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Facelift technique: Skin only pull vs Muscle pull

Do ALL Doctors use the SMAS technique (SKIN and MUSCLE) to perform a full facelift? If not, why?.... I read using the "skin" only pull is useless. Why would a doctor choose to use the skin pull and not the muscle pull?

Doctor Answers (12)

Tightening the smas

Tightening the SMAS is beneficial in the vast majority of cases, and probably in all primary cases (patients who are having their first facelift). You should ask the surgeon why he is doing a skin only facelift as only he would know. Perhaps he is not comfortable doing a SMAS facelift.

Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 8 reviews

Skin lift

Facelift technique that relies on skin pulling rather than tightening underlying SMAS had been commonly used a few decades ago, but now is practically abandoned.  You would be hard pressed to find a surgeon who still uses this method of facial rejuvenation.  However, there might be a situation when skin repositioning rather than tightening is indicated.  Skin only lift would be appropriate in this case.

Best wishes!
Dr. Konstantin

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Is a skin lift useful?

The only time that I do a "skin only" pull is when I am revising scars or pixie ear deformities on patient's who have had a facelift by another surgeon. If any lifting of tissue is desired by the patient, it is essential to address the SMAS. Lifting the SMAS and anchoring it in its more natural position is the most reliable method of providing a lasting result. A skin only lift would likely not last more than several months and there is a significant risk that unwanted scarring could result from putting too much tension on the skin.

Todd C. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

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SMAS vs. Skin Only Facelift

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For a good facelift the SMAS facelift remain the gold standard, and will last longer. why others do skin only facelift, maybe they do not know how.
Samir Shureih MD.FACS

Samir Shureih, MD
Baltimore Plastic Surgeon

Facelift techniques

Dear Netalia,

  • It would be best to get the answer out of your surgeon
  • If you have seen before and after pics of patients that have similar anatomy, then this may be indicated
  • For a full facelift, we usually tighten the skin and muscle to get the most natural result
  • A second opinion may help you get piece of mind

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

SMAS vs Skin-only Facelifts

I believe that most plastic surgeons perform some variation of a SMAS facelift. This gives more longevity to the procedure.  Skin only facelifts can be performed for minimal corrections and this shortfall of skin only facelifts should be discussed with patient prior to any surgical intervention.

Earl Stephenson Jr, MD DDS FACS

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
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Facelift Techniques

The modern facelift typically involves two levels of facial "tightening".  The SMAS layer, which is a layer of connective tissue covering the facial muscles is first tightened.  The skin in then tightened as well.  By tightening the SMAS and skin together, a more lasting and natural result is achieved.  Good Luck

Anthony Corrado, DO
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Face Lifting techniques

There are many different techniques available to surgeons to  rejuvenate the face. Most facelift surgeons  tighten up  skin and muscle. A skin only facelift with very short lasting.
A comprehensive face/neck lift in our practice involves tightening the platysma muscle in the neck in 3 locations, removing fat above and below the platysma muscle in the neck, tightening up the jowls and SMAS, and tightening facial and neck skin. For many examples, please see the link below to our facelift Photo Gallery

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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.