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SMAS facelift with fat transfer - What will improve pronounced creases extending from corners of mouth when I smile? (Photos)

Kim RJun 3, 2025
I had a SMAS facelift with fat transfer 08/2024. I now have pronounced creases that extend from the corners of my mouth when I smile. Can this be fixed? How can it be fixed? Surgical MD suggested nanofat transfer to the areas to fill in the creases.

Answers (2)

From board-certified doctors and trusted medical professionals
Dr. George Marosan, MD
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Dr. George Marosan, MD
Board Certified Plastic Surgeon
4.7 | 96 Reviews
Answered on Jun 18, 2025
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Dr. Zoran Potparic, MD
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Dr. Zoran Potparic, MD
Board Certified Plastic Surgeon
4.6 | 146 Reviews
Answered on Jun 10, 2025
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Jeffrey H. Spiegel, MD

It is possible that the lift you had done was simply not enough for what you needed. The photos are very cropped so we cannot get a complete picture of you, but, there may be some in-office procedures that can help. More information (or ideally an in person consultation) is key.

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Jeffrey M. Darrow, MD

The redundancy that you see is secondary to platysmal muscle underneath your skin. One option for you to consider would be an incision just underneath your chin, suturing/partial resection of your platysma muscle in the midline to tighten it and remove the redundancy. Without this redundant...

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Jeffrey M. Darrow, MD

As a general rule, in patients with a fuller or rounder face, the SMAS is trimmed so the overlapping of the SMAS doesn’t add additional fullness to an already full face. In patients with volume depletion of their face, the overlapping of the SMAS can accentuate the facial volume resulting in a...

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Jeffrey M. Darrow, MD

All facelifts involve elevating the facial skin a certain distance, depending upon the patient’s needs. Where they vary is what is done with the next layer underneath the skin which is called the SMAS and is a strong fascia layer . Suturing the mobile SMAS upward to the fixed SMAS is a SMAS p...

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John Michael Thomassen, MD

A temporal cheek lift will smooth out these lines. It can be done in the office under local anesthesia. I would also recommend a conservative lower lid pinch to remove improve the bunching right under your lower lid.

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Paul M. Steinwald, MD

. . . although swelling may be a limitation. The only two procedures I don't think go well together with respect to this would be lower eyelids and an infracturing rhinoplasty, which requires a splint. Would be selective with what matters most to you, however, and not try to "pack it all in"!

+4 answers
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