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What is a Skin/SMAS Facelift?

The goal of a skin/SMAS facelift is to restore a more youthful but natural facial appearance, avoiding the “tight” and “overdone” appearance some facelifting surgeries can produce. One of the primary causes of facial aging is the gradual descent of fat from the upper cheeks to the lower cheeks. Both lifts elevates the facial volume (i.e., fat and muscle), restoring a youthful, heart-shaped appearance to the face. Ideally suited for a face with thinner tissues, skin/SMAS facelifting surgery results in a more youthful face, neck and jawline contour.

What is the difference between a “deep plane” and a skin/SMAS facelift?

The primary differences between a deep plane and a skin/SMAS facelift is the extent of the surgery, and the requirement for general anesthesia.

The deep plane of the face is below the skin, fat, and fascia (i.e., SMAS in the face and platysma in the neck). To free up the tissue above the deep plane, ligaments, which tether the skin, fat, and fascia to the deeper structures in the face, have to be released. Once these ligaments are released, the volume which has dropped with time into the lower face and neck can be elevated to restore a youthful, heart-shaped facial appearance. Elevating the facial volume also smooths out jowling to improve the jawline and softens the nasolabial folds. The deep plane lift can be extended into the neck, creating long-lasting and natural improvements to the jawline and neck contours. Since the skin has minimal tension after a deep plane facelift, there is very low risk of a tight or overdone appearance. The surgery requires general anesthesia, but because the deep plane is so strong, these facelifts typically provide the longest-lasting results.

The skin/SMAS facelift is performed in the office under oral sedation, usually Valium (diazepam), and local anesthesia. The plane is below some of the ligaments of the face and releases those ligaments, but does not release the tissues as extensively as the deep plane facelift. It is ideally suited for a face with less heavy tissues and may not last as long as a deep plane facelift, especially in heavier faces and necks.

What are possible side effects from facelifting surgery?

Similar to any surgery, bleeding, infection, and numbness around the area of the surgery are risks, but these are very low (less than 10%). An uncommon but serious complication that can result is damage to one of the facial nerves leading to facial asymmetry. This complication is why a facelifting surgeon should be very familiar with the anatomy of the facial nerve to minimize risk of damage to these nerve branches. Patients frequently have bruising and swelling after surgery, which gradually subsides over a few days to a few weeks after surgery.


If you would like to schedule a consultation at the UNC Center for Facial Aesthetics, please call 984-974-2255 to make an appointment.