High SMAS face lift: clinical experience

Wang, Zhijun; Ma, Xiao-Yan; Li-xiang, Yang; Wang, Yan; Chen, Lili; Lv, Hang

doi:10.25056/jcm.2017.1.2.112

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…Raising the malar fat pad vertically and softening the nasolabial fold results in a more rejuvenated midface. 8, 9 More of a lateral facial pull is observed after conventional facelift surgery. This pull vector does not always meet the patient's needs since it ignores the alterations brought on by mid-facial aging.…”

Section: High Smas Facelift Benefit Traditional Faceliftmentioning

confidence: 99%

“…There is no requirement for or recommendation for suturing over the zygoma or along the infraorbital rim. 6,8, 9 Based on figure 3, The SMAS should shift in a path that is parallel to the zygomaticus major muscle's long axis (A). The function of the zygomatic major muscle is affected if the SMAS is moved along a posteriorly oriented vector (B) rather than along its long axis.…”

Section: Skin Flap Elevationmentioning

confidence: 99%

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The Fundamental Concepts of High SMAS Facelift: Literature Review

Samsarga

Adnyana

Suyata

et al. 2022

Intisari Sains Medis

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A number of facelift procedures have been introduced by many surgeons but there is no consensus has yet been established to carry. Since the first description of superficial musculoaponeurotic system (SMAS), it is used as the basis for many facelift methods that produce superior result in rejuvenation compared to traditional skin only facelift. Extended SMAS facelift becoming SMAS modification techniques that is still being developed. It produces two different vector of subcutaneous and SMAS flap, that is essential to restore drooping deep facial tissue with natural appearance. Despite the beneficial use of extended SMAS flap, most of plastic surgeons still traditionally incise the SMAS under the zygomatic arch. However, the low SMAS incision results only on rejuvenation of the lower face and is not sufficient to correct mid-facial aging. Fundamental concepts of high SMAS facelift by reviewing some literatures explain that high SMAS flap transection allowing the surgeon to achieve greater vertical elevation of the deep structures of the face by undermining the middle face, combined with fixation to a fixed structure produces lasting results and oblique vector of skin envelope creating no tension look. Incision above zygomatic arch turns out to be safely performed without facial nerve injury thorough knowledge of the anatomy. The final result is a balanced and harmonious elevation of sagging tissues of the midface, cheek, and jawline, to such an extent that high SMAS facelift becomes optimal, durable, technically simple, reproducible and with a comparatively high safety margin in facelift procedures.

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Section: High Smas Facelift Benefit Traditional Faceliftmentioning

confidence: 99%

Section: Skin Flap Elevationmentioning

confidence: 99%

The Fundamental Concepts of High SMAS Facelift: Literature Review

Samsarga

Adnyana

Suyata

et al. 2022

Intisari Sains Medis

View full text Add to dashboard Cite

show abstract

“…In this group of 32 patients with thread lift, only 1 case had the thread, and its scar passed the full length of the subcutaneous fat layer, and the remaining 31 cases had the thread and its scar through the temporal space and the anterior masseter space, anterior zygomatic space, and cheek space [6,7]. The dissection plane of the superficial temporal fascia-orbicularis muscle-platysma flap [8] of the high SMAS facelift is the abovementioned 4 facial spaces. The scar formed by the thread degradation of thread lift is dense and tough.…”

Section: Dissection Technique Of Postoperative Cases With Thread Liftmentioning

confidence: 99%

Difficulties of facelift in patients with scar after treatment of facial liposuction or thread lift sutures

Wang

Guo

et al. 2021

J Cosmet Med

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Objective: To explore the methods and safety of general abnormal anatomical layers and structure in rhytidectomy, which is also of clinical significance. In this group, 39 patients with static and dynamic deformities formed at different levels after liposuction and thread technique more than one time were treated with stable and active separation skills in high SMAS facelift operation. The results showed that the patients of this group could get the same effect of younger postoperative operation as "initial face" and solve dynamic adhesion deformity.Methods: Magnetic resonance imaging and ultrasound were performed before operation, focusing on the abnormal changes of facial soft tissue. The results showed that the signal of the foreign body, the position and texture of scar, the relationship between scar and masseter fascia, buccal fat pad, and whether there was tissue defect or hyperplasia. In the operation, the normal separation was made in the second and fourth layers of the previously safe and easy to separate plane, instead of in the dense one or two layers of the scar. It is an alternative microsurgical separation technique. The key point is to separate the incomplete SMAS flap to achieve the expected good effect of rhytidectomy, release the scar adhesion and facial spasm. At the same time, the severed injury of facial nerve branches should be strictly prevented.Results: 74 cases of facelift were taken in recent eight months and 67 patients were treated with micro plastic surgery. Among them, 39 patients received more than one facial liposuction and more than one thread lift. In the scar formed by liposuction and thread technology, liposuction is especially serious; liposuction can still absorb the structural layer, and scar directly involves the SMAS and buccal fat pad envelope containing facial nerve branches, one of which directly causes the injury of the mandibular marginal branch. Most of the chronic granuloma scar formed after the degradation of the thread technology is in the facial space, which causes the scar atresia of the space. The flap and SMAS flap of 39 cases were separated, most of which were facial nerve branches in scar. All of them were difficult to separate and form the SMAS flap of superficial temporal fascia-Orbicularis oculi-platysma, and 89.6% of the excellent facelift effect was obtained. Facial nerve injury was found in 2 cases, 1 case was right mandible marginal branch traction injury, and the other side was left corner nerve injury. In the process of recovery. Conclusion:For patients with facial liposuction and thread technique, doctors must be prepared for the difficult separation of scar adhesion and have a high risk of facial nerve branch disconnection. If we don't pursue the rejuvenation effect, it will lead to the existence of surgical effect discount, bilateral asymmetry, and dynamic adhesion deformity.

show abstract

High SMAS face lift: clinical experience

Cited by 2 publications

References 7 publications

The Fundamental Concepts of High SMAS Facelift: Literature Review

The Fundamental Concepts of High SMAS Facelift: Literature Review

Difficulties of facelift in patients with scar after treatment of facial liposuction or thread lift sutures

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