Face Lift Surgery – How can the SMAS Face Lift be Modified to suit you

Mr Adrian Richards, award winning plastic surgeon of Aurora clinics explains how SMAS Face Lift surgery can be modified to suit the individual. Facelift surgery is a cosmetic procedure commonly used to tighten and smooth out facial skin, making the patient look more youthful, radiant and relaxed. For more information or to schedule a FREE consultation with our specialist surgeon, please call us on 01844 214362

Face Lift Surgery – How can the SMAS Face Lift Be Modified

Hello. My name is Adrian Richards. I’m a plastic surgeon and I’m the Surgical Director of Aurora Clinics. Today I’m going to be talking about the SMAS. In a previous video, I talked about the SMAS, superficial musculoaponeurotic system in the face. So I described what it is, and basically it’s a sheet which lies under the skin which supports the tissue which surgeons can modify. Skin over the top, so it’s another sheet like layer underneath which you can’t see which we can tighten up.

Why is it important for surgery? Because we can modify it. So a subcutaneous face lift, that’s a skin only face lift, goes above the SMAS. So the surgeon will go between the skin and the SMAS layer. So skin, SMAS layer, go between the two.

A deep plane face lift the surgeon will go underneath the SMAS. So they don’t go between the skin and the SMAS, they just go in a deeper layer underneath the SMAS. A subperiosteal or a MACS face lift, the surgeon is going on the bones, that’s a deeper layer itself.

Now there are advantages of each. So subcutaneous, advantage is it’s relatively safe. The nerves are prepared because the nerves which power the face, the facial nerve branches, which will supply the muscles are underneath the SMAS. So in a subcutaneous technique, the nerves are protected. It’s very good for tightening up sort of very loose skin in this area in the neck, but it’s not very good if you really haven’t got a lot of loose skin in those areas. And there’s a question whether skin only face lift, although safe, actually has the longevity and lasts as long as a SMAS face lift. So skin only is one option.

The next option is modification of the SMAS, and this can either be done by stitches, which basically are inserted like in a MACS face lift, which basically reposition and hold the SMAS in the position it was sort of 10 to 15 years ago. All techniques, which go underneath the SMAS where the nerves are and actually lift the SMAS up as a layer and reposition it. So it can either be cut, undermined, and repositioned, or it can be sewn back in position, and the sewing back technique is probably a little bit safer because you’re not going quite near the nerves. So that’s a SMAS lift, which as I said can either be done by stitches or by going underneath the SMAS.

And the final technique is the Mask lift, or the subperiosteal face lift, in fact which all the wiggly soft tissues of the face are freed from the bones and the whole area lifted up. This was a technique which was very popular but is less popular now because of the recovery time. You tend to get a lot of swelling with that technique, and it can actually cause quite an unnatural tilt to the eyes where the tilt of the eyes sort of become slightly feline, slightly cat like.

So I hope that’s explained somewhat this rather tricky subject. So again, SMAS, flat layer underneath the skin. Options are skin only, above the SMAS, tightening up the skin. Other options modifying the SMAS probably by going under it and pulling it up, stitching it in different places, or by cutting it and moving it around. And the final option is a Mask  lift, a subperiosteal face lift which is a very specialised procedure and tends not to be done so much in the UK nowadays.

So I hope this answered a few questions. If you have any queries, please either contact us via e-mail at the Aurora Clinics website or just phone us up on 01844 214362. Thanks very much.