The Standard Face Lift
The most common standard lift is a SMAS facelift. SMAS refers to submusculoaponeurotic system, a layer or sheet of fibrous tissue that underlies our facial fat layer. The soft tissues constituting the face are in layers with the skin on the surface then a layer consisting of fat, mixed with a layer of connective tissue, and the SMAS layer. The SMAS layer of the face separates the deeper facial structures such as facial movement muscles, nerves and other structures that are not as affected by aging as the soft tissue.
Although the SMAS facelift produces a longer lasting and more natural look than a lift in which only loose skin is pulled tight, skin-only facelifts, first introduced decades ago, are rarely used today.
The SMAS facelift is sometimes referred to as a ‘muscle pulling lift’, because surgeons often describe it as tightening the muscle (SMAS) layer. Although it is clearly an improvement over skin only facelifts, a SMAS facelift only has a minor effect on the deeper tissues and still can require skin pulling to achieve the result.
The SMAS lift is the procedure that showed the public the importance of approaching aging changes by repositioning the deeper drooping tissue, not the skin. It was this procedure that led the plastic surgery community to the benefits of pure deep tissue repositioning and the development of more sophisticated facelifting techniques such as deep-plane facelifting.