True deep plane mobilization means working beneath the SMAS, the fibrous support layer under the skin and fat, and releasing the zygomatic, masseteric, and mandibular retaining ligaments. Once those attachments are freed, the cheek, jowl, and jawline can move upward together as one connected unit. Without that release, a lift pulls against tethered tissue and leans on skin tension, which is why some results labeled "deep plane" look tight or fade early.
For anyone researching a deep plane facelift on Long Island, ligament release is the single most useful detail to understand. Dr. David Parizh, DO, FACS, is a board-certified plastic surgeon who trained in deep plane face lifting through the Marten Clinic of Plastic Surgery Facial Aesthetic Fellowship in San Francisco. In this blog, he explains what the retaining ligaments are, how releasing them changes a facelift, and what to ask any surgeon who uses the deep plane label.
What Are the Facial Retaining Ligaments?
Facial retaining ligaments are strong bands of connective tissue that anchor the skin and soft tissue of the face to the bone and deep fascia beneath. A review in Aesthetic Surgery Journal describes these ligaments as sitting in constant anatomic locations, where they divide the face into separate spaces and compartments.
The ligaments most relevant to a deep plane facelift include:
- Zygomatic cutaneous ligaments: Anchor the cheek near the cheekbone and hold the midface in position.
- Masseteric cutaneous ligaments: Run along the front edge of the chewing muscle and support the lower cheek above the jawline.
- Mandibular cutaneous ligament: Tethers the skin along the front of the jaw and marks the front border of the jowl.
- Platysma-auricular and cervical ligaments: Connect the platysma muscle near the ear and help link lower-face support to the neck.
With age, these ligaments stretch and weaken. A 2025 narrative review on retaining ligaments links that laxity to facial fat pad descent, looser skin, jowls, deeper nasolabial folds, and platysmal banding in the neck.
Why Ligament Release Matters for a Natural Facelift Result
Ligament release matters because tethered tissue cannot be repositioned without force. When the ligaments stay intact, a surgeon can only tighten the tissue around them, and the pull concentrates on the skin and incision edges. The Aesthetic Surgery Journal review advises surgeons to select a plane of dissection and release the appropriate ligaments based on each patient's goals.
Released tissue behaves differently. Once the zygomatic and masseteric attachments are freed, the cheek fat and SMAS can be lifted together as a single composite layer. The lift comes from the deep tissue, so the skin can be redraped over the new contour with very little tension.
Patients notice that difference in three places. The midface regains fullness instead of flattening, the jawline sharpens without a stretched look, and incisions near the ear are less likely to widen or pull the earlobe out of shape.
Surgeons still debate how much release is ideal. The 2025 review notes ongoing disagreement over preservation versus release and concludes that the choice must be tailored to each patient's anatomy and aesthetic goals. That is why Dr. Parizh evaluates ligament support and facial structure in consultation instead of applying one technique to every face.
Deep Plane vs. SMAS Facelift: Where the Dissection Actually Happens
The core difference between a deep plane facelift and an SMAS facelift is the layer where the surgeon works and whether the retaining ligaments are released. The comparison below summarizes how each approach handles the face.
| SMAS Facelift | Deep Plane Facelift | |
| Dissection plane | Above the SMAS, separating skin from the deeper layer | Beneath the SMAS, keeping skin and SMAS together |
| Ligament release | Ligaments largely left intact | Zygomatic, masseteric, and mandibular ligaments released |
| How tissue moves | SMAS is folded or tightened in place | Cheek, jowl, and jaw tissue move as one unit |
| Tension on skin | Moderate to higher | Minimal |
| Midface effect | Limited | Cheek fat repositioned upward |
Naming adds to the confusion. The 2025 review groups the deep plane and extended SMAS facelifts together as ligament-releasing techniques, yet the extent of release can vary widely between surgeons. Asking exactly which ligaments will be released is the clearest way to compare one "deep plane" consultation with another.
How Dr. Parizh Approaches Deep Plane Mobilization on Long Island
Dr. Parizh plans every deep plane facelift on Long Island around the patient's own ligament anatomy, skin quality, and facial proportions. His surgical training spans more than a decade, including general surgery residency and chief residency through NYU, a burn surgery fellowship at NewYork-Presbyterian/Weill Cornell, and plastic surgery residency at the University of Cincinnati.
His facial aesthetic fellowship at the Marten Clinic focused on deep plane face lifting, neck lifting, and fat grafting under globally recognized experts. Board certification from the American Board of Plastic Surgery and his role as Director of the Burn Center at Nassau University Medical Center add a reconstructive surgeon's command of facial soft tissue to each procedure.
Ligament release is often one part of a broader plan. Many patients pair it with a deep plane neck lift for a continuous jawline or with facial fat transfer to restore volume that repositioning alone cannot replace.
Questions to Ask Your Surgeon About Deep Plane Facelift Claims
The most revealing question is which ligaments will be released and in which layer the lift will happen. Bring these questions to any facelift consultation:
- Which retaining ligaments do you release, and is the release full or partial?
- Is the cheek dissection performed beneath the SMAS or above it?
- How is the neck addressed, and is platysma or deep neck work included?
- Where will the incisions sit, and how is tension kept off the skin?
- Can I see before-and-after photos of deep plane patients at least a year after surgery?
- Are you certified by the American Board of Plastic Surgery?
Specific, confident answers usually signal a surgeon who performs the technique routinely. Vague answers, or a reliance on the term "deep plane" without describing the anatomy, are worth a second opinion.
What Recovery Looks Like After Ligament Release
Recovery after a deep plane facelift follows a timeline similar to other facelifts, with most patients returning to daily activities after about two weeks. Swelling and bruising peak in the first few days and ease steadily over the following weeks.
Strenuous exercise stays off the schedule for four to six weeks, and final results become apparent over three to six months as the tissues settle. Dr. Parizh provides detailed perioperative instructions covering medications, activity limits, and healing milestones.
For a week-by-week breakdown and full pricing, read Deep Plane Facelift Cost & Recovery on Long Island: A Realistic Timeline.
Deep Plane Facelift FAQs
Is a deep plane facelift riskier than an SMAS facelift?
Every facelift carries risks such as bleeding, infection, scarring, and anesthesia complications. Working beneath the SMAS brings the dissection closer to branches of the facial nerve, so surgeon experience matters. The Aesthetic Surgery Journal review notes that surgeons use the ligaments themselves as landmarks to help avoid nerve injury.
How long do deep plane facelift results last?
Facelift results generally last 10 to 15 years. The face continues to age after surgery, but repositioned deep tissue tends to age gracefully because skin tension was never the source of the lift.
How much does a deep plane facelift on Long Island cost?
A deep plane facelift with Dr. Parizh starts at $35,000. That all-inclusive investment covers the consultation, surgical plan, anesthesia, and post-operative care.
Does ligament release improve the neck too?
Releasing the lower face ligaments improves jowls and the jawline and often refines the upper neck. Patients with significant neck laxity or banding may benefit from adding a deep plane neck lift.
Considering a Deep Plane Facelift? Dr. Parizh Is Here to Help
A true deep plane facelift is defined by what happens beneath the surface: the right ligaments released, in the right layer, for the right face. Dr. David Parizh brings fellowship training in deep plane techniques, board certification by the American Board of Plastic Surgery, and years of reconstructive experience to every facial rejuvenation plan.
Patients across Long Island and New York City can schedule a consultation at his Garden City, East Hills, or Park Avenue offices, or call (646) 453-6219. Dr. Parizh will walk you through your anatomy and explain exactly how a deep plane facelift would be tailored to you.
This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.
Sources
- Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthetic Surgery Journal. 2013;33(6):769-782.
- Retaining Ligaments of the Face: Still Important in Modern Approach in Mid-Face and Neck Lift? Journal of Personalized Medicine. 2025;15(12):582.
- American Board of Plastic Surgery
