I want a facelift but don’t want to look fake. Would SMAS facelift be a good option?

SMAS Facelift Dr Robert Drielsma

(Before and After Photos by Dr Robert Drielsma, MBBS, BSc, FRACS)

When you look in the mirror, do you see a face that reminds you of a parent or even a grandparent?

Getting older brings life experience but it also leads to facial lines and wrinkles developing and the facial skin drooping down. From deep wrinkles and lines, to cheek jowls that sag and a slack, wrinkled neckline, an ageing face can be distressing.

And while non-surgical anti-wrinkle treatments like Botox and dermal fillers like Juvederm and Restylane can reduce the signs of ageing, in some cases this is not enough to stop the signs of ageing.

Long gone are the days where a facelift has a ‘windblown’ unnatural effect. The SMAS facelift is a sophisticated cosmetic surgery facial rejuvenation technique that produces natural looking, enduring results.

What is a SMAS facelift?

The SMAS facelift (also known as Rhytidectomy) is a surgical procedure that was pioneered in the 1980’s. Over 100 years ago, when facelifts were invented, all they did was to tighten the facial skin. While this was effective, the results were not natural looking or long lasting.

Over the last few decades, the development of SMAS facelift surgery has progressed to create natural looking results.

This type of facelift tightens the Superficial Muscular Aponeurotic System (SMAS) – the continuous layer of muscle and fibrous tissue that lies beneath your skin and runs from the forehead to your collarbone. Unlike your skin (which is a stretchy layer) the SMAS is a strong fibro muscular fascial layer.

When the SMAS is surgically lifted and modified, the skin is repositioned resulting in a tighter, younger looking appearance.

Why you may be considering a SMAS facelift

You may be considering a SMAS facelift if you feel your face is ageing, making you look and feel older than you are. People who have found that non-surgical, anti-ageing treatments are not sufficient anymore may also consider having a SMAS facelift.

People who are most likely to benefit from a SMAS facelift have one or more of these signs of ageing:

  • Your eyes are wrinkled, saggy and tired looking,
  • You have deep folds in your skin on the sides of your nose and mouth,
  • You have wrinkling facial skin that has lost shape,
  • Your cheeks and/or mouth have begun to sag, or
  • You have developed a double chin or folds in the skin of your neck.

Who is a SMAS facelift for?

Good candidates for SMAS facelifts are struggling with a saggy neck and face that have caused by the natural ageing process. Ideal patients also have some elasticity in the skin and a well-defined bone structure.

If you’ve got signs of ageing in other parts of your face, your Cosmetic Surgeon may suggest that you consider treating these first or at the same time as the SMAS facelift. It’s important to note that most Cosmetic Surgeons will not perform SMAS facelift on active smokers.

How to find the best Australian Cosmetic Surgeons who specialise in SMAS facelifts

In terms of skeletal structures, facial anatomy, muscles, fat, nerves, tendons and other structures; the SMAS facelift surgery is a complex surgical procedure. Only a highly skilled, experienced Cosmetic Surgeon should perform this type of facelift surgery.

It is important to note that SMAS facelift results vary from patient to patient and Cosmetic Surgeon to Cosmetic Surgeon. SMAS facelift success depends on the skill, expertise and experience of the Cosmetic Surgeon, the patient’s health and their facial structure.

You can find the best Australian Cosmetic Surgeons who specialise in SMAS facelifts here.

Before deciding if SMAS facelift surgery is suitable, your Cosmetic Surgeon will carry out a thorough assessment. For the operation to be successful it’s important that you have good bone structure and that your skin has elasticity.

How is a SMAS Facelift Surgery performed?

A SMAS facelift surgery usually takes between 2 to 3 hours, under general anaesthetic in hospital. Most patients will need to stay in hospital for at least 1 night. To make your skin look smoother and younger, your Cosmetic Surgeon will lift and tighten the subcutaneous SMAS.

Any excess skin will be removed after the SMAS has been lifted and fixed in place. So you avoid looking ‘windblown’ and ‘stretched taut’ your skin will be sutured without any tension.

Since every face is unique, your SMAS facelift will be customised to you’re your face. Your Cosmetic Surgeon may choose to surgically ‘fold’ the SMAS layer superiorly and surgically attach it to itself (known as SMAS Plication facelift). Otherwise, they may tighten and lift the SMAS by surgically reducing the muscles and then reattaching them in a more uplifted position (known as SMAS Resection facelift).

SMAS facelift procedures usually result in long scars and a lengthier recovery time than other facelift procedures. Some patients also experience significant bruising and swelling.

What happens during SMAS facelift recovery?

During recovery from the SMAS facelift, you will need to wear a special bandage around your face. This bandage assists the healing process and will minimise any swelling and bruising. Your Cosmetic Surgeon will advise how long you need to wear the bandage for.

To remove any excess blood or fluid that have accumulated during the SMAS facelift, some patients will need to have thin cannulas (tubes) left in place. Your Cosmetic Surgeon will provide you with more information on how to take care of these drains once you leave hospital.

Most patients will need to take prescribed medications to aid healing, prevent infection, or reduce discomfort that may result from SMAS facelift surgery. To assist in your recovery, it is important to practise preventative skin care by using sun protection and not smoking.

After SMAS surgery, you will be able to resume driving once you are comfortable, can react quickly if necessary, are not taking strong painkillers and can see normally. For most patients this is 7 to 14 days after surgery. It is important to avoid heavy exercise 3 to 6 weeks after SMAS surgery.

Key facts you must know about SMAS facelifts

A SMAS facelift is a big cosmetic surgical procedure and will usually involve up to a month of recovery time. It is important to note that any patient having any facelift procedures where the skin is undermined will become numb in the cheek and temple area, in front of the ears, and sometimes in the upper neck. This numbness may last for weeks or months, but will generally improve over time.

SMAS facelifts can change the hairline around the temple area. Not all hairstyles are compatible with this type of facelift. Men considering a SMAS facelift need to be aware of the potential visibility of the incisions, the changes in sideburn position, and the scar position in relation to their ears.

A period of psychological adjustment is common any type of facelift, including a SMAS facelift. It is normal to go through a variety of moods postoperatively. After the fresh wounds, swelling and bruising passes, most people feel positive.

What are the risks and complications of a SMAS facelift procedure?

Any surgery where general anaesthesia is used has possible risks and complications. To reduce any risks and complications with your SMAS facelift surgery, it is very important to use a Cosmetic Surgeon who is highly trained and performed many of these procedures.

You can read about the specific risks and complications of a SMAS facelift here.

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