Ask a doctor

SMAS Facelift No Effect? (photo)

Dear Doctors, I'm 4 weeks post smas facelift. Problems were not resolved. I've posted some pics. It was SMAS facelift lower 2/3. I'm young patient, but I wanted to resolve the problem which happened after cheek implanted and removed and the problem still not resolved. Please look the pics and tell if its normal result after smas facelift or this is improperly done smas facelift? could the result be improved? Should I do another facelift or it can be corrected other way? Thank you!

Doctor Answers 10

Improving a poor facelift - Los Angeles

You may want to wait until swelling is resolved. Otherwise, options include Ulthera, fillers, and a revision facelift. Raffy Karamanoukian Los Angeles

Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

804 7th Street
Santa Monica, CA 90403

SMAS Facelift results

It is difficult to know what was done and why you do not see a good result.  However, I know that the way the face looks immediately post-op is a good indicator of how it will look long term - minus the swelling.  Probably need to go and discuss with your surgeon.

Jay Calvert, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 32 reviews

465 N. Roxbury Drive
Beverly Hills, CA 90210

Results after SMAS facelift

It does not look like you have gotten much of a result from your facelift.  I would have expected the slight tissue conyout int h epre-op picture to have been substantially improved.  Your lift may need to be revised wit a more aggressive procedure. Be sure to see a Board Certified Plastic Surgeon who can show you a comprehensive portfolio of pre- and post-op pictures so you can see the types of results that you can expect.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 19 reviews

1208 East Kennedy Blvd
Tampa, FL 33602

Smas facelift without enough lift

Without seeing good before and after photos, its difficult to comment on the result and whether the procedure was not done well or you have as good a result as one can expect. After 4 weeks, its very early to know what the result will be. I would suggest waiting at least 3 months and if at that time you are not satisfied, discuss the issues with your surgeon.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

1404 E. Broward Blvd.
Fort Lauderdale, FL 33301

SMAS Facelift and post operative options for further cheek enhancement

At just 4 weeks post SMAS facelift, you are still in the early stages of healing and my best advice would be to give things more time before suggesting any further surgical procedures.  Although it does not look like there were any complications with your facelift, you may benefit from some moderate cheek enhancement with either injectable fillers such as Radiesse, Sculptra, or Juvederm or free fat transfer.  However, I would wait at least 3 to 6 months before proceeding with these options.  Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
5.0 out of 5 stars 26 reviews

2581 Samaritan Drive
San Jose, CA 95124

SMAS Facelift

It looks like you lost volume in your face and a SMAS facelift can not accomplish that alone. You need volume either with fat injection or with fillers.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Results after a smas facelift , litelift , lifestylelift

there are many ways to do the smas..  you may need some more time to heal..  the lift may need to be redone. discuss this ,  get another opinion in 3 months

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 30 reviews

3991 MacArthur Blvd
Newport Beach, CA 92660

SMAS Facelift Dissatisfaction

    This really comes down to patient expectations and limitations in current surgical methodology.  I would say that nothing appears to be improperly done in the photos.  However, the full face before and after is necessary to evaluate this further.  You probably have dependent swelling in the lower face at this juncture, which is masking some of the result. 

        You should realize that no surgical technique fully addresses the nasolabial fold, and pulling with your hand cannot be achieved surgically.  This is because your skin has inherent laxity which precludes this drawn sheet appearance. 

      Cheek deficiency cannot be addressed fully with facelift techniques.  Fat grafting is usually necessary to add volume, particularly in a face that has had cheek implants removed.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 336 reviews

435 North Roxbury Drive
Beverly Hills, CA 90210

Nasolabial Fold Very Difficult to Correct

Thank you for your question.  Your question and photos, although not complete suggest that there may be other issues. A history of a cheek implant suggests that you may have underdevelopment of the cheek region.  This makes the soft tissues of the face droop much earlier and more difficult to correct. Removal of the cheek implants would certainly make the folds worse.  When doing a facelift, the nasolabial fold is the most difficult to correct area.  An extended deep plane SMAS dissection with cheek lifting is required...a composite facelift.  This problem can be so vexing that other approaches such as direct excision of the fold and liposuction of the area in front have been performed. Most people opt for fillers or fat to camouflage this area as it is simpler and less expensive.   More definitive answers regarding what is most appropriate would require an in person consultation.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
5.0 out of 5 stars 52 reviews

6499 E. Broad Street
Columbus, OH 43213

No effect 4 weeks after SMAS facelift

Your pictures do not show your neck, so it's difficult to evaluate the results of your SMAS facelift.  Four weeks is much too early to see any final result, so your appearance may still improve with more time.  Normally, a SMAS facelift would primarily affect the upper neck and lower face, so it would not usually be the procedure I would use to address the upper cheek.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

500 Sutter Street
San Francisco, CA 94102

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.