Ask a doctor

What is Your Opinion of the Roundblock SMAS Facelift Technique?

I'm 46 years old Finnish woman and am having some signs of ageing, especially on the neck. One plastic surgeon recommended a Roundblock smas -operation for me.

I was told that the RoundBlock SMAS treatment is a suspension method for face-lifts that is safe, yields fast results and reduced scars and no dead space, requires no drains, and has a quick recovery time.

Is anyone familiar with this surgery method and what is your opinion of it?

Doctor Answers (7)

Roundblock SMAS operation

+5

This technique was published in 2001 in the Journal Plastic and Reconstructive Surgery. It is a form of SMAS plication done through lesser incisions with reduced undermining.

Judging from your picture, there are some issues in the midface, the area below the eye. Upward adjustment of the SMAS does not elevate the midface immediately below the eye. For this area, we like to use an ultrashort incision cheeklift (USIC). The consequence of not elevating the midface along with the side of the face can be a disharmony between the sagging center of the face and the elevated side of the face.

One of the shortcomings of the short scar technique is the neck. The technique often does not reach far enough down to rejuvenate the neck properly. Patients can be disappointed with the looseness of their neck and correction of their jowls.

Another concern with short scar techniques is bunching of tissues. While this bunching often eventually goes away, it can ironically prolong the effective healing past what a bi- or tri-directional facelift with no bunching could accomplish.

Last, when the skin is not undermined and advanced in a hair- and sideburn sparing direction (which is different from the upward vector needed for proper SMAS elevation), an upward swoop can result on the side of the face as the skin, still attached to the SMAS, gets elevated upward.

Ultimately, the patient must weigh all factors. More important than what technique is performed is the surgeon performing the technique.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

Roundblock method

+2

I like the idea of limiting undermining but I prefer a pursestring suture personally. either way your neck will not be addressed with these procedures, might want to consider some cheek volumizing as you don't really "need" a face lift yet. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Which Facelift Shall I have?

+2

Regarding: "What is Your Opinion of the Roundblock SMAS Facelift Technique?
I'm 46 years old Finnish woman
and am having some signs of ageing, especially on the neck. One plastic surgeon recommended a Roundblock smas -operation for me.

I was told that the RoundBlock SMAS treatment is a suspension method for face-lifts that is safe, yields fast results and reduced scars and no dead space, requires no drains, and has a quick recovery time.

Is anyone familiar with this surgery method and what is your opinion of it?"

Ever since Facelifts began being performed in the 1900's there have been MANY different variations of Facelifts and the popularity of one variation over another appeared cyclical. In 1976, two Frenchmen Mitz and Peyronie described the potential use of using and pulling on the SMAS (an anatomic muscle layer than extends from the temple muscle across the side of the face to cover the neck muscles) and Facelift surgery was changed forever. Various techniques of SMAS manipulation were described, each with its own name. Instead of pulling on the skin (and getting the obvious "done" and "wind swept" face we still see by surgeon who should know better) the SMAS is pulled on allowing skin closure to be done without any tension for great, almost invisible scars.
The SMAS can be :
- undermined as flaps and pulled
- strips of it can be removed and ends brought together (Lateral Smasectomy)
- bent on itself and tightened (SMAS plication)
- gathered with purse string sutures (" round block" - better known as a MACS Facelift)
- etc, etc

To get a great result, a Facelift MUST be addressed to the patient's individual needs. In your case, the neck needs to be addressed with an additional procedure as does the area under the eyes where there is a flatness and visibility of the lower rim of the eye socket.

In my opinion a MACS Facelift WITH a Neck lift and fat injections to the middle third of the face would be your best option. Make sure your surgeon CUSTOMIZES THE FACELIFT TO YOU - NOT YOU TO THE FACELIFT.

Good Luck.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

You might also like...

Make Sure How Suspension is done to get best Results

+2

Hello in Finland,

Thank you for posting a picture with your excellent question.

The Roundblock SMAS Facelift is a modification of existing Facelift techniques. It has been previously described by Dr. Ithamar Stocchero in Brazil. He describes it as having the exact benefits you have listed.

In essence this facelift technique uses short flaps (a smaller amount of skin is lifted in order to get to the underlying SMAS/muscle layer). As a result most patients will experience less swelling and bruising after their procedure. Less surgery = less swelling/bruising = quicker recovery.

The SMAS (which is the cause of jowls, sagging tissues) is then pulled up and back and sutured in place making the jowls go away.

I am very supportive of suspension suture techniques as long as they are done properly. The best form of suture suspension is "cranial suspension". You should speak with your Surgeon about how exactly he does the suspension - it is key to getting natural and long lasting results. Threadlifts or single suture suspensions are useless.

Based on your photo, you have overall good skin tone and mild aging changes. You would therefore be an appropriate candidate for a Roundblock Facelift or a Short Scar/MACS facelift.

You would also probably benefit from a liposuction under the chin.

Finally remember that there is always some recovery time needed for these procedures - typically 7-10 days. There is no such thing as a "weekend facelift"!

Good luck & hope this helped you

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

RoundBlock SMAS Technique

+1

The RoundBlock SMAS Technique is a face lift technique that involves limited skin undermining and a pursestring suture placed around the ear.  This may be effective in a small population of patients.  However, most patients require a more involved procedure that allows for repositioning of the facial fat using the SMAS layer to restore the heart-shaped face of youth.  The careful placement of incisions and closure of the skin without tension is by far more important to having inconspicuous scars than the technique of SMAS elevation.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

Roundblock SMAS lift

+1

The round block technique uses mainly plication sutures. I am not a big fan of this because I think that you need to elevate the tissue that you want to move.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

The use of the SMAS to elevate and rejuvinate the face...

+1

The use of the SMAS to elevate and rejuvinate the face is the basis of most modern facelifts whatever you call the procedure. Be sure you have seen plenty of short AND long term results done by the surgeon you have seen and that you see in that surgeon's work results you would like for yourself.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 47 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.