SMAS and skin fascia, what are the major differences between a Facelift where the skin is moved and SMAS?

Good question.  Lots of different types of facelifts.  The SMAS is the name given to the layer of the face that has the muscles that are lifted during a facelift.  Think of a slice of meat in a sandwich (Gross-- I know) . The SMAS is a layer located below the skin. Think of the skin as a slice of bread over the meat (once again---I know).  A facelift can be performed where the skin is separated from the SMAS and only the skin is tightened.  The skin and the SMAS can be elevated separately and both can be tightened, separate from  each other.   The skin and the SMAS can be lifted together, i.e. lift the skin and SMAS as a unit. This type of facelift is called a "deep plane".  Everybody needs or benefits from different approaches. I feel strongly that any facelift should involve the SMAS. As you can see, I am working on my analogies.

There are several different types of face-lift techniques available today.  The SMAS layer is the fascia and skin below your facial and neck skin.  By mobilizing this tissue, and tightening this layer, you will have a more natural and longer lasting result.  This is the layer of tissue that sags with aging.  A skin only face-lift, will not be long lasting, and is a much simpler procedure.

Hi there. It is can be quite confusing with so many different terms and variations in technique so you are not alone in struggling to decipher the differences. Basically, a skin only facelift is a historical procedure except in very rare circumstances. Manipulating the deeper tissue of the face (SMAS layer) is the key to getting a natural look and long-term results. This can be done in a variety of ways - removal of a section of SMAS, suspending the SMAS (pulling it higher up on the cheeks), or just tightening it (plication or imbrication techniques). All SMAS techniques work to some extent and the key is probably your surgeon's experience or expertise with a particular technique. Good luck!

Thank you for your question. For a facelift to be successful, the anatomical changes of aging must be reversed. A modern facelift does not just tighten the skin. This gives a windblown and unnatural appearance. Instead, the most advanced techniques refinish the skin, reposition and contour unfavorable fat deposits and tighten the muscles creating a natural appearing and long lasting, youthful facelift. I suggest that you discuss with your surgeon. Your surgeon should be more than willing to disclose with you all of your surgical information. That transparency is part of the patient-surgeon relationship. Always consult with a board certified facial plastic surgeon.Best wishes,

Skin placed under tension will stretch. For this reason I feel strongly that every facelift should have the tension placed in the SMAS and or muscle layers before advancing and removing skin excess. Additionally, like making a bed, the underlying layers should be firmed  before removing the slack from the top layer (skin) for a smooth toned appearance.  The direction of lifting should that which naturally removes the slack. This may be somewhat different for each layer and even vary for each person

SMAS is a layer of tissue under the skin and subcutaneous fat that when manipulated in a facelift either by imbricating it or raising it as a flap and suturing it under tension, helps give facelifts results longevity.  Skin only lifts tend not to last as long.