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Study suggests superiority of deep-plane face-lifts over SMAS-plication lifts

Toronto — A team headed by researchers at the University of Toronto’s Department of Otolaryngology/Head and Neck Surgery has released results of a study suggesting that deep-plane face-lifts in the mid-face and neck result in outcomes that are clinically and statistically  superior to those of the SMAS-plication face-lift.

The researchers reviewed preoperative and postoperative photographs of 25 patients who had undergone a SMAS plication face-lift and 25 patients who had undergone a deep-plane face-lift. The postoperative photographs were taken at least six months after surgery. Three observers, all facial plastic surgeons, were blinded to the procedure that each patient underwent, and the photographs were randomized. Five aspects of the face and neck were rated for degree of improvement: the malar eminence, the melolabial fold, the jawline, neck banding and the cervicomental angle. A seven-point visual analog scale was used to rate the photographs.

According to the study results, the three independent observers rated the patients who underwent a deep-plane face-lift as having significantly better results in two of the measured locations, and the observed improvements in the deep-plane group were twice those in the SMAS-plication group. 

Most notably, says the study, there was a statistically significant difference seen at all points of comparison with the exception of neck banding. Not only was there a statistical difference at each of the other areas of the face and neck but the differences were clinically relevant. As an example, the study cites the area of the malar eminence, where the mean score for the degree of increase in soft tissue volume in the SMAS plication group was 2.69, while the mean score in that area in the deep-plane face-lift group was 4.64.

The highest overall improvement in the deep-plane face-lift group was in the area of the jowls, with a mean score of 5.29. In the SMAS plication group, the greatest improvement was seen in the cervicomental angle, with a mean score of 4.40.

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