Can a Doctor Call a SMAS Lift a Mid Face Lift?

I had researched the midface cheek lift, because dr. said that is what I was getting. (I paid for a mid face lift to soften the nasal laugh lines.) He did the SMAS lift, and that did not correct the area I needed correcting. Can a doctor do this?? Are they the same surgery?

Doctor Answers 14

SMAS lift and midface lift

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It may not be important what the actual procedure was called, it only matters that it did not address what the initial concern was. SMAS lift is a general term and not greatly descriptive. If you only had incisions around your ears, it is difficult if not impossible to perform a proper or adequate midface lift through that approach. Generally a mini-lift, s-lift, SMAS plication or imbrication type procedures do not address the nasolabial folds adequately. A midface lift requires direct access to the cheek tissue in middle of face through an incision under the eyes and possibly an incision above the gum lines. This can also be done endoscopically with the incisions in the temple area instead of under eyes. It is likely that your surgeon felt confident that he or she can elevate a long skin flap from ears towards the nose and try to lift the cheek tissue by placing a few sutures as close to the middle of the face as possible but it was not adequate. The procedure likely has improved your lower face and neck. You can address the nasolabial folds with soft tissue fillers, fat transfer, cheek implant or a true midface lift.

Cambridge Facial Plastic Surgeon

Is a SMAS facelift the same as a mid facelift

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A SMAS facelift and a mid facelift can be one and the same.  SMAS (superficial musculoaponeurotic system) facelift refers to the tightening of  the deeper tissues of the face and facial muscles of expressionMid facelift refers to the region of the face to be tightened (below the lower eyelids to above the jawline).  It is possible to perform a mid facelift with or without tightening the SMAS.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews


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Ther are many varieties of mid-face lifts that lift the soft tissue of the cheek and periorbital region.  The SMAS is sometimes rotated in this area to elevate the midface.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

All mid-facelifts are not the same

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Many surgeons use confusing terminology when discussing mid-face lifts. The SMAS is commonly lifted or tightened in most facelift techniques, however, unless you have an extended SMAS lift, or a true mid-face lift, you will only get mild improvement in the nasal labial fold.  A true mid-face lift is designed to address the area below your eye down to the corner of your mouth and can be done through a traditional facelift incision or through a lower eyelid incision.  Many surgeons do not venture into this area because it often creates more swelling and has a higher complication rate than other techniques.  If you are not satisfied with the degree of improvement in your nasal labial fold area, there are still many options for you that help you achieve your goals.  You may want to seek another opinion from a board certified plastic surgeon with extensive experience in facial rejuvenation to discuss surgical and non-surgical options to treat this area.  Good Luck!  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

Call a SMAS lift a mid face lift

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Yes? Maybe? No?  There are some many terms that the exact matching can be done but it is best to fully understand what each surgeon means by the terms they use. ASK QUESTIONS - Be informed!

From MIAMI Dr. B

SMAS facelift and mid facelift

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The SMAS stands for superficial muscular aponeurotic system, which is the gristle or muscle layer that is tightened during a facelift. A mid facelift is usually addresses deeper structures including the SMAS in the periosteum and buccal fat pads. Neither one of the operations will address the nasolabial folds also known as the nasal laugh lines. A SMAS lift and mid facelift are not the same procedures.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

SMAS vs Mid-face procedure

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No, I keep these as separaty defined terms in cosmetic facial surgery rejuvenation. The Mid-face lift (I had it performed on me) is designed to life the cheek tissue inferior to the eyes and in the central oval of the face.  This procedure is similar to, and in some cases , cheek implant surgery.  The SMAS (superficial musculoaponeurotic system) consists of a thin layer of tissue which is lifted and can be folded on itself during a facelift to augment the cheeks, but this tissue plane does not give as strong or full of a lift as the mid-facelift does . They SMAS and mid-face lift are often combined in facial rejuvenation surgery.


James Apesos, MD
Dayton Plastic Surgeon

SMAS lift vs. Mid Face Lift

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Face lift surgery has many names & terms, which confuses patients. Face lift surgery typically refers to cosmetic surgery to improve the jawline, lower face, and neck. Most plastic surgeons will speak of SMAS lift, and its variations, as a face lift to improve these areas.

Face lift surgery will generally not improve the mid face or cheeks. Nasolabial lines or smile lines are improved with mid facial & cheek procedures, such as a mid face lift, fat transfer, or facial fillers.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

The Difference between a SMAS Facelift and a Midface Lift

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A SMAS facelift is a catch all phrase for a technique which utilizes the tougher superficial layer of the face to help reposition and tighten the face. There numerous different techniques though only some can affect the cheek. To directly lift the cheek a midface procedure may be utilized which could be subcutaneous, submuscular or subperiosteal, all of which do not directly utilize the SMAS because there is no SMAS in this region around the eye. A midface lifts the cheek and a facelift may cover the lower face and cheek.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 52 reviews

Midface Lift versus SMAS Lift

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There are many different types of face lift procedures that address the midface.  Midface cheek lift procedures are adequate for younger patients to get some lift of the cheek area. However, they almost always need to be combined with a lower facial procedure in order to get acceptable results in older patients.  I believe that a SMAS facelift is the better procedure for elevating the midface and softening the nasolabial folds.  

Michael Sundine, MD
Orange County Plastic Surgeon

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.