Why is SMASectomy not commonly done during rhinoplasty?

Question

For medium to thick skin types, SMASectomy seems to improve nasal tip definition. From the few research papers I have seen using this technique, the results seems to be better than if it were not done. Are there any surgeons who routinely do this? Who are they? Thanks.

Eric M. Joseph, MD · Answer

The nasal SMAS layer is mostly along the side walls of the nose, and this consist largely of the dilator nasal muscles. When somebody has thick skin that limits tip definition, we may perform a defatting of the nasal tip skin to make it a bit thinner. Some people have extensive sebaceous glands underneath the nasal tip skin, and during an external rhinoplasty procedure, this may be dealt with. I hope this answers your question. Sincerely, Dr. Joseph

Anil R. Shah, MD · Answer

While a SMASectomy is not a routine procedure in rhinoplasty it is can be done to address fullness in the Superficial Musculoaponeurotic System (SMAS) can be beneficial for certain patients seeking nasal refinement. Manipulating this soft tissue is a crucial aspect of rhinoplasty to achieve desired aesthetic outcomes.

Lexie Wang, MD · Answer

I think many rhinoplasty surgeons will routinely do this, esp for thicker skin nose patients. It is not that novel of a procedure that you would have to go hunting to find specific people who do it. If you are concerned, you could always specifically ask any surgeon you consult with.

Ronald J. Edelson, MD · Answer

A SMAS is not part of rhinoplasty.  It refers to something that is fine with a facelift.  I have never heard of the SMAS in relation to rhinoplasty

Jeffrey H. Spiegel, MD · Answer

I do this regularly for people with thick skin, or with persistent scarring and thickness after a prior rhinoplasty. When done correctly it is very effective.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You may be confusing facelift terminology with rhinoplasty. Although perhaps some obscure literature states this in rhinoplasty somewhere, it is not a term typically used in rhinoplasty. In thick skin patients it is possible to debulk the soft tissue for improved refinement and many surgeons often perform this. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Why is SMASectomy not commonly done during rhinoplasty?

Answers (6)

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