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Understanding the Deep Plane High SMAS Facelift | The Artist in the O.R. with Dr. Spiro, MD, FACS

Spiro Plastic Surgery · 2026-03-09 · 16 minutes

From the channel

Facelift techniques are widely discussed, but terms like “Deep Plane” and “High SMAS” are often misunderstood. In this episode of Artist in the O.R., Dr. Scott Spiro breaks down what the Deep Plane High SMAS facelift actually means and why working beneath the surface of the face can produce more natural, lasting results. From explaining why faces age the way they do to walking through the deeper l

Deep-plane facelift

A deep-plane facelift releases the ligaments that hold the cheek down and lifts the skin, cheek fat and underlying muscle layer together as one flap, to treat sagging cheeks, jowls and a soft jawline. Hamra described the operation in 1990, and no study since has shown that it lasts longer than other SMAS facelifts.

The technique, its anatomy and the papers behind it

New research on deep plane facelift

Recent studies on the subject of the video, each with a plain summary where one is written.

2026
Conservation facelift: The mesoface
Quinodoz P, Scampa M, Belhaouari L · JPRAS Open · PMID 42630822 · Plain summary
2026
Tunneled Deep-plane Lift: A Novel Approach to Lower Facial and Neck Laxity
Stanford N, Ramírez B, Varela A · Plast Reconstr Surg Glob Open · PMID 42719910 · Plain summary
2026
Deep Plane Facelifts: A Systematic Review and Meta-Analysis of Outcomes
Koroma P, Reji N, Burridge I, Shah M, Gopi P, Lee K, et al. · Aesthetic Plast Surg · PMID 42576065 · Plain summary