SMAS Facelift Surgery (Rhytidectomy)
SMAS is the common abbreviation for a tissue layer called the Superficial Muscular Aponeurotic System. A SMAS Facelift procedure refers to a surgical facelift technique where a Specialist Plastic Surgeon tightens the SMAS layer, along with overlying skin, to attain a more youthful position of the skin and underlying structures, which can help you look much younger (on average, about 7 to 8 years younger for some patients). The SMAS facelift surgery both lifts AND tightens your jowls, your neck, and your cheeks. SMAS Facelift techniques and others that work not just with the skin but with the SMAS, typically produce a more natural-looking result that is also longer lasting than “skin lift only” types of face lifts. Many FRACS Specialist Plastic Surgeons use SMAS as one of their preferred facial rejuvenation surgery methods. Facelift surgery is also sometimes referred to as a Rhytidectomy procedure.
Here are some specifics of how SMAS Facelift Surgery is performed by our Melbourne Specialist Plastic Surgeons including Facial Rejuvenation Specialist, Dr Douglas McManamny.
Definition of Superficial Muscular Aponeurotic System (SMAS):
The SMAS consists of a relatively thin but continuous fibromuscular layer of fascial supporting tissues, which covers and surrounds deeper facial and neck tissues including adipose tissue (fat) and facial muscles as well as the cheek area of the face; SMAS tends to includes the skin covering these areas as well. In terms of facial Anatomy, the SMAS attaches to the superficial muscle(s) covering the lower face along the jaw line as well as the neck (which are formally called platysma muscles). The SMAS attaches to many different areas of the face, meaning a SMAS facelift surgically elevates the entire underlying layers as well as the skin. This helps lift and elevate the soft tissues or underlying structures of the face as well as the lax skin itself, meaning patients often get a more comprehensive rejuvenation facial lifting effect from surgery. See illustrations below for details about the underlying facial structures that comprise the Superficial Muscular Aponeurotic System (SMAS) and why this is sometimes a longer-lasting or more natural looking facelift method than some other forms of facial rejuvenation such as the ‘mini lift’, especially for patients who’s facial skin and underlying facial structures have experienced the advancing effects of ageing.
What is a Superficial Muscular Aponeurotic System (SMAS) Facelift Surgery?
A SMAS facelift procedure is one of the more modern methods of what was once called a traditional Facelift or a full facelift. Early types of facial rejuvenation procedures were first performed around 1901 in Berlin, but they have come a long way since then thanks to advances in medicine and anatomy understandings. No longer getting a ‘windblown’ or pulled look (at least, not in the hands of a highly skilled Plastic Surgeon with expertise in getting a natural looking result), facelifts are about the 6th most popular aesthetic surgery (typically the most popular plastic surgeries each year are liposuction, breast augmentation, tummy tuck, eyelid lift surgery and breast lift surgery, followed by surgical facelift procedures).
How is a SMAS Facelift Surgery performed?
A SMAS Facelift is usually performed by a Specialist Plastic Surgeon in an accredited Hospital facility, typically with at least one overnight stay (but this can vary from patient to patient). One of our leading SMAS Facelift Surgeons is Dr Douglas McManamny, a highly regarded facial rejuvenation Surgeon with over 25 years of experience. You can read more about him on his BIO page or further below. Or if you’re in Sydney, ask about our Sydney Plastic Surgeons.
During the SMAS facelift procedure, the Superficial Muscular Aponeurotic System (SMAS) layer may be surgically “folded” superiorly and surgically attached to itself. This type of SMAS facelift technique is known as a SMAS Plication facelift procedure. Alternatively, the SMAS may be tightened and lifted by surgically reducing a redundant portion of the tissues, then strategically reattaching the SMAS to itself via carefully-placed sutures in a more uplifted position (known as a facial surgery SMAS Resection or SMAS-ectomy procedure).
Both types of SMAS procedures tend to have longer scars than a Round Block facelift, and may involve slightly longer healing periods than other types of surgeries – such as longer bruising and swelling during the recovery period – but Surgeons and Patients may prefer a SMAS Facelift to a mini-lift due to it’s capacity for longer-lasting, aesthetically rejuvenating results that are natural looking.
Difference between a SMAS Facelift and a Mini-lift
Patients may find the differences between facelift surgeries to be confusing. There are many new methods available that claim less downtime and easier healing than the SMAS lift or even the Round Block Facelift. These go by many names (some trademarked) such as LightTouch, Mini-Lift, LifeStyle Lift, MACS facelift, The S-Lift, Quick Lift, LiteLift, Liquid Facelift (the non surgical variety using fillers and anti-wrinkle injections) and others. They may be suited for younger patients or patients who are not interested in the longevity of the results of the procedure, as often a SMAS lift – if done properly – will have slightly longer-lasting and more aesthetically pleasing results for men and women who’s faces are showing a lot of signs of ageing. The best potential facelift results are also usually a result from a combined, customised approach including skin rejuvenation and muscle-relaxing injections – not just a facelift alone or a facelift with a neck lift (it all depends on the patient, but many Surgeons and Patients opt for the SMAS lift after visualising the potential results and knowing it’s one of the most preferred Facelift methods by many facial rejuvenation surgeons, as is also the Round Block procedure).
In many Clinics, there may be more similarities than there are differences between these differently named “lighter face-lift touch” procedures. They tend to involve smaller incisions for minimisation of potential facelift scars. They might also have slightly quicker (or less uncomfortable) recovery periods, as you need to sleep upright for some time after a facelift of any type, particularly a SMAS procedure during the healing and recovery period. There’s also the fact that a lot of the ‘mini’ versions of a facelift might be performed under local anesthesia with oral sedation, in a back room facility; meaning patients might be awake during the procedure rather than under general anesthesia.
Getting a successful Facelift Surgery Result: The Importance of a Highly Skilled Specialist Plastic Surgeon
All surgery results vary from patient to patient and Surgeon to Surgeon. Overall, what makes a SMAS facelift successful (or any other method) is a number of interactive factors, from the skill of the Plastic Surgeon in getting a natural looking but long lasting result (which is why some prefer SMAS), to the patient’s skin health to the overall facial structures of the patient. There’s also the suitability of the selected type of facelift procedure to the patient (for example, SMAS or Round Block) in relation to the patient’s facial anatomy, skin health and ageing appearance concerns – as well as the patient’s ability to follow post-op instructions very carefully. Other factors in getting a good facelift outcome include innate healing capacities, scar minimisation strategies, Rapid Recovery products including Healite II (available to our facelift patients in our Hawthorn, Berwick and Williamstown locations) and even unforeseen factors.
Facelift Surgery Results: Key Factors In Getting A Natural Looking, Good Facelift Result – The Skill of a Highly Experienced Plastic Surgeon is often Pertinent
You really do need a good Plastic Surgeon – someone who’s great at getting it right – with an Aesthetic eye and years of experience to get the most benefits from a facelift procedure.
For a SMAS facelift, your Specialist Plastic Surgeon will use his expertise to:
- engage in appropriate pre-surgery planning and facial analysis/key measurements
- control the lift directional vector
- know how tight to lift the SMAS
- know where to attach the SMAS
- not to go too deeply where underlying important structures could be harmed
Surgery Risks of a SMAS Facelift
All surgeries have risks and should never be entered into lightly or without full knowledge of the procedure. Your Surgeon will go over these in detail during your consultations and before you consent to your surgery, so always ask any questions you have. You want to be very comfortable with the expertise and experience of your selected Surgeon and feel comfortable to ask any and all questions you may have about the procedure, including risks and the fact that results can sometimes be unpredictable (each patient is unique and results can vary).
A good Surgeon for a facelift, however, will have extensive experience in the field of Plastic Surgery and facelift procedures.
In thinking of what Specialist Surgeon you are choosing for your SMAS Facelift or other cosmetic surgery procedure, it helps to understand that a Facelift is quite a complex surgical procedure in terms of facial anatomy, skeletal structures, muscles, fat, nerves, tendons and other structures relating to the surgery. Often, neck rejuvenation or a neck lift surgery and skin refinement may also be needed to get a great result from a Facelift surgery.
Important Information about Facial Plastic or Cosmetic Surgery
There are important facial nerves and blood vessels in your face and neck. Only a highly skilled Surgeon knows how to best work around these nerves and vessels in the safest way possible during a facelift procedure to reduce potential complication risks from a Facelift, such as the loss of facial sensations and/or skin, muscle, blood vessels or nerve damage).
Want to see “before and after” photos of SMAS Facelift Surgery?
Visit our Before and After Facelift Surgery Photos or Register to come to one of our FREE information evening events. Ask which ones our SMAS Facelift Specialists (such as Dr Douglas McManamny) will be attending OR schedule your confidential facial rejuvenation consultation by calling a Patient Care Advisor on (03) 8849 1444 or sending an enquiry form, below.
What Can I Expect During My Facelift Recovery?
In a consultation with your Facelift Specialist Surgeon, you will be given specific information about what to expect.
In a general nature, most patients need about 2 to 3 weeks off from normal activities, such as taking time away from work or care of children or grandchildren, after having a SMAS procedure. Allowing good healing and recovery time is crucial, however, for best results from a SMAS lift – you’ll also want to follow your post-op care instructions very carefully.
After your SMAS Facelift or Rhytidectomy, your Surgeon will wrap the incisions in bandages and often places a drainage tube in the area of surgery, which tends to be removed the next day.
Here is a general synopsis of what you might experience after a SMAS Facelift procedure by our Melbourne Specialist Plastic Surgeons.
- You may experience swelling, numbness, bruising, and a feeling of tightness or tension in the face and neck area
- Your face may look uneven, swollen and distorted
- Your facial muscles and facial and neck area might feel a bit stiff or tense and uncomfortable
- These symptoms usually resolve within about 3 to 8 weeks, with facial sensations typically returning to normal within several months.
- Scars may look ‘angry’ initially (red, raised, lumpy or even itchy) as they heal, but they often fade for most patients over time, with full scar settling occurring in about 12 months or longer.
- You should be extra gentle with your skin and your hair as you recover.
- You may be offered Healite II treatments or other healing recovery aids such as a Rapid Recovery Pack (Melbourne patients)
- Men may need to shave differently, e.g. slightly more behind the neck or ears if areas of beard-growing skin have been surgically re-positioned during the facelift procedure.