Dr. Sam Lam Plastic Surgery Forum

there seems to be some folks prefering SMAS and some Deep plane.......is it true that deep plane is more invasive ,but much longer lasting.?

although i believe that many doctors use 'parts' from several precedures ,to achieve a successful result.!

Deep plane in my opinion is truly unnecessary nowadays for several reasons:

1. deep plane/composite flaps are better for lifting the eyelid and cheek complex. i truly think that area is overlifted nowadays. i believe that the upper and midface should be addressed through volume not lifting. remember that taking your fingers and pulling up on your cheek is NOT equal to a facelift. that is a skin pull. so don't lift your cheek and go, "Oh, I need a deep plane lift."
2. deep plane procedures do carry a higher risk but in experienced hands not that much more. the nerves are exposed in front of you, which i personally do not want to see (and as in point 1 do not believe you have to see).

I also do not believe in a standard SMAS lift anymore. I think the results do not hold as well. I perform a modified MACS lift in which the SMAS is supported in a purse string vertically (a more natural vector than posteriorly) to the zygomatic bone lining so that it does not slip. I also do a redundant suture to hold tissues better. My new textbook, Aging Face: The New Paradigm will focus on this lift among other new ways of looking at aging.