From Mini to Deep Plane: Understanding the Different Types of Facelift

You may notice jowls along the jawline, a softer lower face, or cheeks that sit lower than they used to. These changes can involve different layers of the face, and the pattern of tissue descent helps determine which surgical approach may be most appropriate.

The main types of facelift include the SMAS facelift, deep plane facelift, mini facelift, including the MACS lift and S-lift, extended cervicofacial facelift, endoscopic facelift and midfacelift. They differ in how deep the surgeon works, which area is lifted and how long the incisions are.

At Seline Clinic in Jumeirah, Dubai, the surgeon examines the face and neck together before recommending a technique.

A facelift repositions descended tissues in the cheeks, jawline and lower face, while excess skin may also be carefully redraped or removed. Many facelift techniques address both the skin and the deeper supporting layer known as the SMAS, or superficial musculoaponeurotic system.

A facelift does not treat:

• fine lines, pigmentation or skin texture

• the brows or eyelids, unless those procedures are added

• lost volume, unless fat grafting is added

It also does not stop ageing. The tissues keep changing after surgery, just from a better position.

What has changed and the type of facelift that may be considered:

• Early jowls, good skin, little neck laxity: Mini facelift, MACS lift or S-lift

• Established jowls and lower-face laxity: SMAS facelift

• Lower-face laxity with cheek descent and deeper folds: Deep plane facelift

• Jowls with loose neck skin or neck bands: Extended cervicofacial facelift with a neck lift

• Earlier descent, little excess skin: Endoscopic facelift

• Flatter cheeks, hollow under the eyes: Midfacelift

• Low or heavy brows: Brow lift, sometimes called an upper facelift

Two patients with similar jowls may still require different surgical approaches, which is why the final technique is chosen after a detailed facial and neck assessment.

The SMAS facelift repositions the deeper supporting layer beneath the skin, allowing the skin to be redraped with less reliance on surface tension. Modern SMAS techniques were developed to place more of the lifting force on the deeper supporting tissues rather than relying primarily on skin tension. The SMAS can be folded and stitched (plication), partly removed (SMASectomy) or raised and repositioned (extended or high SMAS).

• Suited to: established jowls, a softer jawline and moderate lower-face laxity.

• Limits: less effect on the cheeks when they have descended significantly.

The surgeon works beneath the SMAS and selectively releases retaining ligaments that contribute to facial tissue descent. The skin and SMAS are then repositioned together as a composite layer, allowing deeper tissues to carry more of the lifting effect rather than relying mainly on skin tension.

• Suited to: lower-face laxity with deeper nose-to-mouth folds or cheek descent.

• Limits: deep plane dissection is performed in anatomically sensitive planes near branches of the facial nerve, so detailed anatomical knowledge and surgical experience are particularly important. It is one option among several and is not automatically the best choice for every facial anatomy.

A mini facelift generally uses shorter incisions and a more limited area of surgical dissection than a full facelift. The MACS lift (minimal access cranial suspension) uses sutures anchored near the temple to lift tissue mostly upward. The S-lift is named after its S-shaped incision.

• Suited to: early jowls, good skin elasticity and little neck laxity.

• Limits: little reach into the neck. When a limited-incision technique is used for more advanced facial laxity, the degree and durability of correction may also be limited.

Dr. Rubin's perspective: A mini facelift is generally considered when tissue descent is still limited and there is little neck laxity. When jowling is more advanced, the neck is involved, or deeper tissues have descended significantly, a broader surgical approach may provide a more appropriate correction.

The term cervicofacial refers to the face and neck being treated as part of the same surgical plan. This approach addresses the lower face and neck together, with incisions extending around and behind the ear to allow appropriate redraping of the facial and neck tissues. It is often combined with a neck lift to tighten neck bands, and may include fat grafting or a brow lift. The exact combination is confirmed at consultation. Our guide to neck lift in Dubai covers the neck side in more detail.

• Suited to: jowls together with loose neck skin or visible neck bands.

• Limits: the procedure is generally more extensive and may involve a longer recovery. In selected patients, staging additional procedures may be considered for safety.

An endoscope and specialised instruments are introduced through short incisions within the scalp or temporal region. Endoscopic techniques are most commonly used to reposition tissues of the brow, forehead and midface, particularly when there is limited excess skin.

• Suited to: earlier tissue descent in patients with relatively good skin elasticity and limited excess skin.

• Limits: it removes little skin, so it rarely suits marked jowls or loose neck skin.

Dr. Rubin's perspective: Endoscopic techniques can be particularly useful when facial tissues have descended but there is relatively little excess skin. When lower-face or neck laxity is more pronounced, an endoscopic approach may need to be combined with, or replaced by, a conventional facelift technique.

A midfacelift repositions cheek tissues that have descended over time. It can reposition soft tissue higher over the cheekbone and soften the transition between the lower eyelid and cheek. It can be done endoscopically, through the temple, or through the lower eyelid together with lower blepharoplasty.

• Suited to: flatter upper cheeks and under-eye hollows linked to cheek descent.

• Limits: it does not treat jowls or the neck.

Not for every face. Recent systematic reviews report high patient satisfaction and comparable safety with both techniques. Some published evidence suggests potential advantages of deep plane techniques for midface repositioning, but high-quality direct comparisons remain limited. The patient's anatomy, pattern of tissue descent and the surgeon's experience may be more important than the name of the technique alone.

Incision length alone does not determine the quality or longevity of a facelift result.

Dr. Rubin's perspective: The choice between SMAS and deep plane techniques should be based on facial anatomy rather than trends. The position of the cheeks, severity of jowling, neck involvement, skin quality and the depth of tissue descent all help determine which approach is most suitable.

The pattern of facial ageing matters more than chronological age or the popularity of a particular facelift technique. For example:

• A softer jawline can come from jowls, neck laxity, fat under the chin or a small chin. Jowls alone may suit a SMAS or mini lift. Jowls with neck laxity usually point to a cervicofacial plan.

• Prominent nasolabial folds can partly reflect descent of the midface and cheek tissues. In selected patients, repositioning descended midface tissues may address the underlying anatomy more directly than adding volume to the fold alone.

• Ageing around the eyes may involve the brow, upper or lower eyelids, midface, or a combination of these areas. A facelift alone may therefore not address every component of periorbital ageing.

The surgeon also weighs skin elasticity, bone structure, smoking, medications, weight stability and how much recovery time you have. A facelift is not one standard operation. It is an individualised surgical plan based on facial anatomy and the pattern of ageing.

• Anaesthesia: general anaesthesia or intravenous sedation, depending on the operative plan, patient factors, surgeon preference and facility protocol.

• 
  Scars: incisions sit in front of or around the ear and within or near the hairline. Plans that include the neck continue behind the ear and may add a short incision under the chin. Scars are permanent but placed along natural contours.

• 
  Recovery: swelling and bruising are usually most noticeable during the early postoperative period. Visible recovery is usually measured in weeks, while numbness and subtle swelling can take months to settle. Your surgeon will advise when to return to work, exercise and travel.
  

• In Dubai, healing skin should be protected from strong sun exposure and excessive heat. Patients travelling home after surgery should also allow sufficient time for early postoperative review before flying.

Dr. Rubin's perspective: During the hotter months in Dubai, patients should minimise prolonged heat and direct sun exposure during early healing, follow scar-care instructions carefully and plan travel around the required postoperative reviews.

A 'liquid facelift', typically using fillers with or without botulinum toxin, and thread lifts are not facelifts in the surgical sense. They may restore volume, reduce selected muscle activity or provide a limited lifting effect, and are generally considered for milder concerns. When established jowling or neck laxity requires meaningful tissue repositioning, surgical treatment may provide a more appropriate option. For fullness under the chin, see our comparison of surgical and non-surgical double chin treatment.

Facelift surgery is an established procedure that is carefully planned around each patient's anatomy, medical history and surgical goals. As with any operation, there are potential risks, but many are uncommon and can be reduced through appropriate patient assessment, careful surgical technique and structured postoperative care.

Possible considerations include temporary swelling, bruising, tightness, numbness or changes in sensation during the healing period. Less commonly, complications such as bleeding beneath the skin, infection, delayed wound healing, scar-related concerns, asymmetry or temporary weakness affecting a facial nerve branch may occur.

Before surgery, the surgeon reviews your medical history, medications, smoking or nicotine use and any factors that may affect healing. You will also receive clear instructions for preparation and recovery, together with scheduled follow-up to monitor healing.

The purpose of discussing potential risks is to help patients make an informed decision and understand what to expect, while allowing the surgical team to plan the safest and most appropriate approach for each individual.

Facelift cost depends on the surgical technique, the areas being treated, operating time, anaesthesia requirements, facility fees and postoperative care. Published starting prices at Seline Clinic:

• Facelift (SMAS or deep plane, confirmed at consultation): from AED 70,000

• Extended cervicofacial facelift (face and neck): from AED 100,000

• MACS lift, mini lift or S-lift: from AED 35,000

• Deep neck lift: from AED 35,000

• Midfacelift: from AED 25,000

• Classic brow lift: from AED 20,000

• Endoscopic brow lift: from AED 30,000

• Blepharoplasty: from AED 15,000

• Endoscopic facelift: quoted after assessment

Prices are indicative starting prices and can change. The final surgical plan and quotation are confirmed after medical assessment.

Healthcare facilities and professionals practising within DHA jurisdiction are subject to local licensing and regulatory requirements. Privacy and continuity of follow-up can also be important considerations for patients travelling from elsewhere in the UAE, the GCC or internationally.

Seline Clinic is a multidisciplinary aesthetic, plastic surgery and wellness clinic located in Jumeirah, Dubai. Facelift surgery is provided by an international team of plastic surgeons, with the operative plan individualised according to facial anatomy, tissue descent and neck involvement.

• Dr. Alexej Rubin, Consultant Plastic Surgeon, MD, PhD

• Dr. Leonard Nenad Josipovic, Consultant Plastic Surgeon, MD

• Dr. Bouraoui Kotti, Specialist Plastic Surgeon, MD, PhD

• Dr. Mazen Arafeh, Specialist Plastic Surgeon, MD

• Dr. Maria Rubatti, Specialist Plastic Surgeon, MD

For patients who prefer a female surgical environment, Dr. Maria Rubatti, Specialist Plastic Surgeon, MD, offers a fully female surgical team, including a female surgeon, anaesthesia team and nurses.

Surgical procedures take place in accredited surgical facilities. Consultation and follow-up care are provided at Seline Clinic on Jumeirah Street.

Which type of facelift lasts the longest?

No single facelift technique provides the longest-lasting result for every patient. Techniques that reposition deeper supporting tissues, such as SMAS and deep plane facelifts, are generally designed to provide more durable structural support than approaches that rely mainly on skin tension. Skin quality, genetics, sun exposure, smoking and weight changes also affect how long the result is maintained.

What is the difference between a mini facelift and a full facelift?

A mini facelift uses shorter incisions and mainly treats early jowls. A full or extended facelift generally involves a broader dissection and incisions extending around or behind the ear, allowing more extensive treatment of the lower face and, when indicated, the neck. The mini lift usually means a shorter recovery but less reach.

Is there a right age for a facelift?

There is no fixed age. Suitability depends on the degree and pattern of tissue descent, skin elasticity, facial anatomy, overall health and the patient's treatment goals. Elective cosmetic surgery is postponed during pregnancy. After childbirth, timing is individualised according to recovery, breastfeeding status, medications, anaesthesia considerations and overall health.

Can a facelift be combined with a neck lift or eyelid surgery?

Yes. A facelift is often combined with a neck lift, blepharoplasty, a brow lift or fat grafting. The surgeon weighs your health, anatomy and total operating time first, and for some patients staging the procedures is safer.

Will the scars be visible?

Facelift scars are permanent, but they are placed around the ear and in or near the hairline, where they are harder to see once healed. Scars may initially appear pink or red and generally continue to mature and fade over many months. Smoking and a tendency to thick scarring can affect how they settle.

Different facelift techniques are suited to different patterns of facial ageing and tissue descent. A detailed assessment of the face and neck allows the surgeon to translate those techniques into an individualised surgical plan.

To arrange a private consultation, call +971 800 735463 or contact Seline Clinic on WhatsApp. The clinic is located at 623 Jumeirah Street, Umm Suqeim 1, Dubai.