Do You Lose Cheekbone Definition on the Side of the Face After a SMAS Facelift?

I really didn't want to lose the tightness I had on the sides of my face which included a well-defined cheekbone area. Have I lost this definition and the hollowness under the my cheekbones, which I actually liked?

Doctor Answers 21

Cheekbone definition after SMAS facelift

On the contrary, a SMAS facelift is designed to move tissue over the cheekbones and accentuate the appearance of the cheekbones.  Not the other way round!  I am not sure what happened so I would recommend reviewing before and after photos of yourself and give the operation a good bit of time (6 months) to heal.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 50 reviews

Facelift Changes

Facelifts do not change the underlying bony skeleton in any way. If your surgery was within the last few months, it is more likely that you have swelling of the cheek fat that will go down over time.

Hope this helps and best of luck.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 50 reviews

The Effect on the Cheek in a SMAS facelift

There are numerous interpretations of a SMAS facelift. A High SMAS facelift will reposition the cheek vertically and should actually improve the cheek volume and not flatten it. A vertical type lift should have this effect, but a lateral pull or lower facelift may flatten and overpull this region.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 42 reviews

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A SMAS Facelift Improves Cheekbone Definition

It's an excellent question. As we age tissue descend and lose volume. What you may have noticed is that the tissue over your cheekbone descended and filled in the hollow portion of your cheek. This would cause your cheekbones to appear less full, and the area below your cheekbones to appear more full. Overall the lower portion of the face can appear more full. This can give the face a boxy appearance.

The SMAS is a connective tissue layer that covers the face and is continuous with the platysma muscle in the neck. A SMAS facelift re-elevates the SMAS and pulls the sagging tissue up into a more youthful position. A SMAS facelift should add volume to the cheekbones and help restore the aesthetic hollow of the cheeks below the cheekbones. The facelift should soften the nasolabial fold, soften marionette lines, and improve jowling. Jowling is the result of this sagging tissue moving below the jawline.

Facial deflation is common during aging and can contribute significantly to an aged appearance. Fat grafting performed at the time of a facelift operation can restore volume to the face. Fat transfer takes fat from another place in the body using liposuction techniques. The fat is then injected under the skin into specific areas of the face. The majority of the transferred fat will obtain a new blood supply within the face. The fat that does live will provide long-lasting volume. Common areas for fat transfer include the cheekbones (malar area), nasolabial fold, tear trough, supraorbital rim (brow), and temporal area.

Rejuvenation of the neck is commonly performed at the same time as a facelift. It involves removing excess fat from above and below the platysma. The platysma is commonly sewn together in the midline to help redefine the angle between the area below the chin and the neck (cervicomental angle). Excess skin from the neck is removed with incisions placed behind the ear.

A facelift should leave patients looking more youthful, refreshed, and should restore volume to the cheekbone area.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 30 reviews

Losing cheekbone definition with SMAS facelift?

Hard to say without photos.  The SMAS facelift has really become the "gold standard." The soft tissue is re-positioned, most patients notice increased definition over the cheekbone area.  Again, everyone is different  Please discuss the operation in detail with your experienced surgeon. Ask questions, and tell him your concerns. 

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Do you lose cheek bone definition on the side of the face after a SMAS face lift?

 Patients do not lose cheek bone definition on the side of the face after SMAS facelift. Most patients  receive a subtle augmentation of the malar mound and cheekbone from the rotation of the SMAS flap and muscle layer underneath the skin. For many examples, please see the link below to our SMAS face lift  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 139 reviews

Cheek bones should be more defined after a Facelift

When doing a face lift one of the maneuvers we as Surgeons will do is to liFt up the sagging muscles and tissues that are causing the jowls in way that helps provide more volume by the cheeks and more definition under the cheek bones. This helps create a nice clean jaw line and and a youthful "heart shaped" face. In the first 3 months after a face lift it is not uncommon not to see these nice changes due to the healing that needs to occur.

Take Care,

Dr. J

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

SMAS Facelift improves appearance of cheekbone definition

The short answer is: No you should not lose any cheekbone definition following a SMAS facelift. In fact you will probably gain some.

A SMAS lift in general refers to any facelift technique that tightens the SMAS layer along with the overlying skin, and underling cheek pad in a more youthful position making you look younger. Specifically the SMAS face lift does its magic by lifting and tightening the jowls, neck, and cheek fat to a more rejuvenated position. These techniques generally produce more natural and long-lasting results than the "skin only" face lifts, and now considered by most board certified plastic surgeons as the most preferred method.


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 150 reviews

Cheekbone Definition and SMAS Facelift

The use of a high-SMAS facelift actually repositions the facial fat using the SMAS as a vehicle to lift the fat.  This repositioning of the facial fat restores softness over the cheekbones and will augment the cheek bones.  By limiting undermining of the flap in the area of the cheek the hollowness under the cheekbones is preserved.  I am not sure what happened in your case that has caused this loss of cheek definition.  

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Cheekbone definition

The SMAS lift can at times be secured to the cheek bone and that can make the area look fuller in some cases, especially when the SMAS was imbricated instead of trimmed. It is not the usual though as the surgeon can typically see what technique needs to be done prior to performing the procedure.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 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.