SMAS Facelift
The dependable workhorse of facelift surgery — tightening the muscular SMAS layer beneath the skin for natural, lasting results.
What is a SMAS facelift?
The SMAS facelift is the technique most UK surgeons trained on and still the most widely performed. The SMAS (superficial musculoaponeurotic system) is the layer of muscle and fibrous tissue beneath the skin and facial fat. In a SMAS facelift the surgeon lifts the skin as a separate flap, then tightens the SMAS underneath — and it is this deeper tightening, not the skin, that does the lifting.
Tightening the SMAS rather than the skin is what separates a modern facelift from the discredited skin-only lifts of decades past. It is the foundation of natural, durable results.
How the SMAS is tightened
There are several ways to address the SMAS, and surgeons often combine them:
- SMAS plication — folding and stitching the SMAS onto itself to tighten it, without cutting it.
- SMASectomy — removing a strip of SMAS and stitching the edges together.
- SMAS imbrication — lifting and overlapping the SMAS before fixing it in its new position.
Each redistributes tension to the deep layer so the skin can be redraped gently. The choice depends on your anatomy and the surgeon’s preference.
Who is it best for?
A SMAS facelift suits a very wide range of patients with jowling and lower-face laxity and is a dependable, well-understood operation. For patients with significant midface descent and deep nasolabial folds, a surgeon may recommend an extended SMAS or deep plane approach, which mobilise the midface more fully.
Recovery
Recovery mirrors other full facelifts: two to three weeks of visible swelling and bruising, most people presentable by around three weeks, and final settling over several months. See the recovery timeline.