SMAS facelift Additional question: is it possible to achieve any lifting of the temple area, with a SMAS facelift? (Photo)

Question

I am planning this procedure for September 2014. I am wondering if it is possible to achieve any lifting of the temple area, with a SMAS facelift. Particularly just above the outer cheek bone, at eye level. I need this but do not want to get another brow lift. I had one in 2004. It lifted forehead, brows and temple beautifully! Loved the results, but I have lost some of the lift. Especially in the temple area. Problem is I had scalp itching that still exists.

Marc DuPéré, MD · Answer

Thank you for an excellent question. Many patients are surprised to learn that a facelift is designed to improve the middle and lower portions of the face, but not the brow or forehead. I will often combine fat grafting to the temple areas to provide a more comprehensive outcome, and I believe you could benefit from this technique. The advantage of using a patient's fat as a facial filler is that it will last much longer than a synthetic dermal filler. Good luck!

Jose Barrera, MD · Answer

A SMAS facelift works by lifting the submuscular aponeurotic system of the face. The layer is in continuity with the platysma neck muscles and the deep fat plane in the face. It does adhere to the zygomatic bone. Therefore, it offers no lift to the temple region. However, it can be combined with a temple incision by which a lateral brow lift can be made.

Martin Jugenburg, MD · Answer

A face lift is not really a 'full face' lift, it addresses the lower face.  If you have concerns about the temporal area, the facelift incision can be extended upward or a separate temporal area for a lateral brow lift may be beneficial

Thomas Buonassisi, MD · Answer

The typical SMAS facelift does not elevate the temporal area. You might consider filling the temples with fat or an HA filler. This may look more youthfull in the end that atually lifting it

good Luck

Konstantin Vasyukevich, MD · Answer

Facelift would not lift the area you are concerned with.  Fat grafting to the temple area might be a great option for you.  Good luck with your procedure!Dr. Konstantin

Toby Mayer, MD · Answer

Smas lift does not lift the temple. Do NOT have an incision in front of your temple hairline as the scar cannot be covered. I need photos to give a better answer to your problem or an exam.

Dean P. Kane, MD, FACS · Answer

Dear Italian1:
The SMAS (superficial musculoaponeurotic system) is a fibrous net around the soft tissues and muscles of the face and neck. The traditional SMAS facelift suspends this or tightens this layer of tissue to lift the upper neck, jowl and lower cheek upward. A high SMAS lift will bring it to the level of the cheek bone but not above it. 
  
There are options to further lift or fill the temporal area without a brow or temple incision. These include:
  
Fat and filler grafting of the temporal fossa or the cup shaped depression just over the lateral cheek bone.
  Suture suspension to the deep temporal fascia at the time of facelift
  Sub-periosteal facelift (recognizing the limitations of this procedure)
  As of this post, the minimally invasive, Silhouette InstaLift dissolving suspension and collagen stimulating sutures to further elevate brow, temporal cheek, face and neck soft tissues without surgical incisions. 
  All of these procedures are advanced techniques, so please consult with an experienced and talented Board Certified Plastic Surgeon for your best evaluation and recommendations. All the best!

Lara Devgan, MD, MPH · Answer

A facelift will not produce a lift at the level of the temples. A browlift would be a better choice. Since you are not looking to have another browlift, consider Botox, which can be used to create a more pronounced eyebrow arch, or filler/ fat grafting, which can address temporal hollowing.

Robert M. Freund, MD · Answer

A SMAS facelift in my experience will lift the temple area slightly, lift the skin around the cheek area, improve the marionette lines and jowls and tighten the neck.Different physicians have different ideas of what a facelift will include in the procedure, but in my experience including these areas as described yield the best results.

Jay Calvert, MD, FACS · Answer

A SMAS facelift is really focused on the lower face and neck.  The temporal region is not really part of a SMAS or even a High SMAS facelift.  My advice to you is find a surgeon who likes doing lateral brow lifts either endoscopically or via smart hand technique.