How Long Will a SMAS Facelift Last?

After a SMAS Facelift is performed, what prevents the sutures from slicing thru the tissues and the face dropping back down and what causes little fat pouches beside the side of the mouth after Facelift?

Doctor Answers 17

SMAS Facelift Duration

A SMAS Facelift can last generally between 7 to 10 years.  The quality of a patient's skin can impact the duration.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 21 reviews

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SMAS Duration varies, but typically several years

My other colleagues make good points. In adding to the discussion, I would offer several points:

1. Any cosmetic procedure will provide longer-lasting results if you reduce the amount of future insult to the tissues. Typically, we discuss this point with laser resurfacing. You can think of it as waxing your car. If you park it in the sun, it won't last as long as if you park it in the garage. Sun-blocking make up and skin care products will help your investment last longer. Surgery is similar. Don't get a face lift, and then lay out every day for 5 years and complain when you age faster than you wish.

2. The sutures will pull through the tissue when there is a lot of tension on them. For this reason, I prefer to place several sutures deep in order to evenly distribute the downward forces over many points, thereby reducing the amount of tension on any given point of pull or fixation. This reduces the amount that any given suture will tear through the tissue. However, realize that the tissues are elevated and moved, and then simply held in place by the sutures until scarring between the layers develops, which ultimately provides the final "hold". Therefore, it's really only an issue if a suture break or tears in the immediate post-op period, which is another reason to place several so that all your work isn't "hanging" or depending on one suture.

3. SMAS lifting means that the surgeon is doing something with that layer, but is not specific as to what they are doing to it. Some surgeons simply put a pleat or plication in the SMAS folding it up on itself, and call that an SMAS lift. Others actually develop a separate layer of elevated SMAS tissue and remove a section of this layer, shortening it, and increasing the pull.

Since I am an ASOPRS-certified oculoplastic surgeon first, I frequently utilize this technique as it is more consistent with our field's surgical beliefs and principles, and the excised SMAS tissue can be used during endoscopic brow lifts to fill the glabella (between the eyebrows) or round out the lateral orbital rims (under the brow tails). It makes a wonderful filler in these areas, whcih I am typically doing in conjunction with the facelift.

Just beware not all SMAS lifts are the same. Ask your surgeon which approach they use and why. As long as they have a good reason, and good results, you should be fine.

I hope this helps!

David M. Mills, MD
Pensacola Oculoplastic Surgeon
5.0 out of 5 stars 1 review

SMAS Facelift Duration

The longevity of a facelift can vary depending on the initial procedure. A facelift that addresses the underlying descent of facial soft tissues provides the greatest longevity. A facelift that lifts the underlying SMAS will re-elevate descended facial tissues and improves the appearance of the cheeks, jowls and often the neck. In a patient with good skin quality, this facelift should last 7-10 years.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 4 reviews

How Long Will a SMAS Facelift Last?

A SMAS (sub-muscular aponeurotic system) facelift is a face lift technique that tightens the deeper layers of the face rather than just tightening the skin. This technique is similar to a deep plane facelift and a MACS lift in that these procedures all aim to reposition the deeper tissues to get a more youthful look. They are more involved than a skin only facelift. A MACS Lift uses much shorter scars.
All of these techniques will last your lifetime but the deeper tissue procedures seem to stand up a little better according to the comparative studies.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
5.0 out of 5 stars 21 reviews

How long does a SMAS Face Lift Last?

We have performed the only study on the longevity of a face lift that has been published. Using a SMAS face lift technique in a carefully followed series of patients, it was 11.9 years from the time of the primary face lift before a secondary face lift was required.  Adequate mobilization of the SMAS and then careful suspension will prevent the tissues from falling back down.

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

SMAS Facelift lasts Forever

You will always have improvement of your appearance following a SMAS facelift. Depending on your age, exam and skin elasticity it could turn back the hands of time 5-15 years.That being said the analogy I like using is; turning back the hands of time with a procedure. It would be nice if the clock stopped but it keeps on ticking. An experienced board certified surgeon will usually turn back your appearance in a natural manner a bit more than others and allow the clock perhaps to tick a bit slower

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

SMAS facelift longevity

A facelift will last different lengths of time for different people based upon their anatomy, genetics, and general habits.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

A facelift may last 5-10 years

With a good technical SMAS facelift, the results may last 5-10 years or longer.  This type of facelift not only removes the excess skin of the face, it lifts the internal structures (SMAS) and tightens the skin.  It should smooth out the folds beside the mouth and lift the jowls.  As long as you take care of your skin afterward, you should expect a long-lasting result.  Good luck!

A well-executed SMAS facelift should last a lifetime.

Most patients have only one facelift in a lifetime if it is well-executed.  A SMAS facelift heals in a matter of days and at that point the sutures are irrelevant.  The tissues that have been repositioned are biologically sealed.  Patients will continue to age, obviously, but most don't reach a point where a full secondary facelift is indicated.  I do secondary facelifts, but probably on less than one in 25 patients.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

SMAS Facelift longevity

Assuming that you continue to enjoy good health, do not fluctuate excessively in your weight, a SMAS facelift can last 10-15 years.  I have noted that the average age of my facelift patient ranges from the mid 40's to mid 50's, which is approximately a decade younger than my father's patient base.  Facial aging can be classified from outside to inside.  Skin texture, tone and color can suffer with excessive sun damage, resulting in fine wrinkles, sun spots and an overall dull complexion.  "Solutions" include medical skin care, peels and/or light based therapies, such as IPL or laser.  Aging also alters the facial fat composition, melting it away in some areas and causing excess deposition in others.  There are a variety of ways to volumize a face, which include fat grafting and fillers. 

Facelift techniques include a) skin only; b) SMAS flaps; c) subperiosteal; d) stem cell augmentation; e) short scar lifts.  Intuitively, a skin only approach is destined to early failure, as the skin's floppiness returns.  By "repairing" the SMAS flap to a more superior position, the longevity of the lift isn't solely dependent on the skin and in my experience has yielded longer lasting results. 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 45 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.