High SMAS, Deep Plane of Cheek Lift - What is best for me? (photo)

Question

Posting pics of my face as it hangs normally and pics of how I would like all the fat and tissue lifted for defined jaw, plump cheeks and contouring. My cheeks are flat when not smiling and sag down making my face look long. When I smile I have some fat cheeks. Thank you I’m really looking for a Surgeon that can lift all this up.

Lucian Ion, FRCS · Answer

In the photos where you are lifting the cheeks you are producing a very detailed increase in contrast with the area under the cheekbones. In your relaxed images, the left side has a more contrasting sub-malar shadow, the right has a smoother contour. This is due to the different strength of some attachments between the skin and deeper structures.Based on you description of outcome, you may want to avoid facelift procedures that produce a uniformly smooth cheek surface, even though some patients prefer that shape. Typically the deep plane produces a smoother contour, and so does the high SMAS. There are some options that can enhance the cheekbone areas:- fat transfer, cheek implants, mid-face liftsThey can be combined with tightening of the SMAS either with a vertical or oblique vector, but with the line of tightening positioned a little lower, to allow the contrast between cheekbone area and mid-cheek.A combination procedure seems more likely to give you the desired outcome rather than a specific type of facelift.

Jeffrey M. Darrow, MD · Answer

Overall, you have excellent facial contour and volume retention. The aging you see in your face is normal. A facelift with a SMAS vertical plication would accent the volume of your face upward over your cheekbones, smooth your mid cheek and jawline, and contour your neck.  The common line in all of this is skin elevation, and a vertical movement of the SMAS. There are a number of variations on how to perform this SMAS, no one has been shown to be better or give superior results to any other one. Have a detailed discussion about your options with your plastic surgeon. Best wishes.

Jeffrey Lisiecki, MD · Answer

You look like a great candidate for a facelift with fat grafting.  The SMAS can be lifted/tightened in many different ways, whether its older techniques like the deep plane or newer techniques like the lateral SMASectomy, and they can all work depending on the surgeon's skills and your anatomy.  The addition of fat grafting to a facelift has been a real game changer for more fuller cheeks, soft and natural contours, and longer-lasting results.  You're also pulling on your eyelids in the photos--definitely speak to your surgeon about eyelid surgery as well, which is commonly performed with a facelift.

Gianfranco Frojo, MD · Answer

I would recommend a deep plane facelift/necklift with some facial fat grafting. You need to make sure that you find a well-trained plastic surgeon (actually completed residency/fellowship in plastic surgery, not "facial plastics"). This is important because you need a surgeon that is comfortable with plastic surgery techniques in the face from adequate training.

Rohit Jaiswal, MD · Answer

High SMAS and deep plane techniques can both be used for excellent results. Both techniques can effectively reposition the supportive structures of the face in the direction you show with your fingers. In addition both techniques can enhance the volume of the cheek by repositioning the mid-face. I prefer a hybrid of both techniques for my facelifts. The exact technique does not matter as much as your comfort with the surgeon and your assessment of his/her before and after photos.

High SMAS, Deep Plane of Cheek Lift - What is best for me? (photo)

Answers (10)

Answer: Lift All This Up

Answer: Lift All This Up

Answer: Facelift techniques

Answer: Facelift techniques

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High SMAS, Deep Plane of Cheek Lift - What is best for me? (photo)

Answers (10)

Answer: Lift All This Up

Answer: Lift All This Up

Answer: Facelift techniques

Answer: Facelift techniques

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Recommended reading

Everything you need to know about SMAS Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.