Can SMAS plication/imbrication permanent sutures be removed during a revision? There is a noticeable suture line down one cheek.
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Doctor Answers 8
"Suture line" visible after facelift
Hello heartsease, thank you for your question. The TYPE of procedure performed on the SMAS - whether plication, imbrication, or otherwise, will typically not cause a line down the cheek as you are describing. I would discuss the case with your surgeon to see what the cause of the crease may be or provide images for review of your particular case. Permanent sutures can be removed during surgery if need be.
SMAS face lift - can visible sutures be removed
- It is possible you had a MACS lift which uses a thick suture in the SMAS
- The only way to know for sure is to ask your surgeon for a copy of the operative note.
- Assuming your surgeon was a Board Certified Plastic Surgeon, s/he should be able to re-open the incision, remove the remaining suture if any and release the indentation.
Revising facelift and removing sutures.
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Revision facelift surgery
Hi - a SMAS plication/imbrication suggests that no SMAS was excised but you should double check with your surgeon. If permanent sutures were used then these should be straightforward to remove during any revision procedure. Typically to correct the jowls the dissection would have to be fairly extensive but there is such a variation in facelift techniques that it is impossible to say the exact type of facelift you had without looking at the operation notes.
Facelift last year, which I believe was some sort of plication/imbrication procedure, hoping this means SMAS can be revised.
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 (using the SMAS Imbrication technique). 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
- minimal tissue dissection = less bruising and swelling = rapid recovery
- can be performed in 90 minutes or less, with or without general anesthesia
- no incisions within the hair = no hair loss
- excess fat can be removed
- excess skin removed
- 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
Hope this helps.
SMAS plication for a face lift
Frank discussion with your surgeon or a copy of operative report if you are considering second opinion consultation would be a good starting point. Good luck.