What is the difference between a S-Lift and a SMAS lift?

Question

If I am interviewing comparable plastic surgeons that have equal resumes/cv's/reputation and I am presenting my facial concerns and the "result" that I would hope to accomplish, how on earth can the recommendations be so different - S-Lift vs. SMAS lift with the price tag being as far off? What does a SMAS lift offer that an S-Lift doesn't? Is and S-Lift old terminology?

Stephen Prendiville, MD · Answer

First of all, thank you for the great question. The answer will depend partially on how an individual Surgeon approaches facelift, but I will offer my opinion on the best approach.  Simply put, both are SMAS based procedures, but the S-lift is a more vertically directed procedure with a truncation of the postauricular incision.  Therefore, it is more of a "short-scar" facelift.  I have largely abandoned such procedures because they do not offer the ability to remove as much of the horizontal laxity present in the neck, and the positioning of the scar compromises skin removal.  A composite SMAS lift, when performed comprehensively, can address the cheeks, neck, and jawline with very natural results.

Babar Sultan, MD · Answer

It can get very confusing with the different names present for facelifts. The key is to express your aesthetic concerns and determine which physician can get you the longest lasting natural result. I personally use the SMAS lift by lifting a separate skin and SMAS flap as well as performing a platysmosplasty if necessary. An S-lift is usually a "mini-lift" and can't correct excessively sagging skin or properly address the neck.

Wish you the best!Babar Sultan MD
Baltimore Facial Plastic Surgeon

Wish you the best!Babar Sultan MD
Baltimore Facial Plastic Surgeon

Steven Wallach, MD · Answer

There are many different ways to preform a facelift. The s-lift is usually a mini lift.  Best to be seen in person to give appropriate information on what might be right for you.

William Portuese, MD · Answer

An S-lift is a mini lift, which will  only give mini results, and we rarely ever perform them.  The  SMAS  is basically the fascia/ muscle layer underneath the skin in the face that is tightened when a face lift is performed.  In our practice, we perform a high-SMAS comprehensive lower face and neck lift, which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, tightening the SMAS, and removing fatty deposits in the neck along with a platysma plasty. A full set of facial photographs required to make a determination about the appropriate surgical face lifting procedure. Study your prospective surgeon's before and after facelift photo gallery and make sure it's extensive and reflective of their work producing natural results. For many before-and-after high-SMAS facelift examples,please see the link and the video below

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. The reality is that there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine.  Because of this plus the differences in "aesthetic judgement", you can get vastly differing opinions of what type of facelift is best for you.  Price is determined by the reputation, location and experience of the Facelift Surgeon as well as the difficulty of the facelift procedure in your particular case.
  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  If the cheeks are flat or concave in the front, Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
Hope this helps.

What is the difference between a S-Lift and a SMAS lift?

Answers (5)

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