SMAS facelift

The SMAS facelift is regarded as one of the most important further developments of modern facelift surgery. In contrast to earlier methods, not only is the skin tightened, but the sunken tissue at depth is mobilised and repositioned in a targeted way. The aim is a natural, harmonious result – without a mask-like impression and without visible signs of surgery.

Principle	Repositioning of slackened soft tissue instead of pure skin tightening
Central structure	SMAS (superficial musculoaponeurotic system)
Effect	Natural rejuvenation of the cheeks, the jawline and the midface
Durability	Considerably longer-lasting than purely cutaneous facelifts
Demands	Between the classic SMAS and the deep plane facelift

Appointment with Dr. Kuzbari    Appointment with Dr. Arafat

Quick facts

What is a SMAS facelift?

A facelift in which, alongside the skin, the underlying connective-tissue and muscular system (SMAS) is also prepared and repositioned.

What distinguishes it from earlier methods?

It is not the skin that carries the tension, but the more stable tissue at depth.

Which areas benefit particularly?

The lower and middle cheek, the jawline, the transition to the neck.

Who is it suitable for?

For patients with a visible sinking of the facial soft tissue who wish for a natural result.

What does “SMAS” mean – and why is it so decisive?

The SMAS as the key structure of facial rejuvenation

The so-called SMAS (superficial musculoaponeurotic system) is a connective-tissue structure that connects the skin, the muscles of facial expression and deeper layers of tissue with one another. It plays a central role in the stability and dynamics of the face. Modern facelift surgery uses precisely this structure in order to lift and reposition tissue that has sunk with age in a targeted way.

Why pure skin tightening is not enough

With older facelift methods it was above all the skin that was tightened. The consequence: the skin had to hold the tension permanently – something it is not anatomically suited to. The result was often short-lived and could produce an over-tightened, mask-like appearance. The SMAS facelift shifts the tension into deeper, more stable layers and thereby relieves the skin.

How does the face age – and what does the SMAS facelift correct?

Sinking instead of “excess”

Facial ageing is not only a problem of  “too much skin”, but above all a problem of sinking. Soft tissue, in particular the cheek fat, loses its original position over the years and sinks downwards. Typical consequences are jowls, deeper nasolabial folds and marionette lines as well as a loss of clear contours.

Repositioning instead of over-tightening

A SMAS facelift starts precisely here: it mobilises the sunken tissue and returns it to its original anatomical position. In this way youthful proportions arise again – without artificially padding out or altering the face.

Which SMAS facelift techniques are there?

SMAS plication – the “simpler” approach

With SMAS plication the SMAS is exposed and tightened by gathering sutures, without preparing it fully as a flap. This method can reliably tighten the lower cheek region, but it has limits when it comes to repositioning the midface. The results are as a rule less lasting than with more extensive SMAS flap techniques.

SMAS flap techniques – effective repositioning at depth

With the classic SMAS flap the SMAS is incised and mobilised in a targeted way. In doing so, connective-tissue anchorages are released in order to lift the cheek fat tissue effectively. What is decisive is not the SMAS incision, but the extent of the cheek preparation. Only this makes a genuine repositioning possible – with natural, long-lasting results.

What distinguishes a modern SMAS facelift

Individually defined vectors of traction

In contrast to schematic “one-size-fits-all facelifts”, with the modern SMAS facelift the vector of traction is adapted individually to the anatomy and to the individually differing ageing of the face. The aim is not maximum tightening, but a harmonious restoration of the original facial contour.

Tension-free skin closure

Since the actual correction takes place at depth, the skin, after its excess has been removed, is closed without any relevant tension. This favours inconspicuous scar healing and avoids visible signs of surgery.

SMAS facelift and the durability of the results

Thanks to the repositioning of stable layers of tissue, the results of a correctly performed SMAS facelift are considerably longer-lasting and more natural than those of a pure skin tightening. The face continues to age after the procedure – but from a “reset” starting position, which is why the rejuvenating effect remains effective in the long term.

Appointment with Dr. Kuzbari    Appointment with Dr. Arafat

Combinations for a harmonious overall result

SMAS facelift & neck lift

Since the face and the neck are closely connected both functionally and aesthetically, a SMAS facelift is frequently combined with a tightening of the soft tissue of the neck. The aim is a clear jawline and a harmonious contour of the face and neck.

SMAS facelift & fat grafting

If there is additional loss of volume, targeted fat grafting can be useful. It replaces the age-related loss of tissue and contributes to a natural, balanced result.

Who is a SMAS facelift particularly suitable for?

• In the case of slackening of the facial tissue with troublesome jowls, marionette lines, and with a loss of contour of the chin line.
• When minimally invasive procedures cannot achieve a satisfactory facial rejuvenation or result in an undesired change of the shape of the face (“filler fatigue”).
• When, besides the face, the neck has also slackened, because a pronounced slackening of the neck can only be corrected by a surgical lift.

Why experience is decisive

Facelift techniques based on SMAS flaps require a deeper knowledge of facial anatomy and great surgical experience. Carried out properly, they make very natural results possible – without an increased complication rate. What is decisive is the careful analysis of all age-related changes of the face and the neck and the individual planning of the procedure.

Summary

The SMAS facelift is a central building block of modern facelift surgery. It shifts the tightening into the depth instead of into the skin, respects the natural anatomy of the face and makes a lasting, harmonious rejuvenation possible – without the typical stigmata of earlier methods.