Long gone are the days of the facelift-with-windblown effect. Today’s sophisticated surgical facial rejuvenation techniques, such as the SMAS facelift, produce natural-looking and enduring results. Pioneered in the 1980s, the SMAS facelift is based on manipulating the deeper tissue layers of the face–as opposed to simply pulling the skin back. Dr. Westreich recommends this cosmetic surgery to his patients who wish to address sagging jowls, hollow cheeks, and a slack neck area.
Superficial Musculoaponeurotic System (SMAS) is the continuous layer, or sheet, of firm tissue that lies beneath the skin and runs from the collarbone to the forehead. Unlike the skin, which is a stretchy layer, the SMAS is a strong fibromuscular web; it is intricately connected to the skin, as well as the various muscles, tissues and fat pads in the face and neck. When the SMAS is surgically modified and lifted, it will also reposition the skin and make it look tighter, creating a more youthful appearance.
During the SMAS facelift procedure, Dr. Westreich will separate the skin from SMAS. The SMAS is then elevated off of the underlying facial muscles. Procedures such as a lifestyle lift may manipulate the SMAS in a limited fashion, but to a lesser degree than a true SMAS facelift. The platysma is often a major source of focus in a SMAS facelift, and its elevation will give enhanced neck and jawline definition. The muscle is then trimmed and reattached at a higher point on the face, lifting both the face and skin. Once the underlying tissue layer has been tightened, Dr. Westreich will redrape and trim the skin. In some cases, Dr. Westreich will suction out fat deposits to give further definition to the jawline. The SMAS procedure often referred to as the standard facelift typically takes three hours. A lower facelift, which may take four hours to complete, combines a SMAS facelift with a necklift in order to tighten hanging muscle cords in the central neck. If the facelift is combined with another surgery, such as a brow lift, it may take up to six hours to complete.
A SMAS facelift is best suited for men or women in their forties to sixties with:
- Visibly lax skin on the face or neck
- Sagging Jowls
- Nasolabial folds (the creases that run from the corner of the mouth to the nose)
- Loss of definition in the chin area
- Some skin elasticity remaining
The SMAS facelift is a comprehensive surgical technique. Immediately after the procedure, patients will experience some facial swelling and inflammation, which generally subsides within 10-14 days. During the first few weeks of recovery, strenuous exercise should be avoided; however, Dr. Westreich recommends moderate activity to facilitate healing during the second week of recovery.
It can take up to four weeks to fully recover, but most patients can look forward to several years of reward. With results long-term results that can last for 10+ years, many consider a SMAS facelift a worthwhile investment. As with any surgery, the procedure does carry some risks.