The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis.

[BACKGROUND] Facelifts remain one of the most common facial rejuvenation surgeries, with SMAS and deep plane techniques being the primary approaches. There is still ongoing debate regarding which method provides longer-lasting outcomes.

[OBJECTIVE] We conducted a systematic review and one-arm meta-analysis comparing patient satisfaction and complications of SMAS and deep plane facelifts.

[METHOD] MEDLINE, EMBASE and Web of Science were searched from 2000 to 2024 for controlled trials and cohort studies following the PRISMA guidelines for systematic review. The primary outcome was patient-rated overall satisfaction. Secondary outcomes included long-term (more than one year) satisfaction and any measure of adverse events.

[RESULTS] We identified 2474 studies for screening with 21 studies included with 2896 patients. The deep plane had a patient satisfaction of 94.4% (95%CI 84.8, 99.7) and the SMAS 87.8% (95%CI 84.3, 91.3). The deep plane had an overall complication rate of 17.2% and the SMAS 10.3% (95%CI 6.20, 14.4) CONCLUSION: Our review shows that deep plane and SMAS facelift both provide robust and long-term outcomes with high patient satisfaction.

[LEVEL OF EVIDENCE II] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.