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Can a Doctor Call a SMAS Lift a Mid Face Lift?

I had researched the midface cheek lift, because dr. said that is what I was getting. (I paid for a mid face lift to soften the nasal laugh lines.) He did the SMAS lift, and that did not correct the area I needed correcting. Can a doctor do this?? Are they the same surgery?

Doctor Answers 13

Is a SMAS facelift the same as a mid facelift

A SMAS facelift and a mid facelift can be one and the same.  SMAS (superficial musculoaponeurotic system) facelift refers to the tightening of  the deeper tissues of the face and facial muscles of expressionMid facelift refers to the region of the face to be tightened (below the lower eyelids to above the jawline).  It is possible to perform a mid facelift with or without tightening the SMAS.

San Jose Plastic Surgeon
5.0 out of 5 stars 25 reviews


Ther are many varieties of mid-face lifts that lift the soft tissue of the cheek and periorbital region.  The SMAS is sometimes rotated in this area to elevate the midface.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 19 reviews

All mid-facelifts are not the same

Many surgeons use confusing terminology when discussing mid-face lifts. The SMAS is commonly lifted or tightened in most facelift techniques, however, unless you have an extended SMAS lift, or a true mid-face lift, you will only get mild improvement in the nasal labial fold.  A true mid-face lift is designed to address the area below your eye down to the corner of your mouth and can be done through a traditional facelift incision or through a lower eyelid incision.  Many surgeons do not venture into this area because it often creates more swelling and has a higher complication rate than other techniques.  If you are not satisfied with the degree of improvement in your nasal labial fold area, there are still many options for you that help you achieve your goals.  You may want to seek another opinion from a board certified plastic surgeon with extensive experience in facial rejuvenation to discuss surgical and non-surgical options to treat this area.  Good Luck!  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 39 reviews

SMAS facelift and mid facelift

The SMAS stands for superficial muscular aponeurotic system, which is the gristle or muscle layer that is tightened during a facelift. A mid facelift is usually addresses deeper structures including the SMAS in the periosteum and buccal fat pads. Neither one of the operations will address the nasolabial folds also known as the nasal laugh lines. A SMAS lift and mid facelift are not the same procedures.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Midface Lift versus SMAS Lift

There are many different types of face lift procedures that address the midface.  Midface cheek lift procedures are adequate for younger patients to get some lift of the cheek area. However, they almost always need to be combined with a lower facial procedure in order to get acceptable results in older patients.  I believe that a SMAS facelift is the better procedure for elevating the midface and softening the nasolabial folds.  

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 17 reviews

Uilizing a SMAS facelift approach in the Mid Face

I am sorry for your disappointment in your results.  The doctor can utilize the SMAS facelift technique to improve the area of the mid face. While it is easy to get upset, it is better to remain calm and discuss further with him/her the techniques that he used and how he/she can ensure your happiness.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 23 reviews

SMAS lift and midface lift

It may not be important what the actual procedure was called, it only matters that it did not address what the initial concern was. SMAS lift is a general term and not greatly descriptive. If you only had incisions around your ears, it is difficult if not impossible to perform a proper or adequate midface lift through that approach. Generally a mini-lift, s-lift, SMAS plication or imbrication type procedures do not address the nasolabial folds adequately. A midface lift requires direct access to the cheek tissue in middle of face through an incision under the eyes and possibly an incision above the gum lines. This can also be done endoscopically with the incisions in the temple area instead of under eyes. It is likely that your surgeon felt confident that he or she can elevate a long skin flap from ears towards the nose and try to lift the cheek tissue by placing a few sutures as close to the middle of the face as possible but it was not adequate. The procedure likely has improved your lower face and neck. You can address the nasolabial folds with soft tissue fillers, fat transfer, cheek implant or a true midface lift.

Edwin Ishoo, MD
Brookline Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Facelift terminology

There are no standard terms used in facelifting that can be used to differentiate one operation from another and one doctor's version from another's.  It is posible to lift the midface with a SMAS facelift or not depending on how you do the surgery (the individual surgeon's version of the SMAS lift).  No matter what you do and what you call it, about the best you can get in terms of improving the nasolabial folds is 50% correction after 6 months of healing.  Set reasonable expectations in this area.

Call a SMAS lift a mid face lift

Yes? Maybe? No?  There are some many terms that the exact matching can be done but it is best to fully understand what each surgeon means by the terms they use. ASK QUESTIONS - Be informed!

From MIAMI Dr. B

Mid-Face lift and SMAS lift

A SMAS is a layer of the face that is used in lift procedures. It is generally preferred to pull on the SMAS than the skin to avoid a "pulled" look and maintain a longer result.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 55 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.