What is the difference between a Facelift combined with a neck lift doing the SMAS technique vs a platysma?
Doctor Answers 31
Face and neck lift
The SMAS layer refers to the "superficial muscular aponeurotic system", which consists of the superficial muscles of the face and neck. There are different approaches to the SMAS layer during face lift. One of the most common techniques is a SMAS plication. This involves resuspending the facial muscles which have descended over time to restore volume in the midface region. Stitches are placed in the SMAS layer to resuspend it and no tissue is actually removed. During a SMASectomy (which is a different technique), a portion of the superficial muscle layer is removed and the edges are stitched together. I recommend clarifying with your surgeon before proceeding to understand the risks and benefits of these techniques. There is slightly higher risk of nerve injury when a portion of the SMAS is resected, since the nerves travel deep to this layer. Although a nerve branch may still be injured with a suture during SMAS plication, there is lower risk of actually dividing the nerve.
The platysma is a superficial muscle in the neck, which is a continuation of the SMAS layer. It is often resuspended during face and neck lift to increase definition of the submental region and cervicomental angle (where your jaw meets your neck).
It sounds as though the two surgeons are using different terminology to describe similar techniques.
Stephanie Power MD, MSc, FRCSC
Smas and platysma
J Weinrach MD FACS
What is the difference between and facelift combined.......
Results from the techniques you mentioned are just as dependent on the skill of the surgeon as they are on the specific technique. Since you have consulted with the surgeons, you should have been able to see before and after photos of patients who had that surgeons procedure (i have attached my photo's as an example). In addition, both surgeons should have been able to relate their experience in terms of the number of procedure performed. Surgeon experience with their particular technique and their ability to tailor the procedure for each patient will lead to lasting and natural results. Many surgeons are good a doing many things however a few are great a doing one thing. Find your expert who you feel comfortable with, both a surgeon and a person. Thanks and good luck with your search.
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SMAS vs. platysma
That is a great question and really it is two ways of saying the same thing for the most part. The SMAS refers to the superficial musculoaponeurotic system. It is a layer of tissue in the body that is under the skin but above the muscles of the face. It works great for facelifts because it can hold a lot of strength so when we tighten it the results last. As you go to the neck the SMAS layer disappears but it is continuous with the platysma muscle. This is a large muscle that is located on the front of your neck extending down to your collar bone. This is the muscle that is lifted in continuity with the SMAS above.
Now a difference can exist when dealing with the mid portion of the neck. First, the platysma is the muscle responsible for those bands that run from the chin towards the collar bone. To help address this you can make a small incision just under the chin and then free up the middle edges of the muscle. You then can either sew these edges together (platysmaplasty) or you can cut them in various ways (platysma myectomy). This may be what your surgeon was talking about and is a great way to help with those bands. Simply pulling on the back edge of the platysma (or SMAS) will not improve these bands in the neck.
I hope this helps to clear things up and good luck.
Approach to Facelift
Face and neck lift technique
Face and Neck, SMAS and Platysma Lifts
Good pick-up on the conversation. About 40 years ago, a second layer of face lifting was introduced which offered many advantages in lifting, suspending and duration of results. This layer is used in various techniques today.
The SMAS or superficial muscular aponeurotic system is a layer of flat muscle and fascia within the face. The platysma muscle of the neck resides in that same layer. Your 2 prominent NYC plastic surgeons are both correct.
This layer of tissue is tougher and therefore can be plicated, lifted, elevated and advanced, suspended and different ways to improve the results of the traditional facelift.
My personal techniques include:
- High plication of the SMAS to lift the jowl, fill the upper cheek lift the corner of the mouth and pull upwardly on the platysma.
- A corset platysmaplasty to join the medial bands of the neck muscle to create a tighter, smoother neck and jawline crease and support the floor of the mouth.
- A neck suspension suture to sling and support the neck creating a more apparent neck crease and outlining the posterior jawline.
- Other options occur depending on the needs of the patient.
I hope this helped. All the best!
Techniques of facelift
Terminology can be difficult...
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