How Long Will a SMAS Facelift Last?

After a SMAS Facelift is performed, what prevents the sutures from slicing thru the tissues and the face dropping back down and what causes little fat pouches beside the side of the mouth after Facelift?

Doctor Answers 19

How long does a facelift last

First, the longevity of a facelift depends on skin quality, elasticity, genetics, and the type of facelift performed.  If there was a point in time when your skin was stressed with excess UV radiation, or excess inelasticity runs in your family, or if you were engaged in other external activities such as smoking or tanning, the results of the facelift won't last as long as someone who hasn't participated in those activities.  

However, if a proper maintenance program is performed, which includes taking care of your skin with medical grade products and if you support the lifted tissue with volume to address the volume that all of us lose over time, then you can make that lift last much longer. 

Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 43 reviews

SMAS Duration varies, but typically several years

My other colleagues make good points. In adding to the discussion, I would offer several points:

1. Any cosmetic procedure will provide longer-lasting results if you reduce the amount of future insult to the tissues. Typically, we discuss this point with laser resurfacing. You can think of it as waxing your car. If you park it in the sun, it won't last as long as if you park it in the garage. Sun-blocking make up and skin care products will help your investment last longer. Surgery is similar. Don't get a face lift, and then lay out every day for 5 years and complain when you age faster than you wish.

2. The sutures will pull through the tissue when there is a lot of tension on them. For this reason, I prefer to place several sutures deep in order to evenly distribute the downward forces over many points, thereby reducing the amount of tension on any given point of pull or fixation. This reduces the amount that any given suture will tear through the tissue. However, realize that the tissues are elevated and moved, and then simply held in place by the sutures until scarring between the layers develops, which ultimately provides the final "hold". Therefore, it's really only an issue if a suture break or tears in the immediate post-op period, which is another reason to place several so that all your work isn't "hanging" or depending on one suture.

3. SMAS lifting means that the surgeon is doing something with that layer, but is not specific as to what they are doing to it. Some surgeons simply put a pleat or plication in the SMAS folding it up on itself, and call that an SMAS lift. Others actually develop a separate layer of elevated SMAS tissue and remove a section of this layer, shortening it, and increasing the pull.

Since I am an ASOPRS-certified oculoplastic surgeon first, I frequently utilize this technique as it is more consistent with our field's surgical beliefs and principles, and the excised SMAS tissue can be used during endoscopic brow lifts to fill the glabella (between the eyebrows) or round out the lateral orbital rims (under the brow tails). It makes a wonderful filler in these areas, whcih I am typically doing in conjunction with the facelift.

Just beware not all SMAS lifts are the same. Ask your surgeon which approach they use and why. As long as they have a good reason, and good results, you should be fine.

I hope this helps!

David M. Mills, MD, FACS
Pensacola Oculoplastic Surgeon
5.0 out of 5 stars 1 review

SMAS Facelifts: Release and Reposition not Stretch and Pull.

The SMAS is a firm layer of tissue in the face that can be safely mobilized and utilized to hold a facelift. The SMAS layer must be dissected to mobilize it and reposition the face on it. This decreases tension on the SMAS tissue so there is no tearing through the tissue. Not all SMAS facelifts do this, and unfortunately few plastic surgeons are performing a sub-SMAS dissection into the cheek and neck to unload the SMAS for long lasting repositioning.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 24 reviews

SMAS Facelift Duration

The longevity of a facelift can vary depending on the initial procedure. A facelift that addresses the underlying descent of facial soft tissues provides the greatest longevity. A facelift that lifts the underlying SMAS will re-elevate descended facial tissues and improves the appearance of the cheeks, jowls and often the neck. In a patient with good skin quality, this facelift should last 7-10 years.

How Long Will a SMAS Facelift Last?

A SMAS (sub-muscular aponeurotic system) facelift is a face lift technique that tightens the deeper layers of the face rather than just tightening the skin. This technique is similar to a deep plane facelift and a MACS lift in that these procedures all aim to reposition the deeper tissues to get a more youthful look. They are more involved than a skin only facelift. A MACS Lift uses much shorter scars.
All of these techniques will last your lifetime but the deeper tissue procedures seem to stand up a little better according to the comparative studies.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 48 reviews

How long does a SMAS Face Lift Last?

We have performed the only study on the longevity of a face lift that has been published. Using a SMAS face lift technique in a carefully followed series of patients, it was 11.9 years from the time of the primary face lift before a secondary face lift was required.  Adequate mobilization of the SMAS and then careful suspension will prevent the tissues from falling back down.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

SMAS Facelift Duration

A SMAS Facelift can last generally between 7 to 10 years.  The quality of a patient's skin can impact the duration.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 35 reviews

SMAS Facelift lasts Forever

You will always have improvement of your appearance following a SMAS facelift. Depending on your age, exam and skin elasticity it could turn back the hands of time 5-15 years.That being said the analogy I like using is; turning back the hands of time with a procedure. It would be nice if the clock stopped but it keeps on ticking. An experienced board certified surgeon will usually turn back your appearance in a natural manner a bit more than others and allow the clock perhaps to tick a bit slower

SMAS facelift longevity

A facelift will last different lengths of time for different people based upon their anatomy, genetics, and general habits.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

A facelift may last 5-10 years

With a good technical SMAS facelift, the results may last 5-10 years or longer.  This type of facelift not only removes the excess skin of the face, it lifts the internal structures (SMAS) and tightens the skin.  It should smooth out the folds beside the mouth and lift the jowls.  As long as you take care of your skin afterward, you should expect a long-lasting result.  Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.