What is the difference between a SMAS and MAS facelift?

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

Hi,
This is a very professional question. MACS lift is in face a more simple suspension facelift. SMAS facelift on the other hand incorporates lifting, tightening and correcting the underlying tissues of the face.
Take care,
Ali Rıza Öreroğlu, MD, FEBOPRASDouble Board Certified Plastic Reconstructive and Aesthetic SurgeonIstanbul - TURKEY

Thank you for your question.  A facelift is designed to tighten and even remove the loose and sagging skin from around the jawline, the neck, and midface.  During this procedure, the deeper tissues lying below the skin will be elevated and secured, as well.  A SMAS facelift (which stands for sub-musculoaponeurotic system) elevates this deep tissue which lies just below the skin.  The elevated tissue is then lifted, and suspended with sutures.  During a MACS facelift (or short incision facelift) the SMAS is only suspended with sutures.  In other words, the SMAS is not elevated and then suspended.  The main difference between these two face lifts is the longevity and the significance of the results.  A SMAS facelift should last longer and give more dramatic results over a MACS facelift.  The recovery time for a MACS facelift should be less extensive, although some would argue the recovery times are very similar.  I would suggest consulting with a board certified facial plastic surgeon or plastic surgeon who specializes in facial rejuvenation for a full evaluation.  Here you will be able to discuss your goals for surgery, and be able to review before and after photographs. I hope that this helps!-David Gilpin

A SMAS facelift physically elevates the deep layer of the face whereas a MACS lift uses sutures to suture the face into a more elevated position. The healing from a MACS lift is shorter, but, in theory at least, the results may not be as dramatic or long-lasting as the SMAS lift.

Thank you for the question. I think you mean a MACS lift? The SMAS is a tissue layer in the face comprised of deep connective tissue and platsyma muscle. A SMAS facelift involves treating this layer (in a variety of ways, depending on your surgeon, etc.), as opposed to just pulling the skin. Some treatment of the SMAS is needed for a facelift to be effective, longer-lasting, and natural-appearing. In my practice I use a sub-SMAS (under this layer) dissection called a deep-plane technique. The MACS lift (minimal access cranial suspension) is a type of mini-facelift that does not dissect out the SMAS layer specifically. Rather, in this technique, purse-string sutures are used to create vertical tension on the connective tissue. This type of lift is, IMHO, only effective in very mild cases. Best of luck with your decision!

MAS is generally a lift of the superficial tissues and skin of the face, while SMAS reconstructs the deeper tissues and usually gives a longer lasting result as compared to MAS alone. It tightens the underlying tissues and give the face a more natural result.

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I highly suggest the SMAS faceift. It goes deeper into the face compared to the MACS. Often, patients who get a SMAS facelift see longer term results although often some argue the healing can take longer.

Dear bskyb1957,
Thank you for posting your question. Both are types of facelift but differ in how they address the underlying supportive tissue of the face - the SMAS layer of tissue.  A MACS lift (I assume this is what you mean by MAS) is a short scar facelift that lifts the SMAS layer by using two to three pursestring sutures to tighten and and lift. It does not extensively dissect or lift the SMAS layer.  A SMAS facelift is usually more comprehensive and deals with the SMAS layer more extensively. It can be short scar or full scar (face and necklift) and can tighten the SMAS layer in a few different ways - plication/lifting and repostitioning flaps of tissue/excising part of the layer and closing it over tighter.  
A full SMAS face and necklift will give better and longer lasting results than a MACS facelift especially in the neck. A short short scar SMAS facelift result can be similar to a MACS facelift result in the early stages but usually the effects last longer than a MACS lift.
If you are considering a facelift, it is important to go over what you are hoping to achieve from it with your surgeon - extent of results, longevity of results and what you are prepared to undergo - lenght of surgery, extent of recovery etc.
I hope this was helpful.
Best wishes

 Hi, I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.   The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience when evaluating the face, it's key to determine the following:  Are the cheeks, chin and lips the ideal aesthetic shape?  Are "jowls" present and is there excess fat and skin in the face and neck.  Once these factors are determined, the proper aesthetic plan can be determined to make the face balanced, (for women) feminine and more naturally youthful and beautiful (while for men creating a more chiseled, angular and handsome face). If you have "jowls”, in the lower face, these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.  Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  With flat or concave cheeks in the front, cheek augmentation with a dermal filler or using cheek implants (for a permanent enhancement) will create full, round cheeks that will feminize the entire face.  Conversely, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.
 When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
Hope this helps.