Want and need a SMAS facelift but afraid!

A SMAS facelift is a "standard" facelift for many experienced ABPS-certified plastic surgeons, and to be fair, ABOto-certified ENT surgeons with additional certification in plastic surgery of the head and neck. The SMAS is the fascia-like layer  above the facial muscles, parotid gland, and platysma muscle in the neck. Lifting and tightening (or simply suture tightening via plication) the SMAS stays well above the facial nerve branches, and rarely causes any issues with jaw, gland, or nerve pain. Sensory nerves are divided by the elevation of the facelift flaps, causing temporary numbness in the cheek skin after facelift, and tightness is controlled by the surgeon.Though there are no guarantees, as you said, there is a very reasonable awareness that a fully-trained, ABPS-certified plastic surgeon who is also a member of ASAPS and performs predominantly elective cosmetic surgery will be very safe and give you a good result with extremely low risk of any complication. Safety is, of course, critical, but then there is quality of work. Verify that your "good doctor" is an ABPS-certified plastic surgeon in good standing, not a "board-certified" cosmetic surgeon with little or no true plastic surgical fellowship training and certification by board or boards that have little or nothing to do with plastic surgery. "Board-certified" is NOT enough--you need to know by WHAT board. Please understand that the "American Board of Cosmetic Surgery" is NOT one of the 24 member boards of the American Board of Medical Specialties (ABMS); the American Board of Plastic Surgery and the American Board of Otolaryngology are both ABMS members, and if your doctor is within one of these groups, then you would need to check experience, type and extent of cosmetic surgical experience, years in practice, etc. Look at before and after photographs for examples of his/her work.Then, leave your worries behind and be confident that you have made the right choice. You will do great! For additional information, you can click on the web reference link below for 7 examples of my own facelift patients. Best wishes! Dr. Tholen

While no procedure can be 100% guaranteed, an SMAS lift should not result in nerve or gland pain, as these structures will not be cut into or moved during your lift. Aside from postoperative bruising, swelling and pain that can be managed with over-the-counter medications, icing, bandaging, and rest, you should experience no real side effects and certainly nothing long-term – providing your surgeon is experienced and skillful.  For this reason, the doctor you choose is the most important decision in undergoing facial plastic surgery.  

If you want a neck lift as well as an SMAS lift, that is a separate procedure called a plastysmaplasty. I usually perform this as part of a regular facelift procedure, as it gives the best results. If you are feeling nervous about your SMAS lift, you might ask your facial plastic surgeon to put you in touch with prior patients who were happy with their results. Their experience should help calm your fears. I hope this helps.

 A SMAS facelift is part of a
true natural “Lift and Fill” facelift to give you longer
lasting results, where you are “Lifting” laterally and “Filling” the deep fat
medially compartments. This should be done in the
hands of a Board Certified Plastic Surgeon with expertise in the science of aging.