About the SMAS facelift

The superficial muscular aponeurotic system (SMAS) is a layer of tissue that lies deep within the facial skin, where it helps to support the structure of the face. As we become older, the SMAS membrane weakens and loses its elasticity, which can result in sagging cheeks, exaggerated nasolabial folds, lax jowls, and a double chin. A SMAS facelift focuses on this membrane, correcting these problems by tightening the muscles and reducing fat and excess skin. This procedure is often combined with a neck lift.

What can a SMAS facelift address?

  • Mid-face sagging
  • Lax jowls
  • Excess facial skin and fat
  • Hollow cheeks
  • Loose, submental skin and fat 

How do I know which facelift technique is right for me?

With the wide array of facelift techniques available, it can be overwhelming to figure out which one is ideal for your aesthetic goals. The best thing to do is to discuss your options with a facelift expert such as Dr. Henry Mentz.

As a triple board-certified doctor in Plastic Surgery, Facial Plastic Surgery, and Head and Neck Surgery, Dr. Mentz brings innovation and progression to his facelift techniques. He uses several different methods to decide which specific procedure will get the best results for your unique facial structure. He takes many factors into consideration, from your face shape and structure to your personal goals to how much skin laxity you have. He will provide you with multiple options for the best outcome. 

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SMAS facelift surgical details

Dr. Mentz performs SMAS facelift surgery at his AAAASF-certified SurgiCentre facility in Houston under general anesthesia or local anesthesia. Procedure time is approximately three hours, but will vary case by case. Dr. Mentz will make an incision at the temple, above the hairline, and will extend it downward, curving behind the ears. Once the incision is created, he will lift the tissue and muscle that is under the skin and place it into a higher position. He will remove excess skin, then re-drape the skin back over the face. The incisions will then be closed with sutures, and you will be wrapped with surgical dressing.

Recovery and results

Immediately following your SMAS facelift, a special cooling mask will be placed on your skin to help minimize bruising and swelling. In addition, small tubes may be inserted beneath the skin to prevent fluid accumulation. (The surgical dressing can typically be removed the day following surgery.) Dr. Mentz may recommend an overnight stay at one of his SurgiCentre’s recovery suites, where you will be taken care of by a registered nurse who specializes in plastic surgery recovery. Moreover, if you live within 20 miles of our facility, Dr. Mentz will offer a visit to your home by a nurse who is trained to assist you with post-operative recovery.

The nurse will change any dressings, monitor your recovery, assist you with your medication, and provide Dr. Mentz with an update on your consultation. This is part of Dr. Mentz’s signature concierge surgical and recovery experience. Most sutures are removed 5 to 7 days after surgery. Peak swelling takes place within 24 to 48 hours, with moderate swelling may lasting for weeks. We recommend elevation of the head (even during sleep) to reduce initial swelling. You can expect to have some numbing, swelling, bruising, and discomfort for about two weeks, and around this time you will be able to return to work and continue exercise. Most of the incisions will be well-hidden within the natural creases of the skin and hair.

Candidates for a SMAS facelift 

  • Are in their 40s to 60s and have moderate facial sagging
  • Still have fairly good skin elasticity
  • Must be generally healthy non-smokers
  • Understand what a SMAS facelift can accomplish
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