The SMAS procedure for facelift involves a dual plane lift that includes both undermining of the skin but as well as an underlying soft tissue layer called the superficial muscular aponeurotic system (SMAS). The SMAS is thin but strong soft tissue layer that lies under the skin by also lines the underlying facial muscles. The SMAS layer is used to not only pull and tighten the deeper layers which include the muscles, tendons, and ligaments, but also allows an expert facelift surgeon to pull the skin layer without undue tension. Avoiding tension on the skin layer is in fact the secret to a successful and natural appearing facelift. Five advantages are achieved by using the dual plane SMAS facelift and they include:
- Smooth and natural results.
- Well healed and hidden surgical incision lines
- Comprehensive lift
- Elimination of skin recoil
- Avoidance of skin only facelift deformities.
The SMAS procedure for facelift is definitely superior to the skin only facelift. Dr. Mowlavi likes to make the analogy of the two facelift techniques to making your bed. If you are lazy and only pull the bed spread over the bed sheet, the bed will look lumpy. In contrast, if you first pull the sheet taut, then the bed spread will hug the bed and look crisp.
The same analogy applies to the face where the SMAS acts like the bed sheet and the skin the bedspread. Undermining and lifting the SMAS allows the skin to re-drape smoothly thus avoiding any lumpiness and achieving natural results. Another advantage of the SMAS facelift is that excessive tension is avoided on the skin layer since the SMAS lift will actually hoist up 60 to 70 % of the skin weight. This results in minimizing the tension required on the skin. The advantage of minimizing skin tension are several and include incision lines that will heal optimally, elimination of skin recoil, and avoidance of skin only facelift deformities such as the windblown or joker deformity.
Finally, the SMAS facelift allows for a more comprehensive pull by virtue of having two separate layers, i.e. dual plane, of pull.
Let us admire our 65-year-old female 4 months following extended SMAS Face and Neck Lift. Patient is enjoying her rejuvenated face and jawline appearance. Her jowls have been eliminated and she now enjoys naturally appearing and aesthetically pleasing earlobes with she did not have.