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What's the Difference Between a Lower Facelift and a SMAS Facelift?

asked 2 years ago by kpilling in walnut
Latest answer by Michael Elam, MD
Question viewed 1,763 times
Tags: face, jaw line, comparison

I have been to two cosmetic surgeons. One says necklift and plastyma muscle that includes midface (Smas). The other says can do necklift with plastyma muscle and fill mid face with fat transfer. Or Necklift with SMAS and cheeklift with suspension system. I am so confused as to the difference between a lower face lift and a SMAS facelift? Help!

25 answers to What's the Difference Between a Lower Facelift and a SMAS Facelift?

Lower facelift vs. SMAS facelift

It is very difficult for patients to decide on what facelift procedure to choose. One surgeon's SMAS operation is equivalent to another doctor's minilift. It is better to choose an expert facelift surgeon than to choose a particular technique. I think my colleagues would agree that this applies to most procedures in plastic surgery. Technically SMAS refers to the deep layer or "muscles", even though it is not muscle tissue except for a few fibers at the jawline. The "lower... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Facelift names and terminology

A lower facelift includes a SMAS lift and is the facial component of the lower face/neck lift. A neck lift only addresses the neck itself by tightening the platysma muscle and removing fat. We do not perform mid facelifts and do not recommend a cheek lift with any suspension systems since they are only temporary. A comprehensive face/neck lift performed by a board certified facial plastic surgeon with many years of experience is probably going to be your best alternative. This includes... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Facelift vs. SMAS Facelift

There are many different types of Facelifts and it is confusing. Between Internet technology and different buzz words it is often difficult to decipher the information. All good Facelifts involve some manipulation of the SMAS. This addresses the underlying muscles of the skin and allows the surgeon the elevate, reposition and lift the face and not just tighten the skin. This allows less tension on the incisions allowing a natural youthful look. You should choose a surgeon based on his/her... more

Michael Elam, MD
Orange County Facial Plastic Surgeon

Facelifts - What's in a name?

Wyou are not alone. The terminology in facelifts for the consumer has become very convoluted and difficult to decifer. Very often I see patients coming to see me who 10-15 years minifacelift. To them, this meant theydin'tt have a browlift or their eyes done. So don't geterr therms Thhink ofthe SMAS as a thick layer under the skin and fat. Tightening this layer helps the entire face and neck. The platysma is the muscle that forms the 2 vertical bands in the neck from the chin down to... more

Steven Schuster, MD
Boca Raton Plastic Surgeon

Not all facelifts are SMAS

The SMAS is a complex structure of the face that is the supporting muscle and tissue of the face. Many facelifts are performed by lifting and tightening the skin that gives it a pulled stretched skin appearance. Lifts that tighten this SMAS result in a more natural and longer lasting result.

Andrew Jacono, MD
New York Facial Plastic Surgeon

Lower Facelift Versus SMAS Lift

There are many different types of facelifts. It is sometimes better to focus less on semantics and more on what is anatomically being done. A lift should focus on the area(s) which require rejuvenation which can include the neck, platysmal bands, jowling, cheek pad, shape of the face, etc.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon

Facelift semantics

There are no standardized terms for the facelift techniques. Most patients would be better served by focusing on the results they see from different doctors and which they like best than to focus on the "name" of one procedure vs another. A lower facelift is one that addresses the face from the cheeks to the neck. A SMAS lift is often done at the same time as part of the lower facelift. The SMAS portion is what is done to lift the deeper tissues of the cheek back up to where... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

SMAS facelift versus lower facelift

The SMAS facelift is typically my operation of choice for most of the patients that I see. This does include lifting the midface. It may or may not include lifting the neck area, depending on the extent of the incision around the ear. In simple terms, a longer incision may tighten the neck more so than a shorter incision behind the ear. What is best for you is what is decided between you and your surgeon. I would also recommend that if your consultations have confused you, seek another... more

Deason Dunagan, MD
Huntsville Plastic Surgeon

Facelift Confusion

I can certainly understand why you are confused! I think the most important thing is that you choose a surgeon that listens to your concerns and addresses them. Pictures can help explain procedures, and you should understand where the incisions and what is being done. If you were comfortable with one of the surgeons you saw, you should go in again and ask for more information. We all fear things we do not understand. I do not know a surgeon that would not... more

Melanie L. Petro, MD
Alabama Facial Plastic Surgeon

Types of Facelift Procedures

You should be confused as it is too much to take in. All the procedures described are technical ways of doing a facelift. A facelift corrects the neck and jowl area, as well as lifting the midface. Now really what I recommend to you is to choose the doctor not on the procedure that they are telling you they will do but go to him or her because of their results and how comfortable you are with the surgeon. Those two things are what matter most.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Necklift With Plastymaplasty and SMAS lift a Good Option

You will be better off with the better surgeon instead of the better operation. Unfortunately it will be very hard for you to decide. Both surgeons being equal I would stay away from the midface fat injections as those can cause prolonged swelling. Necklift with Platysmaplasty and a SMAS lift is a safe and effective option. Regards

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon

Too much information

Hi there- Your question highlights a problem of the internet age... There is so much information available (and I do believe this is overall a good thing) that it is not difficult for patients to become confused with regard to their options. Even worse, because information is so readily available, many patients start to erroneously think that they themselves can (and should) make decisions previously made by the surgeon they would have chosen (like how to do a facelift of how to choose a... more

Armando Soto, MD
Orlando Plastic Surgeon

SMAS and Platysma in a Facelift

Hi, The Platysma is the muscle that lies just under the skin in the neck area. The platys ma is typically pulled and tightened to eliminate the sagging skin of the neck. It also takes the tension off the skin incision to prevent healing with stretch marks. The SMAS ( SubMuscularApenueroticSystem) lies just under the skin in the face. The SMAS is contiguous with the Platysma in the neck. SMAS is also tightened to lift the jowl and sometimes the midface (esp. deep plane facelifts). If your... more

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Facelift terminology

Typically, when we are talking about any type of facelifting procedure, the surgeon will generally address the four underlying layers that need to be corrected. First, there is the removal of excess skin that is created when lifting the face or neck. Second, excess fat can be removed typically from the jaw line and neck areas. In addition, in people with some hollowing or loss of fat to their face, fat can be added or transferred from another part of the body and added to give back a more... more

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon

Different types of facelifts

There are many different types of facelifts. All involve, to some extent, lifting the skin and rearranging the underling tissue. The SMAS is the underlying layer of tissue which holds together the soft tissue of the face. The SMAS layer can be lifted or cut and rearranged. There is not a best answer that applies to all people. Each patient is addressed independently to determine the most appropriate procedure for their specific condition. Good luck.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

SMAS vs Lower Facelift

A SMAS lift is onje technique used for a lower facelift. You should select an experienced surgeon whose results you like rather than a specific technique. There is no consistency in terminology. Decide what you want to achieve and see pictures of results in patients who had similar pre-operative problems.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Confusing face lift terms

I personally don't like fat transfers for a couple of reasons. One is that they can be unreliable and unpredictable. Second they don't actually lift or tighten fallen structures. However, when they work well, they do plump up and add volume. That said, my concept of a lower face lift includes a cheek and a neck lift. The face has a deeper supporting structure, the SMAS, which is important in suspending the sagging structures. Without getting too technical, I usuall use this layer, but... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

Face lift and fillers

Aging is multifactorial. How we age is determined by our genes, sun exposure, smoking are among some of the factors affecting the aging process. We loose fat in the face as we age, fat descends down as we age. Certain areas age faster than others (Genetic factors). When a Plastic surgeon analyzes the facial aging he/she will take all these factors in consideration, as well as what is your major concern and he/she will personalize the face lift to you. There are many types of face lifts and... more

Samir Shureih, MD
Baltimore Plastic Surgeon

Difference in types of facelifts

You say Tomatooo I say Tomatoe. You have to determine what feels, sounds and seems realistic to you. Results are the key ingredient here. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

There are many ways to do facelift and necklift surgery

Improvement in the appearance of the neck and face can be achieved with a variety of different procedures. Different surgeons prefer different techniques based on their own experience. No one way is the best way to rejuvenate a face. Think about the SMAS as a layer in the face and neck that is involved in the repositioning of soft tissues. It is important that you feel comfortable as a patient that the surgeon you are seeing understands your areas of concern and has explained that he or she... more

Elizabeth Lee, MD
Bay Area Plastic Surgeon

You are not the only patient that confused with this

There are new name for the face lift every day. Some surgeons try to distinguish themselfs with creative names like Life Style Lift, S lift, Minilift, Deep SMAS lift, Composite Lift,Neck Lift,Short Scar Liftand.... The main issue is the safety and results. Any plastic surgeon that claimst he does some thing special and new, beware. Please look at the results,look at the office staff, pre and post op pictures and ask to talk to previous ptients. Face lift is an art and the results will vary... more

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Terminology in plastic surgery can be confusing....know what you're getting

Hello - You bring up an interesting question. A SMAS facelift addresses the underlying structures of the skin, such as the muscles and the tissues that cover them. This type of facelift involves lifting these structures to restore volume to your cheeks as well as to lift the skin of your face. A lower face lift may only address the skin of the neck or cheek, but not really the underlying structures. It is this confusion that should guide you to really understand what your plastic surgeon... more

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

Facelift definitions

There are so many techniques, variations, and modification that are not easily translated into nomenclature. it is really no important what a surgery is called. The techniques and procedures should serve the goal. If you anatomy and goals are the same when you go from surgeon to surgeon, the techniques that are used to achieve your desired results are determined by your surgeon with your consent. Different surgeons might have different ideas on how to achieve an anatomic change. The... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Difference between a lower face lift and SMAS face lift

The SMAS is a complex association of muscles of facial animation that extend from the scalp down to the neck including the platysma muscle. A SMAS face lift tends to elevate, reposition and secure the SMAS in order to lift the face. A lower facelift can be done using the platysma ( a SMAS lift) or just the skin (a subcutaneous lift).

Otto Joseph Placik, MD
Chicago Plastic Surgeon

How to improve the appearance of your face and neck

You are right, there are several different types of face-lifts that doctors perform and it can be confusing. A two-layer face-lift, the most common type, involves the tightening of the tissue under the skin, or SMAS (subcutaneous musculo-aponeurotic substance). With a mini-lift, only the lower face -- from cheek to chin -- is lifted, which effectively eliminates jowls and redefines the cheekbones. As with a face-lift, the mini-lift is often accompanied by a neck lift, which removes fat... more

Michelle Copeland, MD, DMD
New York Plastic Surgeon

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