What is an SMAS Facelift, and How is It Different Than a Normal Facelift?

Doctor Answers 16

What is an SMAS Facelift, and How is It Different Than a Normal Facelift?

        SMAS facelift just refers to techniques used to resuspend the deeper tissues of the face, called SMAS.  Find a plastic surgeon with ELITE credentials who performs hundreds of facial procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Full or Traditional Facelift, Mini Face lifts, and SMAS Facelift: What are the differences?

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 159 reviews

Normal Facelift versus SMAS Facelift

When you say a normal facelift I am assuming you are talking about a skin-only facelift.  Skin-only facelifts are limited for many reasons.  In order to achieve a lift using skin-only an extreme amount of tension must be placed onto the skin.  This results in a distorted "facelifted" appearance.  Skin is not meant to hold tension and it stretches resulting in early relapse of the facelift.  Finally, the tension on the skin leads to scar widening and more problems with skin necrosis.  

     The use of the SMAS allows for repositioning of facial fat and restoring the softness over the cheekbones.  The SMAS can handle tension being placed onto it so that tension on the skin is avoided.  This provides for a more natural restoration of a youthful appearance and also increased longevity of the facelift.  The use of the SMAS can be tailored to meet each patients individual needs.  The high-SMAS facelift is my procedure of choice for facial rejuvenation.

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

SMAS Facelift

A SMAS is the normal lift. By manipulating the SMAS, you can have a better, more lasting, and more natural result. The term is being used to differentiate the traditional facelift from a lifestyle lift that typically does not involve the SMAS.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 44 reviews

SMAS facelift versus normal facelift

If we assume by a normal facelift you mean a skin only facelift, then the differences are that the skin only facelift will reposition and excise excess skin but will not treat any of the underlying structures. It is common in aging that the tissues below the skin also sag and repositioning them with a treatment of the SMAS will often give a more youthful natural look rather than just tight skin.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

SMAS facelift

A SMAS facelift is a "normal" facelift. The original facelift involved pulling the skin back giving a patient the "facelift look." By manipulating the SMAS as well as limited skin manipulation, patients can have a more natural and refreshed appearance.

Jacob Freiman, MD, FACS
Miami Plastic Surgeon
4.4 out of 5 stars 271 reviews

Normal facelift vs SMAS facelift.

 Think of your face as 2 layers, (there are more), with the skin being the outer layer and the SMAS being the layer just beneath the skin.  In certain patients:  younger, with excellent skin elasticity, minimal jowling and minimal need for neck correction, a skin only facelift can be done.  This is because the skin will support the lift due to its strength.  However,  most patients considering a facelift are older and have more requirements to fully rejuvenate their face and neck and therefore, the SMAS facelift is done.  There are various ways the SMAS can be manipulated, but all variations elevate the SMAS upward and backward to lift and reshape these strong, deeper tissues of  the face.  Once the lifting is done by the SMAS and it has been sutured into place, the skin can be re-draped over this new shape for a natural, long lasting result. 

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 100 reviews

SMAS facelift vs. regular facelift

A SMAS facelift involves the deeper tissue layer and therefore provides longer lasting and more natural results. A regular facelift surgery only lifts the skin.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

SMAS Facelift

A facelift can be done by pulling back skin alone or by manipulating the thick under tissue called the SMAS.  The latter gives a better, more natural result.  Simply tightening the SMAS with a few sutures isn't as good as entirely mobilizing the SMAS.  

Good luck.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

What is a SMAS lift?

A SMAS facelift refers to incorporating a thin fibrous/muscular layer (superficial musculoaponeurotic system) that sits beneath the skin into the lift. This is in contrast to a facelift that only pulls on the skin itself.

This SMAS layer is quite strong so a facelift that focuses on pulling on this layer is much more durable and gives a much more natural result. A traditional facelift and/or necklift typically involves using this SMAS layer, but you can discuss with your potential surgeon whether the SMAS layer will be incorporated into the surgery.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

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.