What are the differentiators between: endoscopic composite facelifts and SMAS facelifts?

Question

I am 50 & desire long-term facelift & NOT INTERESTED A MINILIFT TYPE TECHNIQUE -My jowls & weak neck area & heavy eyelids (lower face is main concern) -I desire a long-term approach to a facelift that restructures fat, muscle and sagging and NOT a quick fix mini-lift that is a pulling of the skin IS: Endoscopic Composite Facelift just another MINILIFT or on par to a SMAS Facelift (will it stand the test of time and last more than a few years)?

Miguel Mascaro, MD · Answer

Great question.  What's important here is differentiating the different types of lifts.  Endoscopic, composite lifts are usually limited to the midface - as you cannot address the redundancy of the skin along the neck and jawline with this approach alone.  SMAS (whether that be a tranditional, High SMAS, extended plane SMAS, etc) lift will address the vectors you are concerned with - the muscular support as well as the skin overlying it.  I suggest you continue going on consultations and discuss things with PS who are comfortable and knowledgeable in the different procedures, as you want to make sure you are not only comfortable with the doctor, but you yourself understand what the procedure entails.  Best of luck! I hope some of this helps.

Alejandro J. Quiroz, MD · Answer

Thank you for your question; There is not a endoscopic face lift. Open face lift allows you to mobilized tissues and have access to a deep plane of the face and the neck. The brow lifts in some occasion can be treated endoscopically. You have a great question and discuss with your plastic surgeon

Stephen Prendiville, MD · Answer

To be clear, there is no such thing as an "endoscopic facelift".  A facelift is designed to address soft tissue and skin changes in the midface, jawline, and neck.  Elevation of soft tissue leads to redundant skin, which is removed through longer incisional techniques, obviating the need for an endoscope.  There is an endoscopic subperiosteal mid face lift, which is largely a lot of work for a compartmentalized result that does not address the jowls or neck. The best utilization of the endoscope is the endoscopic browlift.  A composite facelift is a deep plane technique that allows for elevation of the skin and SMAS together and is very effective if applied correctly.  Many of us use a laterally based composite technique for patients in your age group; it is very effective and long lasting. The technique is only part of the question, leaving the major part to the skill and experience of the Surgeon who should apply the appropriate approach to the aging changes of the patient.

Arnold Almonte, DO · Answer

A facelift is designed to last on average about 10 years. That means a few patients may need to repeat in about 7-8 years in order to maintain their appearance, while others don’t need anything done for 12-15 years. Many factors go into what makes a facelift “last”, such as age at the time of operation, skin quality, weight gain and loss, sun exposure, and medical problems, to name a few. A good facelift will address the skin, the underlying muscle called the SMAS, and the facial volume, which is the fat content. “Endoscopic” is simply an approach to entering the face. “SMAS” is simply a reference to the muscle under the skin. “Composite” simply means two or more layers are treated. Your plastic surgeon should be able to answer all your questions regarding these areas. The procedure that’s best for you will be the one that addresses your skin, SMAS, and fat. I wish you the best!

William Portuese, MD · Answer

In our practice, we perform a high-SMAS lower face and neck which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fatty deposits in the neck along with a platysma-plasty.   And endoscopic type of facelift cannot accomplish fat removal or excising loose and elastic skin

What are the differentiators between: endoscopic composite facelifts and SMAS facelifts?

Answers (5)

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