Will a SMAS facelift address the mid face?
Doctor Answers 11
SMAS Facelift Considerations
The first techniques attempted utilized pulling of only the skin. Early on it became apparent that pulling of the skin alone led to early recurrence and excess scarring - not an ideal outcome. Other techniques have been attempted with a modicum of success. The most prominent of these other procedures is the deep plane technique whereby the entire sandwich of tissue (Skin, fat, muscle and fascia) is lifted together. This technique leads to a large amount of swelling but an early recurrence of the signs of aging. But most importantly, this technique does not allow us to lift the tissues vertically.
The process of aging is caused by gravity, facial animation, stresses on the skin (weight gain, smoking, drinking, sun damage and age). The combination of gravity and facial animation pulls the tissues of the face in a downward and inward direction. Smiling reverses the sag - so look in the mirror and smile to see where your facial tissues use to be and where you hope that surgery would replace them. It is for this reason that the SMAS lift should move all tissues in a vertical direction - put the tissues back to where they once were.
So with that said, what are the risks and benefits of the Vertical SMAS Facelift.
- More natural lifting of the fascial tissue avoids the windblown or pulled look of many other techniques.
- Vertical lift adds to the volume of the cheek, removes the jowl and marionette lines to yield a more oval face.
- Vertical lift often eliminates the malar depression or tear trough.
- The SMAS facelift has a lower risk of facial nerve injury than the deep plane facelift and recovery from swelling is significantly shorter.
- Perhaps the only really increased risk relative to other techniques is the risk of bleeding or hematoma. The creation of two flaps of tissue can result in an increase risk of bleeding. But these small blood clots under the skin are still infrequent and ultimately resolve.
- All facelift procedures have risks to the sensory and motor nerves of your face. This technique does not have the same risks as a deep plane for motor nerve injury.
If you would like more information on facelifts, please read my book " A More Beautiful You - Reverse Aging Through Skincare, Plastic Surgery and Lifestyle Solutions".
SMAS Facelift and the Midface
SMAS facelift can improve the cheek but is more effective on the lower face and neck
However today most facelift patients eventually require some volume replacement at least with dermal fillers.
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In our practice, a comprehensive face/neck lift does not technically tighten the mid face. The jowls are tightened, excess face and neck skin is tightened, the neck muscles are tightened and fatty deposits are removed above and below the platysma muscle in the neck. To augment the mid face area, we perform cheek implants where there has been a loss of volume that occurs with the aging process.
For many examples, please see the link below to our facelift photo gallery
Treating the mid face
Earl Stephenson Jr MD DDS FACS