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

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.

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.

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.

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.

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.

A Mini Facelift with SMAS tightening can usually be an option on most realistic patients anytime after the age of 35-40. It really depends on your anatomy and genetics. It is best to talk to your surgeon because everybody has different techniques and recovery time is usually based on a number of factors. If we are just talking about a short scar facelift, this can typically be done in the office under local anesthesia. Usually there are no drains, no outside stitches, and patients can go out in public the same day, although I usually recommend they low for the first couple days. Most of the initial swelling is from the numbing medicine and your body absorbs it within the first 4-6 hours. Obviously the body heals with swelling and inflammation and usually that maxes out at two days and then starts getting better. Most of these patients take no pain medicine and usually feel very comfortable going out in public within a few days.  I usually call my patients the night of surgery and check on them the next day. If everything is fine the next day, I then let them shower and they do not need a dressing over their incisions. They can usually start using make up after a few days.  At the two week check up, I usually have people start working out and then after six weeks they can do whatever they want. I routinely tell people to take a few days to a week off work and to hide out but some people are very nervous especially celebrities and I usually tell them to hide out for two weeks. As with any scar on the human body, initially scars are red, hard and raised and it typically takes six months to a year for them to become a soft thin white line. Additionally with recovery, there're many things we do to expedite healing such as nerve blocks during surgery, oral supplements, skin care and scar therapy recommendations, lymphatic massage sessions that are included in our pricing.I strongly feel that it's very important to have an honest conversation with your surgeon about your particular situation, lifestyle, work environment and specifically which procedures you're having done so that you both have the most honest answer about your recovery and are realistic with expectations and results.Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls.I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

Thank your question.  The high SMAS surgery will restore the fullness in the chicks, improved the jowls, thigh ting your skin and have a sharper jaw line.   So after reviewing your pictures I believe that is a good technique for you

Much more information is needed, such as a set of facial photographs from all angles and your age. If you're looking to augment the mid-face permanently, cheek implants would be a your best solution. Cheek implants are manufactured in a large array of thicknesses, sizes, and shapes which is best determined at the time of the consultation and examination. In our practice, we place cheek implants through intraoral incision under a brief general anesthesia.  The goals of a high-SMAS lower face and neck lift procedure is to tighten loose facial and neck skin, tighten loose facial and neck muscles, remove fatty deposits in the neck, and lift the jowls.

In a SMAS procedure, the tissue deep to the skin is either
tightened, partially resected, or elevated which generally achieves a
longer lasting and better result than a skin lift alone. A high SMAS
divides and reattaches the SMAS farther up on the cheek. Deep plane lifts
dissect all of the tissue at a deeper level but may result in a higher level of
facial nerve injury, generally have a longer recovery and there is no valid
scientific evidence that they last longer.
Good results can be achieved with any of the techniques in
the appropriate patient. What is more important than the specific technique is
the experience and artistry of the plastic surgeon
 I
would suggest your plastic surgeon be certified by the American Board of Plastic
Surgery and ideally a member of the American Society for Aesthetic Plastic
Surgery (ASAPS) that you trust and are comfortable with who has all of the
modalities of treatment available. You should discuss your concerns with that
surgeon in person. Facial rejuvenation needs to be individualized. What would
be an ideal approach for one patient is not necessarily the same for someone
else. Based on the examination and discussion at the consultation, you should
have a better understanding of the various options that can achieve the best
cosmetic result for you.
 Robert
Singer, MD FACS 
La
Jolla, California 

Thank you for the question and all the techniques you mentioned are to lift and rejuvenate the face but which might be best for you would depend on an examination.  Do go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results Dr Corbin