During a SMAS facelift, is the masseter muscle cut to help redrape the skin better?

Question

Hi doctors, During a smas facelift, is the masseter muscle cut to help redrape the skin better? Thank you

Stephen Prendiville, MD · Answer

The masseter is an important masticatory muscle on top of which several facial nerve branches run.  Therefore, during a deep plane or SMAS based facelift, the layer on top of the masseter is always left intact.  Because of its functional necessity, an aesthetic procedure to cut the masseter would be a very bad idea.  In rare circumstances during a facelift, reduction of the parotid gland may be advisable

Jonathan Kulbersh, MD · Answer

No, the masseter muscles (or any other muscles) are not cut during a facelift. An SMAS facelift involves lifting and tightening the skin and the underlying SMAS layer to achieve a more contoured and youthful look, but no muscles are cut during the process. There is no need to cut the masseters to drape the skin. Cutting muscle leads to longer and more painful recovery times, and can lead to complications and bad results. If you wish to reduce the size of your masseters, Botox is a safe and effective option that works very well in the right candidate. I hope this helps.

Paul Lanfranchi, DO, FAOCOO · Answer

Hi there- to be quick to the point, there is no reason for the masseter muscle to be violated during any type of standard lower facelift. It would not help redraping of the skin and would only be fraught with potential post-op issues. I'm not sure where you received this info, but I'm sure most of the docs on RS will recommend leaving your masseter alone for a lift. You can get a great result while leaving the masseter alone.

Michael I. Echavez, MD · Answer

The masseter muscle is not normally cut in a SMAS facelift.  In fact, no muscles are normally cut during the procedure.  The skin layer and the SMAS layer are tightened but the muscles are deeper below and normally not exposed during the surgery.  I also do not believe that cutting the masseter muscle would enhance the redraping of the skin in a facelift.

Keith Denkler, MD · Answer

During a SMAS facelift, the masseter is left alone.  The masseter goes up and down, and cutting it does not help with pull.Facial nerves travel just over the masseter muscle, so it is an area avoided if possible.

Peter A. Aldea, MD · Answer

The family of various SMAS facelifts pull on it to get a tightening effect on the face and neck. There is nothing to be achieved by cutting the underlying chewing muscle, the masseter, since the SMAS is the tool of lifting. The only time the masseter is cut is when it is very bulky and creates a square face as may be seen in some Koreans. In such faces the masseter is thinned either with surgery or by repeated injections of Botox/Xeomin.

Michael R. Whetstone, MD (retired) · Answer

good afternoon, the masseter muscle is left alone. however, sometimes a surgeon will tighten the "covering" over the muscle called the SMAS.

P. Craig Hobar, MD(retired) · Answer

Thank you for your question. In short, no muscles are typically cut during a SMAS operation. The goal of the procedure is to tighten the superficial muscle layer and skin without damaging the structure of muscles deeper within the face. This creates a natural and refreshing look that helps restore a younger appearance of your face.

During a SMAS facelift, is the masseter muscle cut to help redrape the skin better?

Answers (8)

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