standard deep plane releases the first three; extended deep plane adds the fourth. **How long is recovery?** Hospital stay is typically one or two nights. Most patients return to desk-based work around two to three weeks, though bruising may still be visible in the neck and jawline. Social activities typically resume from three to four weeks, light exercise from four weeks and more demanding activity from six weeks, with the settled appearance at around twelve months. Bruising tends to be more prominent in the neck than after standard deep plane surgery because the dissection extends further. Individual recovery varies considerably. **Who is a suitable candidate?** Typically patients whose ageing spans the lower face and neck together, including significant jowling with neck laxity or platysmal banding, loss of the cervicomental angle, or submandibular gland prominence where soft-tissue support could help. Most are in their 50s to 70s, though the pattern of change matters more than age. Candidates also need good general health, complete nicotine cessation and realistic expectations. Where the neck is not significantly involved, a standard deep plane operation is usually the better match. --- If you're weighing a standard against an extended approach, the deciding factor is whether your neck is part of the picture, which an examination establishes. Dr Scott Turner consults in Sydney and Brisbane. For clinic information and the consultation pathway, visit the [Sydney clinic](https://drturner.com.au/locations/sydney-clinic/) or [Brisbane clinic](https://drturner.com.au/locations/brisbane/), or [contact the practice](https://drturner.com.au/contact-us/) to arrange a consultation.