What Is a SMAS Facelift? High-SMAS vs Deep Plane

What Is the SMAS?

The SMAS (Superficial Musculoaponeurotic System) is the connective-tissue layer just beneath the facial skin that envelops the mimetic muscles and supports the soft tissues of the face. With ageing it loosens: the cheeks descend, jowls blur the jawline, and the neck-chin angle softens.

The core principle of modern facelift surgery is to reposition this deeper SMAS layer rather than simply pulling the skin. Skin-only lifts relapse quickly and risk an operated look; SMAS-based techniques give a more natural, longer-lasting result.

How a SMAS Facelift Works

Incisions are hidden along the hairline and the natural creases around the ear. After the skin is elevated, the SMAS layer is either folded (plication) or partially removed and re-anchored (SMASectomy/imbrication). This restores the jawline and cheek, allowing excess skin to be removed without tension. The operation is performed under general anaesthesia and is frequently combined with a neck lift (platysmaplasty). Recovery is typically 2–3 weeks to social activities.

What Is a High-SMAS Facelift?

In the high-SMAS variant the flap is released and suspended from a higher level, above the zygomatic arch, which gives stronger midface (cheek) elevation than the classic approach.

SMAS vs Deep Plane — the Real Difference

The difference is whether the surgeon works on top of or underneath the SMAS:

• SMAS facelift: the layer is tightened from its surface. Well suited to earlier or milder laxity; recovery ~2–3 weeks.
• Deep plane facelift: the surgeon releases the retaining ligaments beneath the SMAS and repositions cheek, midface and neck as one composite unit. It provides the strongest, most natural correction for significant midface descent, with the lowest risk of a pulled look; recovery ~3–4 weeks.

Op. Dr. Hüseyin Arslan generally prefers the deep plane technique for pronounced midface and neck descent, and SMAS-based techniques for milder laxity. The right technique is decided at examination, based on anatomy, tissue quality and expectations.

FAQ

How long does a SMAS facelift last? Results are long-lasting — typically 8–10+ years of visible benefit — though natural ageing continues.

Which is better, SMAS or deep plane? Neither is universally better; the degree and location of laxity decide. Pronounced midface descent favours deep plane; milder laxity is well served by SMAS techniques.

Can it be combined with a neck lift? Yes — combining a SMAS or deep plane facelift with platysmaplasty in one session is common when neck laxity coexists.

*This content is for information only; the treatment decision is made with your surgeon after examination.*