SMAS Facelift
Not just pulling the skin —
we correct sagging from the deep layers that cause it
Facial aging is not simply the skin stretching. As the fat and fascial layers beneath the skin move downward together, the cheeks sag, the jawline blurs, and the lines around the mouth and neck deepen.
An SMAS facelift does not just remove loose skin; it also adjusts and secures the SMAS layer that supports the shape of the face.
TOV Plastic Surgery Clinic does not forcibly pull the face to create a different look; our goal is to return tissues that have moved downward to a position close to where they originally were, for a comfortable, natural change.
What Is the SMAS?
SMAS stands for Superficial Musculoaponeurotic System, the fibromuscular layer beneath the skin that supports the facial tissues.
As aging progresses, not only the skin but also the SMAS layer and fat tissue sag together, causing the following changes:
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Sagging below the cheekbones and in the front of the cheeks
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Deeper nasolabial folds and lines around the mouth
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Deep-cheek sagging and jowls
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A blurred jawline
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Sagging under the chin and around the neck
Therefore, rather than strongly pulling only the skin surface, the deep tissues that cause the sagging must be adjusted as well to expect a more natural facial contour.
TOV's SMAS Facelift
Moving tissue in the right direction matters more than pulling hard
Where sagging starts and how severe it is differ from person to person. For some, the front of the cheeks and the nasolabial area stand out; for others, deep-cheek sagging, the jawline or neck sagging is more pronounced.
TOV Plastic Surgery Clinic does not pull every face the same way with a fixed method.
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We analyze facial sagging area by area
We look at skin thickness and elasticity, the amount and position of fat, the condition of the SMAS, jawline and neck sagging, and the facial bone structure together.
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We move tissue in the direction that suits it
The skin and the deep tissues must be adjusted with different directions and forces. We decide the direction of movement according to the structure of each area so the face does not look pulled sideways.
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We do not leave excessive tension on the skin
Rather than relying on skin sutures alone for the result, we support the tissues in the deep layer and then naturally trim the remaining skin.
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We preserve your original look
The goal of a facelift is not to create a completely different face. Considering your current bone structure and expressions, how you looked when younger, and the range of change you want, we aim for a result that does not compromise your original look.
Areas That Can Be Improved
An SMAS facelift is mainly performed to improve sagging of the lower face and neck.
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Sagging front cheeks and tissue below the cheekbones
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Deepened nasolabial area and lines around the mouth
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Deep-cheek sagging and jowls
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A blurred, uneven jawline
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Sagging under the chin and around the neck
However, nasolabial folds and lines around the mouth have many causes besides skin sagging, including bone structure, fat loss, skin thickness and facial expressions. A facelift alone therefore does not completely remove every wrinkle, and fat grafting or other treatments may be considered together if needed.
It May Be Considered For
People whose cheeks and jawline have sagged overall
People whose facial contour has become heavy from deep-cheek sagging and jowls
People for whom dermatology treatments alone did not sufficiently improve sagging
People who want a natural, structural improvement
People whose sagging has returned after a previous facelift
When sagging is mild, non-surgical treatments such as ultrasound or radiofrequency lifting may be more suitable. Conversely, when tissue has clearly descended, it is difficult for non-surgical treatments alone to achieve the same degree of change as surgery.
Incisions and Scars
The incision line generally starts around the hair of the temple, follows the natural curve in front of the ear and, if needed, continues behind the ear. For a less noticeable scar, not only the incision position but also suturing so that excessive tension is not concentrated on the skin is important. Scars do not disappear completely; they gradually soften and fade over time, and this varies by individual depending on skin characteristics and the healing process.
Recovery After Surgery
After surgery, swelling, bruising, a tight feeling and reduced sensation may occur. Early on, swelling may differ between the left and right sides, or the face may feel firm and wide.
Major swelling and bruising decrease over time, but it takes longer for the deep tissues to settle and the facial contour to look natural.
The exact recovery period depends on the extent of surgery, skin condition, age, smoking and your individual healing speed. It is best to plan important events with enough recovery time.
What to Check Before Surgery
During your consultation, please tell us accurately about the medications you currently take, your health condition, and your previous procedure and surgery history.
In particular, the following must be discussed with the medical team:
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Taking aspirin or anticoagulants
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High blood pressure, diabetes and cardiovascular disease
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Smoking and e-cigarette use
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A previous facelift or thread lift
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Filler and fat grafting procedures
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Allergies to anesthesia or medications
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A history of keloids or hypertrophic scars
Do not stop any medication on your own; adjust it according to the medical team's instructions.
Side Effects and Precautions
All surgery carries the possibility of side effects and complications. After a facelift, bleeding and hematoma, infection, changes in sensation, delayed wound healing, skin damage, scarring, asymmetry, changes in the hairline, deformation of the ear shape and recurrence of sagging may occur. Rarely, temporary or permanent facial nerve injury may occur, and additional correction may be needed if the result differs from expectations. Smoking interferes with blood circulation and wound healing and can increase the risk of skin damage and scarring, so please follow the no-smoking instructions before and after surgery.
Frequently Asked Questions
How is an SMAS facelift different from a mini lift?
A mini lift generally means surgery that reduces the extent of incision and dissection to improve relatively mild sagging. However, since the scope of surgery differs between clinics, it is more important to check which areas and tissues are actually corrected than the name of the surgery.
Will a facelift make my expressions look unnatural?
If tissue is pulled excessively or secured in the wrong direction, an unnatural look can result. TOV Plastic Surgery Clinic considers it more important to move sagging tissue only as much as needed and to leave no unnecessary tension on the skin than to make the skin taut.
How long do the results last?
A facelift moves sagging tissue, but it does not stop aging. How long results last depends on skin condition, the extent of surgery, lifestyle, weight changes and your individual rate of aging.
Will my nasolabial folds disappear completely?
Nasolabial folds form from a combination of sagging, bone structure, fat loss, skin folding and facial expressions. A facelift can soften them, but not every line disappears completely.
