A lower SMAS facelift is a surgical procedure that targets the lower face and neck to address signs of aging, such as sagging skin, jowls, and deepening facial folds. SMAS stands for Superficial Musculoaponeurotic System, which is a layer of connective tissue and muscle beneath the skin. During a lower SMAS facelift, incisions are made around the ears and possibly under the chin, allowing the surgeon to lift and reposition the underlying SMAS layer. This technique not only tightens the skin but also improves the contour and definition of the lower face and jawline. By addressing the specific concerns of the lower face and neck, a lower SMAS facelift can provide a more youthful and rejuvenated appearance.
Patient is unhappy with their neck and jowls. No recent weight changes or prior treatments to the area. There is mild midface atrophy and descent with up to use nasolabial folds. The lips are full and symmetric. There is mild to moderate jowls with buccal fullness. This is worse on the right. The mentum is within normal limits. There is mild obliteration of the inferior mandibular border. There is mild to moderate cervicomental adiposity and laxity. There are several, horizontal lower cervical rhytids.
After examination and reviewing options including doing nothing, threadlift, cryotherapy/Renuvion, direct cervicomental, and deep dermal heating, the patient expressed primary interest in a facelift, sub-SMAS with midline platysmaplasty. If indicated, laser lipolysis to address adiposity may be performed.