What constitutes a SMAS facelift?

The SMAS refers to the sub muscular aponeurotic system, which is a fibrous tissue that envelops the muscles of facial expression. It is this layer that is tightened and resuspended when performing a facelifting type procedure.
The incisions to access the SMAS vary from a minilift to a full facelift.
The minifacelift insision (short scar, S-lift, minilift) generally starts in the temple area, either in or just in front of the ear and around the ear lobe and behind the ear. The skin is lifted and the SMAS is tightened. Then the excess skin is removed.
It is important to speak with your facial plastic surgeon and explain what your expectations are. Generally, the mini facelift does not help if there is a lot of laxity in the neck- a neck lift or full facelift is then required.
It is important that you express all your concerns during your consultation so that you can have the best result possible.

The incision that you describe in your question would be considered a short-incision facelift technique. It is possible to lift and tighten some of the SMAS (connective tissue in front of the facial muscles) through this incision, however, a full SMAS lift typically requires an incision that begins behind the temple hairline and extends down to below the earlobe and goes up behind the ear to the hairline and back down along the hairline behind the year.  This is a classic or typical full facelift incision which is used for SMAS lift or extended SMAS lift, or deep-plane facelifts.  Shorter incisions, like you describe, have become much more popular in recent years because they are  less invasive and provide a quicker recovery.  My preference for a short-incision technique is the MACS lift.  With this technique the SMAS is lifted and suspended from a very strong layer of connective tissue above the cheekbone.  In addition, this technique provides better volume restoration of the cheek and  more natural facial rejuvenation than a limited-SMAS tightening procedure.  This still offers the patient a short-incision with less downtime and is an excellent technique for facial rejuvenation for most patients.  I would recommend you have a consultation with a board certified plastic surgeon with extensive experience in facelift techniques before making a final decision.  Good Luck. 

The incision for a Facelift is the same whether the skin only is tightened or whether a deep plane or SMAS Facelift & Neck Lift are performed - it extends in the crease in front of the ear, around the earlobe, behing the ear, and back into the hairline. A SMAS or deep plane Facelift will give you a better, longer-lasting result, and usually has better scars.

The skin incisions for a facelift do not change that much depending on the type of facelift that is performed. A SMAS, deep plane, lower facelift, neck lift, skin lift procedure can all be done through exactly the same skin incisions. The incisions you describe are the fairly standard incisions for all those types of facelift and neck lift. It is important to realise that the real differences in facelift technique are found in how the deeper tissues are addressed. A deep plane facelift is a type of SMAS facelift that mobilises the SMAS layer close to the mouth and jawline. The skin does not need to be separated for as large a distance off the underlying muscle layer. This leads to longer lasting results, a more natural look and a quicker recovery. 

The type of lifting procedure that is performed under the skin is generally not dependent on the type of incision that is made. A skin-only facelift, a SMAS facelift, a Bi-planar facelift, and a deep-plane facelift can all have the same skin incisions. Skin incisions tend to be very similar from one surgeon to another, but do have small nuances that will vary from surgeon to surgeon. In short, the skin incision does not dictate the type of lift performed under the skin.I recommend facelift techniques that involve tightening the SMAS layer under the skin in addition to the skin itself. I personally perform a Bi-planar SMAS technique that incorporates elements of several different types of facelift techniques. In doing so, we are able to achieve excellent, long-lasting, and natural-appearing results that are also very safe with limited down time.All the best,

The SMAS facelift is a type of facelift that describes the manner in which the tissues are lifted and tightened underneath the skin.  So, a small incision can be made and the SMAS can be tightened or a large incision can be made and the SMAS tightened.  The real question is if the type of lift you are having will address the amount of skin excess or fatty tissue you have.  In general, a facelift incision starts at the top of the ear and continues around the earlobe onto the back of the ear to get a good improvement for excess skin.  

A SMAS facelift elevates the sagging facial tissue that
results from aging. The SMAS (superficial muscular aponeurotic system) is a
deep connective tissue layer that forms a continuous sheath within the face and
neck. A facelift that lifts the underlying SMAS will re-elevate descended
facial tissues and improve the appearance of the cheek-bone area (malar area)
and jowls.



The typical incision starts in the sideburn, travels behind
the tragus, around the earlobe and behind the ear. The incisions give the surgeon
access to the SMAS, so that it can be elevated. The incisions also allow the
surgeon to remove excess skin.



A facelift that elevates the SMAS is treating the underlying
sagging facial tissues. A skin-only facelift relies on pulling the skin taught
to support the underlying tissue. This can lead to an undesirable “pulled” appearance.
A SMAS facelift should have excellent results that last about 7-10 years.

A full or "traditional" facelift addresses the sagging upper and lower neck skin and (platysmal) vertical neck bands, jowls, lower and mid nasolabial folds and marionette lines. It involves incisions from the temple scalp, along the front of the ear (inside the mid part for women), behind the ear in the crease then along or into the scalp hair behind the ear towards the back of your neck with undermining of the skin and  tightening of underlying support tissues. SMAS mini-facelifts can do much of the same with smaller procedures.

A SMAS lift in general refers to any facelift technique that tightens the SMAS layer along with the overlying skin in a more youthful position making you look younger. Specifically the SMAS face lift does its magic by lifting and tightening the jowls, neck, and cheeks to a more rejuvenated position. These techniques generally produce more natural and long-lasting results than the "skin only" face lifts, and now considered by most board certified plastic surgeons as the most preferred method. Incisions can be large or small depending on if it is a traditional facelift or mini-facelift approach. Both can be SMAS lifts.
A  SMAS mini-facelift, or "short scar facelift" or as I call it in my practice the LiteLift addresses all of the above except for the lower neck. The difference is that the incisions are shorter - basically the same description in front of the ear and temple scalp but ending at the level of the earlobe (in front or in back) - as much as 40% less scarring. We prefer the Lite Lift procedures as it allows us to do most of these procedures with oral sedation and local anesthesia without IV's or general anesthesia. 

 

The incisions for most facelifts are just like you've described:  inside the ear (tragus) and down and around the earlobe staying behind the ear and ending in the hairline.  After several months of healing, massage, and allowing the swelling to resolve, you should have scars that are very well hidden.  Talk with your plastic surgeon about scar therapy after your facelift.  Good luck!

Incisions are one important component of getting a successful facelift.  Incision placement is critical to concealing the signs of having had a facelift.  The most important factor in well healed incisions is the surgeon.

This is an access incision that most facelift surgeons use.  A SMAS facelift had nothing to do with the incision on the skin.  A SMAS facelift involves tightening the underlying facial muscles via various methods.  

Dr. ES