August 25, 2026 | Facelift
7 minute read
Dr. Sean Delaney, Facial Plastic Surgeon
“Deep plane facelift” has become one of the most widely used—and sometimes misused—terms in facial plastic surgery. Patients may assume that it is simply a more aggressive facelift or that it automatically lifts every part of the face.
In reality, the term describes the tissue plane in which the surgeon operates. What the procedure improves depends on how far the dissection and ligament release extend, which areas of the face and neck are treated, and the patient’s individual anatomy.
A deep plane facelift can produce substantial improvements in the cheeks, jawline, jowls, the area under the chin, and the neck. However, it does not correct every sign of facial aging, and not all operations described as “deep plane facelifts” treat the same areas.
How Does a Deep Plane Facelift Work?
Beneath the skin is a supportive fibromuscular layer called the SMAS. In a deep plane facelift, the surgeon works beneath, or “deep” to, this layer and releases specific retaining ligaments that tether the facial tissues in place.
Once those ligaments have been released, the descended facial tissues can be repositioned as a more unified layer. The goal is to place tension on the deeper supportive tissues rather than relying on the skin to create the lift.
This approach can produce a natural-looking result because the skin, fat, and deeper facial tissues remain connected and move together. However, the term “deep plane” alone does not guarantee a particular result. The extent and location of the ligament release are just as important as the name of the technique.
1. Jowls and Loss of Jawline Definition
Improvement in the jowls and jawline is one of the most important—and often most noticeable—benefits of a deep plane facelift.
Jowls form as the tissues of the lower face descend across the jawline. Simply pulling on the skin may temporarily camouflage this, but it does not adequately address the deeper tissue descent.
By releasing the retaining ligaments of the lower face and repositioning the deeper tissues, a deep plane facelift can:
- Reduce the prominence of the jowls
- Restore a smoother, more continuous jawline
- Improve the transition between the lower face and neck
- Reduce heaviness around the corners of the mouth
The goal is not to create an unnaturally sharp or pulled jawline. It is to restore the cleaner facial contours that have become obscured by tissue descent.
2. Loose Skin Under the Chin
Patients frequently use the word “neck” to describe any looseness below the cheeks. Anatomically, however, loose skin immediately under the chin is different from laxity farther down the neck.
The area directly under the chin often cannot be adequately corrected with a small incision alone. Meaningful improvement usually requires the loose skin and deeper tissues to be redraped laterally toward the face.
This is why I generally recommend at least a lower facelift when submental laxity—the loose tissue immediately beneath the chin—is a major concern. Treating the lower face and neck together creates a smoother transition from the chin to the jawline and into the neck.
3. Neck Laxity and Platysmal Banding
A comprehensive deep plane facelift is commonly combined with a neck lift to improve loose neck skin, fullness beneath the chin, and visible platysmal bands.
The facelift component allows the skin and deeper tissues to be redraped laterally, while the neck-lift component addresses laxity beneath the chin and farther down the neck. Treating these areas together creates a smoother transition from the jawline into the neck.
In my practice, when I use the term “facelift,” I am generally referring to treatment of the lower face and neck together. The exact operation is then tailored to the patient’s anatomy.
4. Descended Cheeks and Midface Heaviness
An extended deep plane facelift can also reposition descended cheek tissue.
As the midface ages, the soft tissue over the cheek may descend, contributing to:
- Flattening of the upper cheek
- Heaviness in the lower cheek
- Deepening of the nasolabial folds
- A tired or elongated facial appearance
- Loss of a smooth transition between the cheek and lower face
During an extended deep plane facelift, the surgeon releases the retaining ligaments of the midface. This allows the descended cheek tissue to be repositioned toward its previous location over the cheekbone.
The procedure does not add volume in the way that filler or fat transfer does. Instead, it moves existing tissue into a more youthful position. Patients with true volume loss may still benefit from carefully selected fat transfer or another volume-restoring treatment.
5. Nasolabial Folds
An extended deep plane facelift can soften the nasolabial folds—the creases that run from the sides of the nose toward the corners of the mouth—particularly when those folds have deepened because of cheek descent.
However, a facelift should not be expected to erase them completely.
Nasolabial folds are normal anatomical structures. Their appearance is influenced by facial movement, skin quality, facial volume, skeletal support, and the natural attachments around the mouth. Completely eliminating them would require excessive tension and could create an unnatural appearance.
A realistic goal is to reduce the heaviness above the fold and soften the crease while preserving normal facial expression.
6. Marionette Lines and the Prejowl Area
By lifting the lower facial tissues and reducing the jowls, a deep plane facelift may also soften the marionette region and improve the hollow or depression in front of the jowl.
The amount of improvement varies. Deep, etched-in lines around the mouth are partly caused by skin changes and volume loss, not simply tissue descent. These areas may require complementary treatments such as fat transfer, filler, laser resurfacing, or chemical peeling.
Mini Deep Plane Versus Extended Deep Plane Facelift
Not every deep plane facelift includes a midface lift.
In my practice, a mini deep plane facelift is primarily designed to improve the lower face and neck. It includes release of the retaining structures along the cheek and jawline, but it does not substantially release or elevate the midface.
An extended deep plane facelift includes treatment of the midface in addition to the lower face and neck. Releasing the midface retaining ligaments allows the descended cheek tissue to be repositioned and can provide more meaningful improvement in cheek descent and nasolabial heaviness.
The appropriate operation depends on the patient’s anatomy:
- A patient with early jowling and neck laxity but relatively good cheek position may be well suited to a mini deep plane facelift.
- A patient with cheek descent, deeper nasolabial folds, jowling, and neck laxity may benefit more from an extended deep plane facelift.
“Mini” does not have to mean an abbreviated or superficial operation. It can be a targeted procedure that treats the lower face and neck while intentionally leaving the midface undisturbed.
What Does a Deep Plane Facelift Not Improve?
A deep plane facelift can reposition descended tissue, but it does not directly correct every component of facial aging.
It does not, by itself, substantially improve:
- Forehead or brow descent
- Upper or lower eyelid aging
- Fine lines and wrinkles
- Sun damage or pigmentation
- Enlarged pores or uneven skin texture
- Dynamic wrinkles caused by facial muscle movement
- Lip shape or lip volume
- Significant facial volume loss
These concerns may require other procedures, such as a brow lift, blepharoplasty, fat transfer, laser resurfacing, chemical peeling, neuromodulators, or carefully selected injectable treatments.
This is why facial rejuvenation should begin with an anatomical assessment rather than the name of a particular technique.
The Bottom Line
A deep plane facelift primarily improves tissue descent. Depending on the extent of the operation, it can restore the cheeks, reduce jowling, define the jawline, tighten the area beneath the chin, and improve neck laxity.
An extended deep plane facelift also addresses midface and cheek descent, while a mini deep plane facelift may focus primarily on the lower face and neck.
The goal is not to change the patient’s identity or pull the skin tightly. It is to reposition the deeper facial tissues, restore more youthful contours, and help the face look refreshed while still looking natural.
Ultimately, the most important question is not simply whether a surgeon performs a “deep plane facelift.” It is which retaining ligaments are released, which anatomical areas are being treated, and whether that particular operation matches the patient’s concerns.
