SMAS face lift (Face lift with
SMAS muscle)
A facelift is a procedure which is used
to provide patients with a tighter face and neck. It is used to reduce
wrinkling and sagging of the skin on the neck and face which is usually caused
by the aging process, or significant weight loss. The main goal of a facelift
is to restore a balanced and youthful appearance.
What is SMAS?
The face is composed of four main
layers: skin, fat tissue under the skin, fascia and the last layer is muscle.
During the aging process, loss of fat tissue and sagging of the fascia occur
which creates wrinkles and sagging.
SMAS (Superficial Musculoaponeurotic
System) is a layer of fascia which can be imagined as a sheet lying on top of
muscles. It is a very tight sheet and it doesn’t stretch much. A layer of
fascia (SMAS layer) which is under the skin and the fat tissue will be
tightened up together during the SMAS face lift. It will provide much more
support for the overlying structures and the results will be more satisfying.
The SMAS facelift provides long lasting results so the patient can expect the
results of surgery to last for at least 10 years.
Who are Suitable Patients for a SMAS
Facelift?
SMAS facelifts can be used for patients who
suffer from deep nasolabial folds, loose jawline, deep wrinkles over their
face, and wrinkles on the neck. It is also recommended for all patients who
desire longer lasting results. So, if you have major sagging skin on your face
or deep wrinkles and want a long term solution, then the SMAS facelift might be
the best choice for you.
The Process of the SMAS Facelift
A facelift is a highly individualized
procedure because every face is different and needs a different approach.
The length of the incision will depend on
the purpose of the surgery. It should be long enough to address all the issues,
and to allow for the removal of excess skin.
The full facelift incision usually starts
from the top of the ear, then along the front of the ear canal, behind the ear
and it ends in the hairline behind the ear. Nowadays, mini facelifts have become
a very popular procedure and in that case the incision is significantly
smaller. It is placed from the front side to back side of the ear.
After the incision is made, the skin is
elevated and the SMAS layer is visualized. After that SMAS layer is released
from its attachments (retaining ligaments) and lifted up. There are several
techniques for addressing the SMAS layer. In a deep plane facelift, muscles and
fascia will be elevated from the bone underneath them and moved up in order to
reduce sagging.
In SMAS plication, parts of the muscle will
be sutured onto themselves after they are folded. That way the length of the
muscle will be reduced and there will be less sagging.
Another technique is SMASectomy, in which
part of the muscle is cut out and the two ends are then sutured together.
The lower eyelid muscle is tightened so
that under eye hollow is diminished. Muscles in the cheek area are moved
upwards, muscles at the corner of the mouth are moved up as well as muscles
under the marionette lines. SMAS in the neck and jowl area are tightened.
After the SMAS layer is repositioned and
tightened, the skin is retracted and the excess skin is removed. At the end,
the wound is sutured in multiple layers to prevent excessive scarring and skin
tension.
Recovery After a SMAS Facelift
The SMAS facelift is an extensive surgical
procedure, so the recovery period can last for a few weeks. It is usually
associated with bruising and swelling. You should be able to continue doing
your daily activities after stitches are removed. Bruising should start
reducing after a week, so you might want to avoid going outside during the
first week. Most patients don’t have any severe pain. After a week, there will
be less bruising and swelling should start to subside.
Two weeks after the surgery, most of the
swelling will subside. Your bruises might change in color and they will be less
visible. After a month, there should be no more bruising and most of the
swelling should subside.
Most surgeons recommend ice and elevation
to reduce swelling. You should use higher pillows while sleeping to keep your
head elevated.
