SMAS Facelift (Face and Neck Lift)

SMAS facelift at EsteticUsti addresses the primary structural cause of facial ageing — descent of the superficial musculoaponeurotic system (SMAS) and overlying soft tissue — through a surgical technique that tightens the deep facial layer rather than simply pulling skin. Incisions run from the hairline above the ear, around the earlobe, and into the hair behind the ear; the SMAS layer is repositioned under direct vision, and drainage tubes are placed to prevent haematoma. The procedure takes approximately two hours under IV sedation and local anaesthesia. Sutures are removed at days 10–14; bruising resolves by 2–3 weeks. The clinic's on-site recovery rooms allow patients to remain for the first night(s) after surgery.

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 the SMAS layer — achieving results that are more durable and more natural-looking than skin-pull-only techniques, because the deep layer bears the tension rather than the delicate skin. 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 re-draped without tension in a more youthful vector. Drainage tubes are placed in the temporal region to prevent fluid accumulation and removed at the first post-operative dressing change. 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 lateral brow and temple area specifically. Recovery follows a predictable course: dressing change on day 2; the main bandage is removed by day 3, allowing hair washing; sutures are removed at days 10–14; bruising resolves by weeks 2–3; social presentability is typical by 3 weeks.