Facial Widening with SMAS Facelift

Hi Oklahoma City2013-

There are many different ways to handle the SMAS during facelift surgery - fold, excise, reposition, purse string, long flap, short flap, deep plane, etc. The choice of which to choose is determined by the patient's physical attributes and the techniques that work best in the hands of the particular surgeon.

Sincerely,

Tom Kaniff

Performing a SMAS plication versus a SMAS-ectomy depends on the experience of the surgeon.  Many studies have shown no difference in the two techniques and the SMAS-ectomy, so it's really surgeon preference.

I routinely perform SMAS facelifts, but customize the actual lift for each individual's anatomy. Some patients have very thin tissue and folding, or plicating the SMAS can be appropriate. Others have thicker tissue. In these patients I remove a strip of the SMAS and then lift the SMAS and suture it back to itself. This prevents the bunching and unwanted volume in that area. You may still see some thinning of the area, but after 4 months the majority of healing has occurred. I would recommend speaking with your surgeon about your concern.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon
 

The SMAS can be trimmed, cinched or folded depending on the technique and goals for your surgery.  Some upper facial  widening may occur with repositioning the SMAS and soft tissues upward.  This may be desirable and  rejuvenating as it helps to transform the " triangle" of aging marked by descent of tissue resulting in widening at the jowls to the "inverted triangle" of youth with more upper fullness.          

 

 

The reason is personal preference of the surgeon and his aesthetic goals. You will have the swelling go down for 1 year and if it is still wide, return to your surgeon or get a second opinion.