SMAS Facelift Q&A
33%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
5 Reviews
SMAS Faceliftbefore & after photos
View Before and Afters

Average SMAS Facelift Cost: $8,640

Learn about SMAS Facelift

48 people and 137 doctors are talking about SMAS Facelift

Get Free Email Updates

Does Lifting and Tightening the SMAS Cause Cheeks to Flatten?

asked 2 years ago by kpilling in walnut
Latest answer by Babak Azizzadeh, MD
Question viewed 1,002 times

A doctor told me that tightening the SMAS causes the cheek to flatten. Is this true and if so how do you avoid that? Also, if you just do a composite necklift which address the lower third of the face is the SMAS involved?

14 answers to Does Lifting and Tightening the SMAS Cause Cheeks to Flatten?

+1

SMAS plus adding volume to the cheeks

No, SMAS should not cause the cheeks to flatten. But keep in mind that the cheeks are not addressed with lifting during SMAS. If your cheeks need to be rejuvenated, that will require add volume to them with fat, Sculptra or fillers. see video
Babak Azizzadeh, MD

Beverly Hills Facial Plastic Surgeon
+1

SMAS and cheek flattening

It depends upon where the muscle is sutured. The important thing, if a patient has any qualms about which area of the cheek would be tightened and flattened, is to discuss them with her plastic surgeon.
Robert L. Kraft, MD

New York Plastic Surgeon
+1

Smas facelift

Liftint he soft tissue of the face by suing the SMAS doesn't flatten the cheeks but often autoaugments them.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

SMAS Elevation Creates Voluptuous NOT Flat Faces.

It is skin tightening across cheeks that causes flat faces.  A advanced technique SMAS Facelift should uses the SMAS layer as a vector to carry the facial fat to more superior positions, enhancing cheeks, periorbital, and cheekbone regions.  This result actually looks more full and voluptuous, with little tension applied to the skin for the actual lift.  Facelifts that rely upon tension on the skin move little of the facial fat, and when pulled over structures such as the... more
Daniel Shapiro, MD

Scottsdale Plastic Surgeon
+1

SMAS cause cheeks to flatten

As the majority of the expert posters have stated NO! The SMAS if done correctly can not flatten the cheek, just the opposite happens. Please re think the question. From MIAMI DR. B
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

SMAS facelift do not cause cheeks to flatten

The cheeks themselves are not flattened with SMAS tightening. However, there can be a slight flattening effect in the area in front of the ear due to tightening of the SMAS itself. This is not over the cheek area; it is just in front of the ear. The SMAS is involved with a comprehensive face/neck lift. The SMAS is not involved with a neck lift only procedure.
William Portuese, MD

Seattle Facial Plastic Surgeon
+1

SMAS Facelift do NOT flatten cheeks

The cheek or the malar eminence is a bony structure which short of being hit well with a powerful blunt object cannot be flattened. There is no way in which pulling on the SMAS will lead to cheek flattening and I must only conclude that either your surgeon was inarticulate or you may have misunderstood him. There is a large number of SMAS manipulation based Facelift procedures all of which lift the neck and sagging face structures and put them back in their attractive youthful... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

SMAS face lift

The SMAS in a face lift is the vital structure that allows the tightening of the facial structures. There are many ways to deal with the SMAS depending on the experience and knowledge of the surgeon. When contemplating and planning for a face lift, the amount of subcutaneous tissue is taken in consideration as well. The SMAS can be used to give bulk to the cheek and infact there are techniques that  the SMAS can lift the cheeck. If there is not enough subcutaneous tissue... more
Samir Shureih, MD

Baltimore Plastic Surgeon
+1

What do SMAS lifts do to the cheek?

The way that most surgeons do these nothing happens to the cheek. If the surgeon wishes to add to the cheek with a more vertical pull of the SMAS, this will give very little cheek fullness in the average patient. Because of this we often do a cheek lift at the same time or cheek implants.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

NO, IT ADD FULLESS

THE SMAS IS FOLDED AND ADDS FULLER CHEECKS AND YOUTHFUL  DIMENSIONS TO THE LIFT.
James Apesos, MD

Dayton Plastic Surgeon
+1

SMAS, cheeks and necks

It depeds on what is done with the SMAS. Occasionally it is folded and rotated on itself to augment or enlarge the cheeks. A neck lift is commonly performed by resuspending the platysma muscle which is part of the SMAS.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

SMAS Face lift

I strongly disagree that SMAS lift will flatten the midface, and agree with Dr. Rand.  I can only speculate why a plastic surgeon experienced in facelifting would say that. Please see my photos, as they are worth 10,000 words.
Scott E. Kasden, MD

Dallas Plastic Surgeon
+1

SMAS lifts should enhance not flatten the cheeks

By rotating the SMAS directly vertically and folding it on itself before suturing it you should see enhanced cheek volume not a flattening.  It's almost like having a cheek implant put in.  Check my photos on RealSelf and on my web site/ 
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

SMAS lift and shaping the face

The advantage of the SMAS lift is that as the SMAS is lifted vertically, there is excess that can be manipulated in several ways.  In the full face, this excess is removed so as not to add volume to an already round face.  In the thin or hollowed face, this tissue can be folded on itself to increase volume.  As for the question about the neck lift, there are so many ways and so much terminology that is used with respect to these operations- the best thing to do is ask your... more
Adam David Lowenstein, MD

Santa Barbara Plastic Surgeon

Ask a question