The Ultimate Guide to SMAS Facelift: Techniques and Results
SMAS Facelift

As we age, our skin naturally begins to lose elasticity, and we may start to notice sagging, wrinkles, and other visible signs of aging, particularly in the face. For individuals looking to achieve a more youthful, lifted appearance, the SMAS facelift has become one of the most effective and popular options available. A SMAS facelift provides a long-lasting solution that targets not only the skin but also the underlying structure, delivering natural-looking results. This guide covers everything you need to know about the SMAS facelift, from its techniques to before-and-after expectations, helping you decide if this procedure is the right choice for you.
What is a SMAS Facelift?
SMAS stands for Superficial Musculoaponeurotic System, a layer of tissue that lies beneath the skin and over the facial muscles. The SMAS facelift is unique because it targets this deeper layer rather than just tightening the surface skin. By addressing the SMAS layer, surgeons can achieve more comprehensive lifting and rejuvenation that better contours the face and produces longer-lasting results.
The SMAS facelift is often considered the gold standard for facelifts, especially for individuals in their 40s, 50s, and 60s who are experiencing moderate to severe signs of aging, including sagging in the midface, jowls, and neck. The technique can lift and tighten both the face and neck for a complete rejuvenation.
Why Choose a SMAS Facelift?
Here are some of the primary benefits of choosing a SMAS facelift over other facial rejuvenation procedures:
- Natural-Looking Results: By lifting deeper layers and redistributing facial tissues, the SMAS facelift creates a more natural, youthful look that avoids the “stretched” appearance that can result from skin-only facelifts.
- Long-Lasting Effects: A SMAS facelift can provide results that last up to 10-15 years, depending on the individual’s lifestyle and natural aging process.
- Improved Facial Contours: By targeting the lower two-thirds of the face, a SMAS facelift can redefine the jawline, reduce jowling, and lift sagging cheeks.
- Comprehensive Rejuvenation: The SMAS facelift addresses both the face and neck, creating a balanced, harmonious look that restores youthful contours throughout.
- Suitable for Severe Signs of Aging: While non-surgical treatments can be effective for mild aging, the SMAS facelift is ideal for individuals experiencing moderate to severe sagging and volume loss.
SMAS Facelift Techniques
The SMAS facelift involves advanced surgical techniques that require expertise and precision. Here are the main techniques associated with SMAS lifting:
- SMAS Plication: This technique involves folding the SMAS layer and securing it with sutures to tighten the facial structure. SMAS plication can lift sagging tissue, reduce jowling, and define the jawline.
- SMASectomy: In this method, the surgeon removes a portion of the SMAS layer and repositions it to lift and tighten the face. This technique can create a significant lifting effect while maintaining a natural appearance.
- SMAS Imbrication: This involves overlapping or repositioning layers of SMAS tissue to create lift in the mid and lower face. SMAS imbrication is commonly used for patients with more advanced sagging and offers more robust results.
- Extended SMAS Facelift: For patients with extensive sagging in the neck and jawline, an extended SMAS facelift may be recommended. This approach addresses the SMAS layer along with deeper tissues, providing dramatic rejuvenation.
What to Expect During a SMAS Facelift Procedure
The SMAS facelift is typically performed as an outpatient procedure under general anesthesia or local anesthesia with sedation, depending on the surgeon’s recommendation and patient preference. Here’s a general overview of what the surgery involves:
- Incision Placement: The surgeon makes incisions around the hairline and behind the ears. These incisions are strategically placed to minimize visible scarring and are carefully designed to blend into the natural hairline.
- Lifting the SMAS Layer: The surgeon lifts the SMAS layer, then uses one of the techniques mentioned (such as SMAS plication or SMASectomy) to reshape and tighten the deeper tissues. This repositions the underlying muscles, fat, and connective tissues for a more youthful contour.
- Skin Repositioning: Once the SMAS layer has been addressed, the surgeon redrapes the skin over the newly contoured structure. Excess skin is removed to prevent sagging and maintain the new shape.
- Closing the Incisions: The incisions are closed with sutures, and in some cases, a small drainage tube is temporarily placed to prevent fluid buildup.
- Recovery Room: Patients are monitored in a recovery room for a short period after the surgery before being discharged. The procedure usually takes between three and four hours, but it can vary based on the patient’s unique needs.
Recovery After a SMAS Facelift
The recovery time for a SMAS facelift varies from person to person, but here is a general timeline of what you can expect:
- First Few Days: Swelling, bruising, and mild discomfort are normal during the first 48 to 72 hours post-surgery. Your surgeon may prescribe pain medication to manage any discomfort.
- First Week: Most swelling and bruising begin to subside, although it will still be present. You’ll likely wear a compression garment around the face to help reduce swelling and provide support.
- Two Weeks: By the two-week mark, a significant portion of the bruising and swelling has usually faded. Many patients feel comfortable returning to light activities and even work, depending on the nature of their job.
- One Month and Beyond: The majority of swelling and bruising will have resolved, revealing a smoother, more youthful appearance. Full results are typically visible within three to six months as the healing process completes.
SMAS Facelift Results: Before and After
A SMAS facelift can transform the face by restoring a youthful contour to the cheeks, jawline, and neck. Patients often report looking 10-15 years younger, with improvements in areas that had sagged or lost definition. Here are some key improvements typically seen in before-and-after results:
- Lifted Cheeks: The SMAS facelift lifts sagging cheeks, restoring volume to the midface and creating a fuller, more youthful look.
- Defined Jawline: Jowling is significantly reduced, leading to a more defined, sculpted jawline.
- Smooth Neck: Loose skin and excess fat in the neck area are addressed, eliminating the appearance of a “turkey neck” or double chin.
- Youthful Contours: By addressing the SMAS layer, the procedure restores natural facial contours that enhance the overall appearance without looking overdone.
Choosing the Right Surgeon for a SMAS Facelift
The SMAS facelift is a complex, skill-intensive procedure that requires an experienced surgeon. Here’s what to look for when selecting a surgeon:
- Board Certification: Choose a board-certified plastic or facial plastic surgeon who specializes in facelift techniques and has extensive experience with the SMAS facelift.
- Before and After Photos: Reviewing before-and-after photos can give you a sense of the surgeon’s skill and the type of results you can expect.
- Patient Reviews: Patient testimonials can provide insight into the surgeon’s professionalism, bedside manner, and overall patient satisfaction.
- Consultation: During the consultation, discuss your aesthetic goals and ask any questions you have about the procedure, recovery, and results. A reputable surgeon will provide realistic expectations and guide you through the process.
The Cost of a SMAS Facelift
The cost of a SMAS facelift can vary widely depending on the surgeon’s expertise, geographic location, and additional fees, such as anesthesia and facility costs. In the U.S., the average cost of a SMAS facelift ranges between $10,000 and $20,000. While this is a significant investment, it’s important to prioritize quality and safety when selecting a surgeon for the best possible outcome.
Is a SMAS Facelift Right for You?
If you’re looking for a long-lasting, comprehensive solution to address sagging in the face and neck, a SMAS facelift could be an ideal choice. Candidates for the procedure are typically in good overall health, do not smoke, and have realistic expectations about the results. A consultation with an experienced, board-certified surgeon will help you determine if a SMAS facelift aligns with your aesthetic goals.
Final Thoughts
The SMAS facelift has become one of the most sought-after procedures for those looking to restore a youthful, lifted appearance to the face and neck. With long-lasting, natural-looking results, the SMAS facelift goes beyond a surface-level improvement to address the foundational layers of the face. By choosing an experienced surgeon and understanding what to expect during recovery, you can achieve a transformative outcome that enhances your natural beauty and confidence.