Lower smas facelift.

I'm thinking of having a smas lower facelift mainly because of Jowls and my neck has a bit of laxity, not so much under my chin but front of neck mainly. Would a lower smas address this problem also ?

Doctor Answers 19


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Thank you for your question. If you could include non smiling photos from the front and a side view that would be helpful in understanding your concerns better. You are a good candidate for a SMAS facelift with some skin looseness, some soft tissue laxity and some deflation in soft tissue in the cheek. With all three a SMAS is the right recipe and will likely provide the longest lasting result. Seek a board certified plastic surgeon or facial plastic surgeon and visit several offices. Facelifts are one of the most complicated procedures that plastic surgeons perform and an experienced surgeon who performs at least 100 procedures per year will likely the best result. 

Best of luck to you,

Dr. Mentz

Houston Plastic Surgeon
4.4 out of 5 stars 36 reviews

Lower SMAS face and neck lift

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From your description it seems that you are a perfect candidate for a lower SMAS face and a neck lift.  Some extra work in the neck with the loose skin pulled and removed behind the ears would be required to get you the best result.

Best of luck!

Dr. Konstantin

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 51 reviews

Lower SMAS facelift for jowls and neck

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To answer this question does require good facial and neck photos. In general the procedure you have mentioned will improve these areas, but may create imbalance with a ptotic or deflated midface, so expert advice from an experienced facelift surgeon is warranted. Unanticipated deformities, such as "lateral sweep" may result, for example.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Thinking of having a smas lower facelift mainly because of Jowls and my neck has a bit of laxity.

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia (local anesthesia)
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed from the face and from under the chin
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Facelift with SMAS, Z lift

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Key is to get a natural looking result in the correction of your jowls and neck. Best to see a board certified ASAPS plastic surgeon in consultation. I find the face lift with SMAS and Z modification give the best natural results.

Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Lower SMAS facelift

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In our practice we perform a lower face and neck lift with a high-SMAS technique. Rather than picking your technique, pick your surgeon based on natural results. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Lower SMAS facelift

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A lower SMAS facelift should be able to address your issues. All facelifts are essentially the same, in that they tighten the SMAS. the difference between one type and another is length of incision and degree of SMAS manipulation. Heavier jewels or tissues may require a deep plane or extended SMAS approach. 

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

Lower SMAS Facelift

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I'm sorry that my response will be vague but that is the best I can do without pictures. A lower SMAS facelift can be done to reduce jowls and decrease laxity of the anterior neck but I don't know if this is appropriate for you.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Lower Face and Neck Rejuvenation

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Thanks for your post. Your best recommendations require an examination and consultation with your Facial Plastic Surgeon. That said, a lower SMAS Facelift would generally improve your face, jowl, neckline and portions of your neck. If you have central laxity or platysma muscle bands in the front, you may need to combine your lower SMAS Facelift with a platysmaplasty to address this appropriately. These procedures are commonly performed together. Hope this helps. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

Will Lower SMAS Facelift Address Neck? Facelifts Should Include Neck Lifts

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I almost always include a neck lift and plastysmaplasty as part of either a lower facelift or full facelift. Thus, at my center any SMAS lift will address neck laxity, jowls, and the lower face. Each facial plastic surgeon has a different protocol, so consult with several until you find one who is offering what you need. I hope this helps.

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.