Background:The ultimate goal of facelift is to lift the sagging soft tissue as much as possible, so as to restore them to the original anatomical position for facial rejuvenation.Objective: In our High-SMAS facelift, the SMAS-platysma flap were tighten strongly, so as to obtain full and youthful facial morphologic characteristics. In addition, the effectiveness of high-SMAS was evaluated in this paper. Methods:A total of 86 cases of SMAS face lift were performed in 22 months from January 2015 to November 2016. High SMAS technique was applied in 39 cases of them. All the 39 patients were female averaged 44 (29-65) years old. Postoperative follow-up wascarried out in 18 cases for an average of 13 months (4-22 months). After the SMAS-platysma flap was dissected in the lower face and neck，the key point of operating is focus on：The middle temporal fascia and superficial temporal fascia flap was dissected carefully. Break off the ligaments medial to the zygomatic arch and on the malar process exactly, and pay attention to protect the facial nerve. So that the high-SMAS and even higher-SMAS flap can be dissected. Results:In all the 18 cases followed up, most (11/18) obtained a clear mandibular margin after operation and scored even full mark.Perfect nasolabial fold improvement was achieved in few (7/18). In terms of Ogee curve evaluation, most (15/18) made it to the level of "acceptable", which was shared by the evaluation of lower eyelid shortening effects (13/18). Very satisfied indicators as follow: the obtuse jowl line becomes clear, midface "ogee curve" is vary from linear to curves, and the nasolabial sulcus have been improved. Conclusion:High-SMAS Facelift is one of the most effective rhytidectomy, the most prominent parts of its effect including the improvement of midface and jowl line contour. Level of Evidence: IV