Can a high smas lift lift my upper cheeks? How can I find a doctor who does this procedure?

I had a cheek lift about 2 months ago which i thought was a smas lift but after surgery from droopy face/cheek & horrible recovery plus googling i realized it was subperiosteal. Everyone thinks i had cheek implants rather than a lift & as swelling is going down, volume is diapearing too. Cheeks look hard unsmooth horizontal short. face is wide and droopy (hollow temples as cheeks is out of my temple line)

Doctor Answers 4

Can High SMAS Lift Lift the Upper Cheeks?

Sorry to hear about tough recovery and bad outcome. Subperiosteal upper or mid-face lifts (often done endoscopically) have largely been abandoned by most surgeons because of problems of prolonged swelling and non-anatomic results, along with other types of complications, such as ectroprion, when the procedure was performed through a lower lid incision. That operation was conceived prior to our contemporary understanding of facial aging which today emphasizes volume loss or fat atrophy as a major component of facial aging. Descent of the deflated facial tissue and skin laxity are also major components of the facial aging process which do not occur in the sub-periosteal plane. Consequently it makes no sense to try to lift the mid-face in a plane in which it doesn't sag.

I routinely do a high SMAS type of facelift specifically with the goal in mind of achieving a better lift in the upper/mid-face region. The goal is to eliminate as much as possible what is referred to as lid/cheek disjunction. This is what appears as a dark crescent under the lower lid which interrupts a nice smooth youthful transition from the lower lid into the cheek. This lack of a smooth transition is major contributor to the appearance of aging in the face, and obtaining a smoother transition from the lid to cheek is one of the goals of a high SMAS type of lift. We also know today that the descended SMAS layer is not the only reason that lid/cheek disjunction occurs over time. Part of the problem is also volume loss or fat atrophy, so in most facelifts I am also doing autologous fat transfer to replace lost volume in the upper cheeks and achieve enhanced smoothing of the lid cheek junction.

Without photos it is really impossible to give you any specific guidance on what procedure you might benefit from most at this point. Given that the sub-periosteal procedures are known for the prolonged post-operative swelling it would probably be best to wait a year before embarking on any further facial rejuvenation procedures. An in person evaluation and thorough discussion of your goals will be essential to devising a surgical plan that has good potential to achieve the result you are looking for.

Needs an exam

A high SMAS facelift can be performed after a subperiosteal facelift.However, it is very important to obtain your records from the previous doctor.  This help your new plastic surgeon evaluate the areas of scar tissue from the previous operation.

High SMAS

You would have to be seen in person to be properly evaluated.  A high SMAS is a good lift for the cheek region. This can also be combined with fat grafting to enhance the area.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

High-SMAS facelift candidate

In our practice, we perform a high SMAS facelift routinely to rejuvenate entire face and neck areas.  The procedure involves tightening loose facial and neck muscles, tightening loose facial and neck skin, removal of fatty deposits in the neck and lifting the jowls.  It will not correct a midface cheek lift.  It is also best to wait at least a year after the primary procedure before embarking on another one to allow the healing process to be complete.For many facelift before and after results, please see the video and link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 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.