Facelift (Deep Plane & SMAS)

Brandeis Clinic offers both SMAS and Deep Plane facelifts — two distinct surgical approaches to lower-facial and neck rejuvenation — performed by MUDr. Lucie Kalinová under general or combined local-sedation anaesthesia. The SMAS technique addresses the superficial musculoaponeurotic system to lift and reposition facial tissues while preserving a natural appearance, typically for patients in their 50s with moderate facial ageing. The Deep Plane technique works at a deeper tissue plane, repositioning the entire cheek-jowl unit and correcting nasolabial folds more completely — it is the preferred approach for more advanced laxity or when the patient wants the most durable result. A MACS (minimal access cranial suspension) short-scar option is also available for the right candidate. Surgery takes 3–5 hours; patients stay one night in the clinic.

The facelift offering at Brandeis Clinic sits in an important differentiation tier: most aesthetic clinics in Prague offer a single facelift technique, whereas MUDr. Kalinová performs both the SMAS and the Deep Plane procedure, selecting between them based on the patient's anatomy, degree of ageing, and desired durability of outcome. **Understanding the two approaches:** *SMAS Facelift (from 95,000 Kč):* The SMAS (Superficial Musculoaponeurotic System) is a fibromuscular layer connecting the facial muscles to the overlying skin. In SMAS facelift surgery, the skin and SMAS are elevated as separate layers. The SMAS is then repositioned and secured at a higher, more youthful position — pulling the deeper structure, not just the skin. This produces a more natural result than a pure skin-pull technique and avoids the "windswept" appearance of overcorrected skin-only lifts. The SMAS technique is well-suited to patients with moderate lower-facial and jowl descent, typically in the 50–60 age group. *Deep Plane Facelift with Necklift (from 150,000 Kč):* The deep plane technique works at the plane immediately below the SMAS, releasing the osteocutaneous retaining ligaments of the cheek — particularly the zygomatic and masseteric ligaments — which anchor facial fat and tissue to the underlying bone. Once released, the entire cheek-jowl composite flap can be repositioned vertically and superolaterally to its original anatomical position. The advantage is that nasolabial folds are directly addressed (in SMAS facelift they are improved indirectly), jowl correction is more complete, and the result tends to last longer because the repositioned tissues are secured at the ligament level rather than by suture suspension alone. The neck component addresses platysmal banding and submental fat for a smooth jawline-to-neck transition. This is the most technically demanding approach, taking 4–5 hours, and is preferred for patients with more advanced ageing, patients who want the most durable long-term result, and patients for whom a second procedure in 5–7 years is not desirable. *MACS Lift:* A minimal access cranial suspension (MACS) technique is also available. This uses purse-string sutures through small temporal incisions to suspend facial tissue with a shorter scar than the traditional facelift. It is an appropriate option for the right candidate — particularly younger patients with mild laxity who are not ready for a full SMAS procedure. **Incision design:** In all full facelift approaches, incisions are placed in the preauricular skin crease, around the earlobe, and into the hairline — areas chosen because healing scars blend with natural skin transitions. No incision is placed in a visible, non-concealed position. **Anaesthesia and hospitalisation:** General anaesthesia is standard. A combined local anaesthesia with sedation is an option for appropriate candidates. Patients remain in the clinic for one night following surgery, under nursing supervision. **Preparation:** Smoking cessation is strongly recommended before and after surgery — nicotine causes peripheral vasoconstriction that impairs wound and flap healing. A standard pre-operative examination includes blood testing and cardiovascular assessment. **Recovery:** An elastic compression garment is worn for 2–3 weeks. Visible bruising and swelling begin to subside within 2–3 weeks; return to normal activities is typically at approximately 1 month. Full facial stabilisation and final result visibility occurs over several months as deeper tissue oedema resolves. **Ideal candidates:** Typically patients aged 50–65 with sagging lower facial tissues, deepened nasolabial folds, jowl formation, and/or platysmal banding of the neck. Candidates must be in good general health, non-smokers or willing to cease, and have realistic expectations about what surgery can achieve.