SMAS Facelift (Face and Neck Lift)

The SMAS (superficial musculoaponeurotic system) is the fibromuscular layer that connects facial muscles to the overlying dermis and fat. With age, gravitational descent of the SMAS and the compartmentalised fat pads it anchors produces the characteristic features of facial ageing: jowl formation, deepening nasolabial folds, neck banding (platysmal laxity), and loss of jawline definition. A SMAS facelift addresses these changes by directly repositioning…

At EsteticUsti, the incision design follows a well-established pattern: beginning in the temporal hair-bearing scalp, curving in front of the ear (pretragal or retrotragal approach, depending on anatomy), around the earlobe, behind the ear along the post-auricular crease, and into the occipital hairline. The skin is elevated from the underlying SMAS, the SMAS is plicated or advanced under direct vision, excess SMAS is excised or suspended, and the skin is…

For the neck component, the platysmal muscles may be tightened centrally (platysmaplasty) and/or the lateral platysma advanced and secured to the mastoid fascia to restore a more defined cervicomental angle. The mini facelift (limited incision facelift) uses a shorter scar confined to the preauricular area without a temporal or occipital extension — appropriate for younger patients with early jowling and mild neck laxity. The temporal lift addresses the…