Peter A. Adamson, MD, and colleagues present a retrospective blinded study of deep-plane and superficial musculoaponeurotic system (SMAS) plication face-lift techniques. The 2 study groups consisted of 25 patients, each followed up for at least 6 months. Three expert observers were blinded to the type of procedure performed and were asked to evaluate photographs taken before and after surgery. Five aspects of the face were rated using a linear 7-point visual analogue scale that included the appearance of the malar eminence, melolabial fold, and cervicomental angle. Statistically significant and clinically relevant differences were observed, especially in the malar eminence and the melolabial fold, showing that the deep-plane face-lift can provide superior results. The SMAS plication technique show less marked improvement, but its results approached those of the deep-plane face-lift for improvement of platysmal banding and appearance of the cervicomental angle. The authors conclude that the deep-plane face-lift technique achieves a superior improvement of the appearance of the midface compared with that of the SMAS placation technique.