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Preservation Facelift vs Deep Plane Facelift: Key Differences

1 day ago
7 min read

Updated: 1 day ago

Quick answer. A preservation facelift is not one standard operation. The term describes facelift techniques that try to keep more of your own anatomy intact, usually by lifting less skin off the deeper layers and, in some versions, by keeping the retaining ligaments. A deep plane facelift releases key ligaments and lifts skin, fat and the deeper muscle layer together. Several published "preservation" lifts are modified deep plane lifts.

Key takeaways

  • "Preservation facelift" has no single agreed definition; surgeons use it for different techniques.

  • Most published versions limit skin undermining, which may reduce some wound and fluid problems.

  • Deep plane facelifts have a low pooled complication rate in a 2026 meta-analysis of 10,784 patients.

  • No long-term study shows that one label lasts longer or looks better than the other.

  • Ask your surgeon what is lifted, what is released and what is left alone, not what the operation is called.

What does "preservation facelift" actually mean?

The word "preservation" came into facelift surgery to describe keeping structures rather than cutting them. One early version, published in 2016, aimed to keep most retaining ligaments and the connections within the SMAS (the superficial muscular and fibrous layer under the facial fat) in place (Funk, 2016).

A 2025 paper used the term differently. There, the preservation face lift combined elements of the extended deep plane and high SMAS techniques, with much less skin lifted off the deeper tissues in the face and neck (Sadati et al., 2025). A 2026 report called a similar idea a "conservation facelift": a deep plane lift with limited undermining (Quinodoz et al., 2026).

Even surgeons disagree about the label. In 2025, letters in Facial Plastic Surgery & Aesthetic Medicine debated the use of the term "preservation" for facelift procedures (Gentile, 2025; Roskies et al., 2025). So when you read "preservation facelift" on a website, ask what is actually done.

  • Scarless deep plane facelift: before and after
  • Face

What is a deep plane facelift?

A deep plane facelift works under the SMAS. The surgeon releases the retaining ligaments that tether the cheek and jowl, then moves skin, fat and SMAS as one connected flap. Because the skin stays attached to the tissue underneath, tension is carried by the deeper layer rather than by the skin. The technique was first described in 1990 and has been adapted many times since (Koroma et al., 2026).

How do the two approaches compare?

  • Skin undermining — "Preservation" facelift (as published): Deliberately limited — Deep plane facelift: Varies; often wider in the neck

  • Retaining ligaments — "Preservation" facelift (as published): Some versions keep them; others release selected ligaments — Deep plane facelift: Key ligaments released

  • Deep layer — "Preservation" facelift (as published): Moved with limited separation from skin — Deep plane facelift: Skin, fat and SMAS moved as one unit

  • Neck — "Preservation" facelift (as published): Separate neck work added when bands or fullness are significant — Deep plane facelift: Often combined with deep neck work

  • Evidence base — "Preservation" facelift (as published): Small, mostly single-surgeon series — Deep plane facelift: Larger series and meta-analyses

Video: Scarless deep plane facelift: before and after. Watch on YouTube

What does the evidence say about safety?

The direct comparison most often quoted is a 2025 retrospective study of 134 face and neck lifts by one surgeon: 57 preservation lifts and 77 extended deep plane lifts (Sadati et al., 2025). Drains stayed in for an average of 1.5 days after the preservation lift and 4.3 days after the deep plane lift. Hematoma occurred in 0 versus 7 patients, and the total complication rate was significantly lower in the preservation group.

Read those numbers with care. Patients chose their own technique, the study was retrospective, and the authors note it had no objective measure of the aesthetic result.

For deep plane facelifts in general, a 2026 meta-analysis pooled 45 studies and 10,784 patients (Koroma et al., 2026). The overall complication rate was 6.6%. Temporary facial nerve weakness occurred in 1.2%, hematoma in 1.8%, and no permanent facial nerve injury was found. An earlier meta-analysis concluded that technique should be chosen on the quality of results rather than on complication profile alone (Jacono et al., 2019).

Does one approach last longer or look better?

Nobody knows yet. There are no long-term studies comparing a preservation lift with a deep plane lift using blinded photo assessment. A 2025 systematic review in Plastic and Reconstructive Surgery found that medially based deep plane techniques have not been shown to give significantly better midface results or longer-lasting results than other SMAS techniques (Schultz et al., 2025). A 2025 meta-analysis reported patient satisfaction of 94.4% for deep plane and 87.8% for SMAS facelifts, but also a higher pooled complication rate for deep plane (17.2%) than for SMAS lifts (10.3%) (Khoury et al., 2025). Pooled complication rates differ widely between reviews, depending on which studies and which complications are counted.

Results depend more on diagnosis and surgical execution than on the name of the technique.

Video: Face, neck, temporal and forehead lift: before and 7 days after. Watch on YouTube

Who suits a preservation-style lift, and who needs more?

The authors of the 2025 comparison felt their technique suited most patients, especially those aged about 40 to 70 having a first facelift without significant platysma bands (Sadati et al., 2025). They added a separate neck procedure through an incision under the chin when bands or neck fullness were moderate to severe, which was the case in most of their patients.

You may need a fuller deep plane face and neck lift if you have:

  • heavy jowls and a blunted jawline

  • marked neck bands or fullness under the chin

  • a previous facelift that has relaxed

  • significant laxity after large weight loss

What should you ask your surgeon?

  • Which ligaments will you release, and which will you keep?

  • How much skin will be lifted off the deeper layer?

  • How will my neck be treated?

  • What complications have you seen with this exact technique?

  • Can I see results at one year or later, not only at three months?

How Prof. Dr. Suleyman Tas approaches this

Prof. Dr. Suleyman Tas performs deep plane face and neck lifts under local anesthesia, with you awake and without general anesthesia. He operates on one patient per day and performs the surgery personally. He also teaches deep plane facelift to other surgeons at international live-surgery courses. Read more about the deep plane facelift and see how the awake deep plane facelift works.

His TAS Signature Lift can combine a deep plane facelift, neck lift, temporal and forehead lift, upper and lower eyelid surgery, fat injection and lip lift in one session under local anesthesia, but only the parts your face needs. You stay in Istanbul for about 10 to 14 days, with daily hyperbaric oxygen sessions and a private nurse, followed by one year of online follow-up. View facelift before and after photos.

Sources

Frequently Asked Questions

Is a preservation facelift less invasive than a deep plane facelift?

It usually involves less skin undermining, which is what most authors mean by "preservation". It is still a full surgical facelift with incisions around the ears, work under the SMAS and a similar general recovery. "Less undermining" does not mean "mini" or "non-surgical". Ask your surgeon to describe exactly which layers will be lifted.

Does a preservation facelift have fewer complications?

One 2025 single-surgeon study found shorter drain times, fewer hematomas and fewer total complications with its preservation technique than with its extended deep plane technique. Patients chose their technique and the study was retrospective, so the result needs confirmation. Larger meta-analyses show low complication rates for deep plane facelifts too.

Will a preservation facelift last as long?

There is no long-term comparative data yet. Longevity depends on your anatomy, skin quality, weight stability, age and how well the deeper layer is repositioned and fixed. Be cautious of any claim, for either technique, that promises a set number of years. Ask to see the surgeon's own results at one year or more.

Is a deep plane facelift the same as an extended deep plane facelift?

Not exactly. "Extended" usually means the dissection is carried further, for example higher toward the cheekbone or further into the neck, to release more tissue. Definitions vary between surgeons, so ask what "extended" means in your plan and what extra recovery or risk, if any, it brings for you.

Can I choose between a preservation facelift and a deep plane facelift?

You can and should discuss it. A good plan starts with your diagnosis: where the tissue has descended, how heavy the neck is and how your skin behaves. The surgeon then explains which structures need release and which can be left alone. The label matters far less than that reasoning.

About the Author

This article was written and medically reviewed by Prof. Dr. Suleyman Tas, a plastic, reconstructive and aesthetic surgeon in Istanbul with over 20 years of experience. He is the author of Rhinoplasty in Practice (CRC Press, 2020), has more than 40 peer-reviewed scientific publications and five patents, and teaches facelift and rhinoplasty techniques to surgeons at international courses. Read more about Prof. Dr. Suleyman Tas.

Individual results vary. Before and after photos and videos are shared with patient consent. This article is for general information and does not replace a personal medical consultation.

See More Before and After Results

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