From the Research
Deep plane facelifts have a higher risk of complications, including facial nerve injury and hematoma formation, compared to SMAS facelifts, as evident from the most recent and highest quality study 1.
Complications of Deep Plane Facelift vs SMAS Facelift
The complications associated with deep plane and SMAS facelifts are distinct and varied.
- Deep plane facelifts carry a higher risk of facial nerve injury, particularly to the buccal and marginal mandibular branches, which can cause temporary or permanent facial asymmetry and weakness.
- They also have higher rates of hematoma formation, prolonged facial edema lasting 2-3 weeks, and longer recovery times of 2-4 weeks.
- SMAS facelifts, while generally safer, still carry risks including skin necrosis (especially in smokers), visible scarring, pixie ear deformity (where the earlobe is pulled downward), and less dramatic or shorter-lasting results.
Comparison of Complication Rates
A meta-analysis of complication rates among different SMAS facelift techniques found that high lateral SMAS and composite rhytidectomy had the highest rates of temporary nerve injury, while the deep plane technique had a higher risk of major hematoma 1.
- The study also found that the risk of permanent injury did not differ among techniques.
- Another study found that the overall complication rate was 29.4% for subcutaneous facelifts compared to 24.4% for sub-SMAS facelifts, although the difference was not statistically significant 2.
Patient Satisfaction and Outcomes
A study on the triple-C SMAS plication facelift found that the technique had a low complication rate and high patient satisfaction rate, with 96.4% of patients reporting satisfaction with their results 3.
- The study also found that the technique was effective in restoring a youthful contour to the face, with minimal morbidity.
Risk Factors for Complications
A large, prospective, multi-center database study found that male gender, BMI ≥ 25, and combined procedures were independent risk factors for complications, including hematoma and infection 4.
- The study also found that the complication rate for facelifts was 1.8%, similar to the rate for other cosmetic surgeries.