SMAS Facelift: Submuscular Aponeurotic System

The SMAS facelift (rhytidectomy) is a surgical procedure that corrects the appearance of the neck and lower two-thirds of the face. This facelift corrects signs of aging such as sagging skin, excess fat, dimples, loss of cheek volume or a double chin. It is less invasive than a regular facelift and recovery or recovery is faster.

The SMAS (superficial muscle relaxant system) is a layer that connects the muscles of the face and neck to the skin. It contains fibers, collagen and connective tissue and plays a key role in facial expression.

This article discusses the SMAS facelift, who is a good candidate, the potential risks, and the steps of the procedure.

What is a SMAS facelift?

The superficial myofascial system, or SMAS, is the layer of tissue or membrane that connects the muscles of your face and neck to your skin. It includes muscle, fiber, collagen and fat. As you age, your skin and SMAS lose elasticity.

These changes lead to sagging of the cheeks along the jawbone, excess skin and often a “double chin”. Cheek fat will also hang forward, increasing the nasolabial folds, or folds on the sides of the nose that extend to the mouth (also causing smile or laugh lines).

A SMAS facelift reverses the signs of aging by tightening muscles, removing fat and trimming excess skin in the lower two-thirds of the face. As a result, most people look 10 to 15 years younger, but the effects of aging gradually reappear about 10 to 15 years after the procedure.

Candidacy

You may be a good candidate for a SMAS facelift if you:

• He is over 50 years old
• You want to surgically correct one or more signs of aging on your face
• You still have some elasticity in your skin
• He is a non-smoker (this helps with proper healing after surgery)
• He is in good general health

It is important to have realistic expectations of the process. Talk to your plastic surgeon to discuss your appearance, healing and recovery expectations.

Potential risks

Risks of the procedure include the general risks of surgery and anesthesia, such as drug reactions, breathing problems, bleeding, infection, and blood clots.

Possible side effects include nerve damage to your face, bleeding under the skin, tissue death, pain, numbness, and sores that don’t heal. Some people are unhappy with the result due to scarring, irregular contours or changes in skin color.

Procedure

After you are prepared for surgery, it will be given to you anesthesiausually intravenous sedation (IV) and a local anesthetic.

Your face will be marked for incision placement. An incision is made at your temple, above the hairline. It will extend down along the natural folds of the skin and curve behind the ears.

Next, the face and neck tissue and muscle beneath the skin will be lifted and pulled into a higher position and excess skin will be removed. It will extend down along the natural folds of the skin and curve in front and behind the ears. Most of the scars will be hidden within the hair and normal skin folds.

During recovery, you will have a head bandage and drainage tubes. You should expect to have some swelling, bruising, numbness and discomfort for a few weeks. In general, you should expect to return to work after two to three weeks and resume exercise and daily activities after treatment is complete.

Summary

The SMAS (superficial musculoaponeurotic system) is a layer of tissue that connects the muscles of the face and neck to the skin and plays a key role in facial expression.

The SMAS facelift (rhydectomy) is a surgical procedure that corrects the signs of aging in the lower two-thirds of the face and neck. It is less invasive than a regular facelift and recovery or healing is faster.

If you are over 50, in good health and do not smoke, you may be a good candidate for this procedure. Potential risks include the usual risks of surgery and facial nerve damage or side effects.

A word from Verywell

Signs of aging can affect your self-esteem and confidence. These feelings can negatively affect your career, relationships or how you experience life. Cosmetic surgery is a form of self-care that helps many people feel better about their appearance, increasing their quality of life.

If you decide you want to consider a SMAS facelift, find a plastic surgeon who is board-certified and specializes in this procedure. It can be helpful to look at their before and after photos and get more than one opinion before making a decision.