Deep Plane Facelift

The deep plane facelift is an advanced technique that releases the muscle layer under the skin and allows it to be repositioned without tension providing a more natural looking result, rather than pulling the skin layer, which can give a tight look.

This technique is performed by less than 5% of facelift surgeons as it is more technically demanding and requires more experience. However, most facelift surgeons believe it to be superior to the traditional technique in providing superior results that are longer lasting. Dr. Samaha has extensive experience with the deep plane facelift technique at his Montreal centre and is one of very few surgeons in Canada who perform it.

What is the advantage over a regular facelift?

  • No tightness, tension, or stretched appearance (more natural-looking facelift results).
  • Release and repositioning of the muscle layer under the skin, called SMAS provide superior results with a younger look.
  • Also because of the muscle release, the “midface” (consisting of the cheekbone and cheek) is improved in a subtle but remarkable way.
  • Longer-lasting results.

Anatomy of Facial Muscles

Under the skin is a kind of muscular sheet that covers much of the face and neck called SMAS. It is this sheet of muscle that sags and loosens that can cause the skin to drop down with gravity over time.

This SMAS layer is attached with strong ligaments to the tissues under it, which include other muscles, bone, etc. So, from the outside in, there is skin, SMAS, and deeper tissues with the SMAS attached to these deeper tissues through strong ligaments.

How does a deep plane facelift work and how is it different than the regular technique?

The regular facelift involves getting under the skin layer only and just folding the muscle layer over itself to tighten it (see illustrations).

Deep Plane Facelift Figure 1

The surgery is taking place under the skin. The muscle is not released. Rather sutures are placed to fold it onto itself. Because the muscle is not released from the deeper layers, this technique may cause stretching and tension and the result may not be as long lasting.

The muscle layer (SMAS) is not lifted nor supported. Surgeons have found that operating only under the skin layer often creates that tight, stretched, unnatural look. Also, because the skin is elastic, the results do not last as long because the skin loosens again after a few months.

With a deep plane facelift, the surgeon operates under the muscle layer (SMAS) to release the ligaments tethering it. This release allows a more complete and tension-free (no tightness) repositioning of the muscle and skin to its original youthful position (see illustrations).

Illustration of muscles lifting during deep plane facelift

Deep plane facelift. The surgery takes place under the muscle. The ligaments are released.

Muscle repositioning illustration during a deep plane facelift

The muscle is then lifted and repositioned more freely and without tension or stretch.

Deep Plane Facelift excess skin removal illustration

The excess skin is then removed.

This advanced surgical technique also provides an improvement of the “midface” area. Because the muscle is more thoroughly and completely released to be mobilized to a higher, more youthful position, the resulting rejuvenation is more radiant as it affects the highlights of the cheeks and cheekbones in a subtle but remarkable fashion.

In comparison, a traditional facelift doesn’t treat sagged cheekbone and hollowed cheek areas, typically found in the aged face.

What is the best age to have a facelift?

The majority of Dr. Samaha’s patients are in their mid-40s to mid-70s, with the majority in their 50s and 60s.

In the last 10 to 15 years, there has been a growing trend toward patients opting to have surgery earlier rather than waiting for aging changes to be more advanced. Indeed, people now prefer to address early signs of aging more proactively to “nip them in the bud” and preempt a more aged appearance. The advantage is enjoying the benefits of the surgery for longer.

How many years younger will I look after a deep plane facelift?

In general, 10 to 15 years. This does not mean that after that time, patients “lose” the benefit of the surgery. Quite the contrary, patients retain the benefit of the surgery for years to come.

For example, a 65-year-old patient may, after surgery, look like they are in their early 50s. They will continue to age but will still have the benefit of having brought the clock back such that at 75, they will appear to be in their early 60s.

How much does a facelift cost in Montreal?

The cost of facelift surgery depends on many factors, including:

  • The level of complexity of the surgery: a regular facelift will cost less than a deep plane facelift because of the complexity and the time required for the latter.
  • The surgeon performing a surgery: just like in any profession, the more specialized a professional is, the more costly the rate. As a surgeon specializing uniquely in facial surgery, Dr. Samaha may charge more than a surgeon who performs facial surgery as well as all body surgeries.
  • The patient’s anatomy: Because every patient is different, Dr. Samaha tailors and personalizes every procedure according to the patient’s anatomy and needs. This means that some patients’ surgery will require more work and time while others less. This is reflected in the cost.

Can a deep plane facelift be combined with other procedures?

The facelift usually includes a neck lift. The result in the lower face and neck is remarkable. Our patients will frequently opt to have additional procedures to address other facial areas affected by the aging process, such as the eyes, the brows, and the lips with procedures like eyelid lifts (blepharoplasty), brow repositioning, and lip lift, respectively.

How long does facelift surgery take?

Most good surgeons will take 3 to 4 hours to complete the surgery (facelift and neck lift together). It is a meticulous exercise that takes an experienced surgeon time to complete. If additional procedures are performed, such as eyelid rejuvenation or brow repositioning, then it can take about 5 hours.

Dr. Mark Samaha

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he's carefully refined his skills to sculpt your beautiful face.

Meet Dr. Samaha

Is there more scarring with this technique?

No. In fact, because there is no tension on the skin, this leads to thinner, less perceptible scars. Dr. Samaha dedicates a large portion of the surgery time to carefully closing the incisions to create virtually invisible scars. In fact, most patients cannot detect their scars afterwards, even with their hair pulled back, and they report that their hairdresser cannot see the scars either.

How long is recovery from a facelift?

Two weeks. Although traditional facelift surgery recovery can often last several weeks, the overwhelming majority of patients undergoing facelift in our Montreal clinic are able to return to daily normal life after 2 weeks without obvious traces of surgery. This relatively short recovery time is the result of Dr. Samaha’s Maximum Result Minimum Recovery™ approach.

What is Maximum Result Minimum Recovery™?

Following about 20 years of research, experience, and fine-tuning, Dr. Samaha devised a system he calls the Maximum Result Minimum Recovery™ approach. This approach encompasses the patient’s entire journey, including the preoperative preparation, the surgery itself, and the postoperative period. The goal is to make the process of surgery easy to tolerate, including a painless surgery and a shorter recovery period.

Examples of some of the measures and techniques include the use of a less invasive “twilight” anesthesia and minimally invasive surgical techniques. The result is less inflammation with minimal swelling, bruising, and scarring during the healing period (see photos below). Learn more about Dr. Samaha’s Maximum Result Minimum Recovery™ system.

Facial swelling a couple of days post-op vs. 2 weeks post-op with Maximum Result Minimum Recovery™ method.


Dr. Samaha has developed techniques and methods to minimize swelling and bruising after surgery for his patients to shorten their recovery. This has culminated in his Maximum Result Minimum Recovery system.

Learn More

Ces photos sont publiées à titre indicatif afin de fournir de l’information sur la nature de l’intervention. Elles ne constituent aucunement une garantie de résultat.
These photos are published for information only in order to provide information on the nature of the intervention. They do not constitute a guarantee of results.

Is a deep plane facelift safe?

Yes. Like any surgery, the risk is very low when performed by an experienced surgeon. Of course, if the surgeon does not have extensive experience with facial surgery or performs facelifts infrequently, there is a higher risk. Dr. Samaha has a great deal of experience with this technique and has been performing it regularly for many years.

Facelift FAQs

How much swelling will there be after my facelift surgery?

The swelling associated with a deep plane facelift is minimal compared to traditional techniques. Bruising is also significantly less. Much of the swelling is noticeable in the first 5 to 6 days, with the remaining minor amount resolving in the following week.

Is a facelift painful?

No. A feeling of tightness is normal in the first week, but patients do not report any pain. The overwhelming majority of patients do not take any pain medication, though it is prescribed on an as-needed basis.

How long do I have to wear compression bandages after my facelift surgery?

A head dressing is placed for the first 24 hours only. After it is removed, a lighter elastic (ACE) bandage is provided, which is applied by the patient, as needed for support and comfort for the remainder of the week.

Will I still need fillers or BOTOX after my facelift?

While a facelift provides a significant and natural rejuvenation, nonsurgical options such as BOTOX COSMETIC®/Dysport Aesthetic® and skin fillers complement the results of a facelift by addressing areas the surgery does not address. It’s generally not a decision between either injectables or facelift surgery, but rather, how injectables can enhance and prolong the rejuvenating effect of a facelift when they are used appropriately and administered by a skilled injector.

Would you like to discover how a deep plane facelift in Montreal, Quebec, could rejuvenate your look? Request your consultation with Dr. Samaha online or call us at (514) 613-3004 to make your appointment. Dr. Samaha attracts patients from Quebec City, Laval, and Gatineau.

Back to Top