Deep Plane Facelift Surgery Sydney, Australia

What Is the Deep Plane Technique?

Traditional facelift techniques work at the level of the skin and the surface of the SMAS layer. The SMAS is tightened through plication or excision, but the retaining ligaments that hold facial tissues in their descended position remain intact. The result is a lift that works around the underlying problem rather than correcting it.

The deep plane technique is different in a fundamental way. The dissection passes beneath the SMAS into the deep plane, where the facial retaining ligaments, the zygomatic, masseteric, and cervical ligaments, are identified and released. Once released, the SMAS and the soft tissue above it can be repositioned as a single composite unit, lifted vertically or obliquely rather than simply pulled back toward the ear.

Because the ligaments are released rather than worked around, the repositioning is more complete. The descended midface tissue, the cheek fat pads, the nasolabial soft tissue, can be moved back toward where it sat previously, rather than being tightened against structures that are still anchoring it in a lower position. The result tends to look different from a well-performed SMAS facelift. Not more surgical, in fact often less so, because the tissues are in their correct anatomical position rather than under tension.

What Deep Plane Facelift Addresses

Deep plane facelift surgery primarily addresses changes in the midface and lower face, with the neck frequently treated as part of the same procedure:

• Midface descent — sagging cheeks and flattening of the cheek prominence
• Jowling along the jawline
• Deep nasolabial folds running from the nose to the corners of the mouth
• Neck laxity, neck skin excess, and platysma banding
• Loss of the cervicomental angle — the jaw-to-neck transition

It does not directly address the upper face, brow descent, or eyelid concerns. Where these are also present, a brow lift or blepharoplasty may be discussed as a combined procedure. Where changes are more comprehensive across multiple facial zones, the Vertical Restore Facelift may be a more appropriate approach.

Deep Plane vs SMAS Facelift

The SMAS facelift is appropriate for patients with mild to moderate changes primarily in the lower face and jaw. The deep plane approach tends to provide more comprehensive correction, particularly where the midface has descended significantly. The right technique for a specific patient is determined at consultation based on their anatomy and the degree of change present.

For a full comparison, see deep plane vs SMAS facelift.

How the Surgery Is Performed

Deep plane facelift is performed under general anaesthetic at an accredited Sydney private hospital, with a specialist anaesthetist managing care throughout. Operating time is typically 3 to 5 hours depending on the scope of the procedure.

Incision placement. Incisions are positioned in the natural hairline and skin crease lines around and behind the ears. Careful placement means the incisions are not visible with normal hair styling. Where the neck requires treatment, a small incision beneath the chin is added.

Dissection. Skin is elevated in the superficial plane. The dissection then passes beneath the SMAS into the deep plane, where the zygomatic, masseteric, and cervical retaining ligaments are identified under direct vision and released.

Repositioning. The SMAS and the overlying composite tissue are lifted, primarily in a vertical direction, and secured to stable anatomical structures using permanent sutures. This vertical emphasis counteracts the downward vector of facial ageing.

Neck. The neck is frequently addressed through the same incisions. Through the facelift approach and the submental incision where needed, Dr Turner may address excess fat through neck liposuction, platysma muscle banding through formal platysmaplasty, and excess neck skin. For patients with more advanced neck changes, an extended deep plane approach incorporates release of the cervical retaining ligaments for integrated face and neck treatment in a single procedure. For more information on neck procedures, see neck lift.

Fat grafting. Deep plane facelift surgery may incorporate facial fat transfer to address volume that has depleted over time. Fat is gently harvested from a donor site, processed to isolate viable cells, and placed in areas that may benefit from volume correction. Not every patient requires fat grafting, and this is discussed at consultation.

Closure. Incisions are closed with fine sutures. A supportive dressing is applied. An overnight hospital stay is standard before discharge the following day.

The Preservation Deep Plane Approach

The Preservation Deep Plane Facelift is a refinement of the traditional deep plane technique that has emerged as part of the modern evolution of facelift surgery. It builds on the same underlying principles of deep plane dissection and retaining ligament release, but introduces specific modifications designed to reduce surgical dissection where possible and preserve natural tissue relationships that are disrupted in older facelift approaches.

The term “preservation” refers to what the technique deliberately does not do rather than what it adds. In a traditional deep plane facelift, the skin is separated from the underlying SMAS over a relatively wide area to allow the surgeon to reach the retaining ligaments and reposition the composite flap. In a preservation-style deep plane approach, the extent of this skin undermining is deliberately limited. Less skin is separated from the SMAS, which means the blood supply between the two layers remains more intact than it would with wider dissection. Preserving this blood supply may contribute to faster healing, less bruising, and a reduced risk of skin-flap complications, particularly in patients with thinner or less elastic skin.

A second defining feature of the preservation approach is the position of the high SMAS incision. Rather than entering the deep plane closer to the midline of the face (as with some traditional deep plane techniques), the preservation approach places the entry incision approximately 1.5 centimetres closer to the ear. From this more lateral entry point, the surgeon then dissects medially into the deep plane. Working outward from this position protects the medial portion of the malar fat pad, maintaining its anatomical connection to both the underlying SMAS and the overlying skin. The result is a composite flap with its natural tissue architecture more intact, which can contribute to a settled appearance that aligns with the patient’s original anatomy rather than a surgically altered one.

The preservation approach suits particular patient presentations rather than being a universal substitute for traditional deep plane technique. It may be appropriate for patients in their 40s to early 50s with mild to moderate facial changes, patients with good skin elasticity, patients who want a shorter recovery where clinically appropriate, and patients whose anatomical pattern of ageing suits a less extensive dissection. For patients with more advanced ageing, significant skin laxity, or a need for wider tissue mobilisation, a traditional or extended deep plane approach may produce more appropriate structural repositioning.

Individual recovery, longevity, and outcomes vary considerably between patients. The preservation approach is one technique within a spectrum of deep plane variations, each suited to different anatomical situations. Whether it’s appropriate in any specific case is assessed during consultation.

The Extended Deep Plane Approach

At the other end of the deep plane technique spectrum sits the Extended Deep Plane Facelift. Where the preservation approach deliberately limits dissection, the extended approach deliberately widens it, carrying the deep plane further than traditional deep plane dissection to address changes that extend beyond the lower face into the neck.

The defining anatomical feature of the extended deep plane technique is the release of a fourth retaining ligament group: the cervical retaining ligaments. Traditional deep plane dissection addresses three ligament groups (the zygomatic, masseteric, and mandibular ligaments) that tether the facial soft tissues to the underlying skeleton. The cervical retaining ligaments anchor the platysma muscle at the border of the sternocleidomastoid muscle in the neck. When these additional cervical ligaments are released, the SMAS of the face and the platysma of the neck can be moved together as a single continuous sheet, rather than being addressed as separate anatomical units.

This matters for patients whose concerns extend across both the face and the neck. A traditional deep plane facelift addresses the face and may include some neck work through a separate submental approach. An extended deep plane facelift integrates the two: the composite tissue flap lifted in the face continues into the neck, so the jawline, neck skin, and platysmal contour are repositioned as part of the same structural movement. For patients with significant neck laxity, platysmal banding, or a blurred transition between the jawline and neck, this integrated approach may produce a more coherent result than addressing face and neck separately.

The extended approach suits patients with ageing changes that extend across both the face and the neck, patients with significant platysmal banding or upper neck laxity, and patients whose overall pattern of change warrants the additional dissection. It is a more technically demanding operation than a traditional deep plane facelift and carries a correspondingly longer operating time and recovery.

For a detailed technical explanation of the Extended Deep Plane Facelift, including the anatomy of the cervical retaining ligaments, the full dissection sequence, and how the technique compares to traditional deep plane approaches, see our Extended Deep Plane Facelift guide.

Combining Deep Plane Facelift with Other Procedures

Deep plane facelift is frequently combined with complementary procedures in a single operation, reducing overall recovery time compared to staging separately:

• Upper blepharoplasty — addresses excess upper eyelid skin
• Lower blepharoplasty — addresses under-eye bags and lower eyelid skin
• Brow lift — corrects brow descent contributing to upper face heaviness
• Deep neck lift — for patients with more significant structural neck concerns
• Facial fat grafting — volume restoration in the midface and temples

For patients where changes span multiple facial zones from brow to neck, the Vertical Restore Facelift may be recommended as a single comprehensive approach rather than combining several individual procedures.

Are You a Suitable Candidate?

Candidacy for deep plane facelift depends on anatomy and the degree of structural change present, not chronological age. Most patients are between 45 and 70 years, though some younger patients with significant early descent benefit from this approach, and older patients in good health are also suitable candidates.

Deep plane facelift may be appropriate where:

• Significant midface descent, jowling, or nasolabial fold depth is present
• The degree of change warrants a more comprehensive structural approach
• The patient is a non-smoker or can cease all nicotine products at least six weeks before and after surgery — smoking significantly increases the risk of complications, particularly skin healing problems, due to the extent of tissue elevation involved

Dr Turner may advise against deep plane facelift or recommend an alternative approach where uncontrolled medical conditions increase surgical risk, where a less extensive approach is more appropriate for the degree of change, or where the patient’s expectations cannot be met through surgery.

Candidacy is determined through a comprehensive consultation assessment. Dr Turner does not make technique recommendations before examining the patient.

Considering Deep Plane Facelift Surgery in Sydney?

The right surgical approach depends on your individual anatomy, the degree of change present, and your personal goals. During a consultation with Dr Scott J Turner at his Bondi Junction or Manly clinic, you can discuss your concerns in detail, understand which technique may be most appropriate, and make an informed decision with the guidance of an experienced Specialist Plastic Surgeon.

Request a Consultation →

Recovery

Recovery from deep plane facelift is more involved than from mini or short scar approaches, reflecting the depth and scope of the surgery. Planning an appropriate recovery period before surgery is important.

Overnight hospital stay. An overnight admission is standard. Most patients are discharged the following morning.

Days 2 to 3. Swelling and bruising peak. Drains, if placed, are removed at the first post-operative visit.

Week 1 to 2. Sutures are removed at approximately one to two weeks. Bruising progresses through yellow-green and begins to resolve. Most patients are comfortable at home and managing independently.

Week 3. Most patients return to light social settings and desk-based work. Residual swelling and some firmness in the tissues is normal and expected.

Week 6 to 8. Exercise and strenuous activity can typically resume.

Months 3 to 6. Residual swelling continues to resolve. Sensation in the treated areas normalises progressively. The final result becomes fully apparent between three and six months as deep tissue healing completes.

For a comprehensive week-by-week guide, see recovery after facelift surgery.

Risks

Deep plane facelift carries the general risks of any surgical procedure performed under general anaesthetic, as well as specific risks associated with this technique. These include haematoma, temporary or permanent changes in skin sensation, infection, scarring, and in rare cases facial nerve complications. The deep plane technique works in close proximity to the facial nerve branches, which is one reason it requires specific surgical experience to perform safely.

Dr Turner discusses all risks in detail at consultation. For a comprehensive guide, see facelift risks and complications.

Cost

All-inclusive: surgeon, hospital stay, anaesthesia, and all follow-up appointments. A formal itemised quote is provided after consultation. For full pricing detail, see the facelift cost guide.

AHPRA Regulatory Requirements

Under AHPRA cosmetic surgery guidelines (effective 1 July 2023), the following apply before deep plane facelift surgery can proceed:

• A referral from your GP or a specialist physician
• A minimum of two consultations with Dr Turner before surgery is booked
• A psychological evaluation to confirm suitability
• A mandatory cooling-off period before formal consent is given

Related Procedures and Resources

Related procedures:

• Facelift Surgery Sydney
• Vertical Restore Facelift
• Neck Lift Sydney
• Deep Neck Lift
• Ponytail Facelift

Helpful guides:

• Deep Plane vs SMAS Facelift: What’s the Difference?
• Facelift Surgery Cost Sydney
• Recovery After Facelift Surgery
• Facelift Risks and Complications

Consult with Dr Scott J Turner

Dr Turner consults for deep plane facelift surgery in Sydney at Bondi Junction and Manly. He also sees patients in Brisbane, Canberra, and Newcastle. Surgery is performed in Sydney at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.

Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.