How to confirm a SMAS procedure was performed?

The discussions regarding if a surgeon did or did not perform a SMAS is mind boggling. Would it take a CAT scan, simple manual exam or what to put the issue to rest?

Doctor Answers 10

SMAS facelift proof

No, there are not any tests that could verify what exactly was done. I think you have to rely on the Operative Report that all surgeons dictate after the case.

Confirmation of SMAS Elevation

The only way to be able to tell is the operative report.  Imaging might show some inflammation in the acute phases after surgery, but is unlikely to be very helpful after that. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 reviews

Confirming SMAS facelift

your best bet would be to obtain the operative report, as others have noted.  In it you would have a description of whether a SMAS flap was raised, it was imbricated/plicated, extended plane, etc.  Best of luck.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Operative Report

The operative report of the operation would discuss what was done with the SMAS. Your surgeon would provide you with this at your request.

A CT scan would not give the details necessary.

How to confirm a SMAS facelift procedure was performed?

Thank you for your question.  My recommendation is that you obtain a copy of your operative report which showed clearly state if any modification of the SMAS was done.  If a SMAS plication was done you can often palpate the suture just beneath the cheek bone in front of the year and one in the neck behind the ear. 

Was a SMAS procedure performed?

It may not be possible to determine by examination whether a SMAS procedure was done.  Your surgeon should have dictated an operative note and would have dictated the SMAS procedure.  Obtaining a copy of the report will answer your question. 

No need to worry

There are so many variations on the SMAS facelift technique with varying degrees of SMAS dissection that it sort of doesnt really matter.

All the should matter is if the result you have is what you wanted. It may matter a little to your next facelift surgeon but even then its not so important.

If you have a very minimal improvement then it might be of interest but any surgeon would and should be honest if you ask them directly. Hope that helps. 

Adam Goodwin

SMAS Facelifts Versus Skin Facelifts

The simplest way to determine whether a SMAS facelift was performed is to read the operative note dictated by the surgeon. Particularly in the immediate postoperative period, it can be difficult to determine by physical examination whether or not a SMAS facelift was performed. 

Similarly, it would be difficult to determine from an imaging study whether or not a SMAS facelift was performed. Over time, facelifts that elevate and reposition the SMAS tend to last longer than simple skin lifts or SMASectomy or SMAS plication facelifts, but you may not have the patience to wait the ten to fifteen years it would take to observe this longevity of effect.  Of course, whenever we perform a secondary facelift on a patient, we can determine whether or not the SMAS was elevated in the first facelift procedure. 

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 47 reviews

Was a SMAS procedure performed in facelift

Ideally your surgeon  should have discussed what type and extent of facelift was planned and performed; confirmed at your postoperative review. If you are unsure, it is difficult to see this from scans or scars / appearance. One of the main advantages of a SMAS manipulation in face lifting is the longevity of outcome (which is better but one has to wait to see that) and possibly a more natural appearance if the surgery is undertaken well - again difficult to judge for any individual patient. 

I have operated on patients for revision face lifting and of course then it may be  more obvious from the intraoperative findings but otherwise the simple answer is to look at the operation note which you would be entitled to request.

I hope that this was helpful.

best wishes

Tariq Ahmad, MBBChir, FRCS(Plast)
London Plastic Surgeon
5.0 out of 5 stars 8 reviews

How to confirm that a SMAS procedure was performed?

The easiest way to confirm whether a SMAS procedure was performed would be to obtain a copy of the operative report.  This is part of the patient's medical record, which the patient can request.  An exam or imaging scan would not necessarily be able to confirm that a SMAS procedure had been performed.

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.