Once a taboo procedure, facelifts are stepping into the limelight and quickly becoming the center of attention in the best way. However, it’s hard to call it a comeback. Today’s procedures are as much about undetectability as they are change, and that’s largely due to the Superficial Musculoaponeurotic System or SMAS. You may have heard the term before, but it’s more than just a buzzy series of words. The distinct area is the hub for delivering natural-looking lifts and smoother jawlines. Keep reading to learn more about SMAS facelifts and the benefits they can provide.
Featured experts
- David M. Lieberman, MD is a board-certified facial plastic surgeon in Palo Alto, CA
- Robert Singer, MD is a board-certified plastic surgeon in La Jolla, CA
- Oren Tepper, MD is a board-certified plastic surgeon in New York City
What is an SMAS facelift?
The first thing to know about an SMAS facelift is what its acronymmed letters stand for. “SMAS is short for the Superficial Musculoaponeurotic System and refers to a layer of tissue that exists throughout the face and neck,” says Palo Alto, CA facial plastic surgeon David M. Lieberman, MD. He explains that the SMAS contains two different types of tissues, depending on the location. “In the face, the SMAS is a complex fibrofatty tissue that is deep to the skin and superficial to the deeper layers of fascia in the face. However, in the neck, the SMAS is a muscle layer called the platysma,” he says. So what is an SMAS facelift? The answer isn’t so cut-and-dry. According to La Jolla, CA plastic surgeon Robert Singer, MD, the SMAS is worked on in many facelifts to get a natural result. “Plastic surgeons modify their procedures depending on the anatomy of the patient, but something has to be done to the SMAS,” he says.
What makes SMAS facelifts unique?
While the SMAS facelift isn’t easily defined on paper, it’s wrapped in even more complexities, given that several different facelifts can address the area. “Things get more complicated as you delve into the details and examine the specific techniques being employed,” says Dr. Lieberman. For example, deep plane and mini facelifts, two common procedures, both manipulate the SMAS. However, there is variation in how the system is treated. “Deep plane facelifts provide a more extensive release under the SMAS, while mini facelifts use smaller incisions and have limited SMAS work,” says New York plastic surgeon, Oren Tepper, MD. The goal of an SMAS facelift is to tighten the jowls and jawline, but the amount of work done to the area will depend on the type of procedure you choose.
“Generally speaking, a SMAS facelift doesn’t just lift and tighten the skin but also the supporting layer beneath it,” says Dr. Tepper.
Why is it popular?
It’s no secret that a more natural appearance is currently driving beauty trends. The SMAS facelift follows the same aesthetic and can produce results that look organic. “Some of the benefits include the restoration of a sharper jawline, smoothing jowls and improving the neck without the super tightly pulled look,” says Dr. Tepper. He adds that repositioning the deeper foundation allows you to get a natural correction of jowls along with a tighter upper neck and jawline. There’s also the added benefit of longevity. Since the support layer is lifted, the results tend to last longer.
Who should get an SMAS facelift?
Those with sagging jowls that affect the appearance of the jawline will benefit the most from a lift that tightens the SMAS area. If you’re just starting to notice signs of skin laxity, Dr. Tepper notes that a mini facelift may be the best type of SMAS procedure. If sagging is an issue in multiple areas, a deep plane facelift with more extensive SMAS work is more ideal as it helps mobilize the cheek area and lift as a unit.
While some surgeons favor this approach, Dr. Singer notes that there is no evidence a deep plane lift produces a better or longer-lasting result than a standard SMAS lift, and because of the more extensive dissection, it does carry a higher potential risk of facial nerve injury.
SMAS facelifts target the lower face and neck, so if your concern is outside of these areas, it may not be the procedure for you. “Facelifts are never one-size fits all, and the best results come from tailoring the technique to each patient’s specific anatomy,” says Dr. Tepper. Dr. Lieberman agrees, noting that while each lift addresses the SMAS in different ways, they can each still achieve very nice results when done by an experienced surgeon.
