Adrian Richards explains how a SMAS Facelift can be modified to suit you
Thinking about SMAS Facelift surgery? Below is a guest post on the procedure, written by Aurora Plastic Surgeon Adrian Richards.
Hello, my name’s Adrian Richards. I’m a Plastic Surgeon and the Surgical Director of Aurora Clinics.
Today I’m going to be talking about the SMAS Facelift. The SMAS is the superficial musculoaponeurotic system in the face. It’s basically a sheet which lies under the skin which supports the tissue, that surgeons can modify. So you have skin over the top, and another sheet-like layer underneath which you can’t see, which is what we can tighten up.
Why is it important for surgery? Because we can modify it. A subcutaneous facelift, that’s a skin-only facelift, goes above the SMAS. So the surgeon goes between the skin and the SMAS layer.
With a deep plane facelift, the surgeon will go underneath the SMAS. They don’t go between the skin and the SMAS, they just go in a deeper layer underneath the SMAS.
With a subperiosteal or a mask facelift, the surgeon is going on the bone so that’s a deeper layer itself. There are advantages of each.
The main advantage of the subcutaneous approach is it’s relatively safe. The nerves of the face, the facial nerve branches which supply the muscles, are underneath the SMAS and in a subcutaneous technique, the nerves are protected.
It’s very good for tightening up very loose skin in the neck but it’s not very good if you haven’t got a lot of loose skin in that area. There’s also the question of whether a skin-only facelift, although safe, actually has the longevity and lasts as long as a SMAS facelift.
So skin-only is one option, with pros and cons.
The next option is modification of the SMAS and this can be done with stitches which are basically inserted like in a MACS facelift which basically reposition and hold the SMAS in the position it was 10-15 years ago. Or there are techniques which go underneath the SMAS, near where your 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 into position. The sewing back technique is probably a little bit safer because you’re not going near the nerves.
The final technique is the mask lift with a subperiosteal facelift. Here, 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 and it can actually cause quite an unnatural tilt to the eyes where the eyes become slightly feline – catlike.
I hope that’s explained some of what is rather a tricky subject and answered a few questions. If you have any queries, please either contact us either via the Aurora Clinics website or call us on 01324 578290.