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Cosmetic and Plastic Surgery-SanFrancisco Bay Area|Marin County

What is a SMAS Face Lift?

May 26th, 2011 Miguel A. Delgado Jr, MD

There are different face lift techniques available, depending on a patients age and condition of skin, Dr. Delgado evaluates which face lift procedure is appropriate for each individual patient.

SMAS is an acronym for: Superficial Musculo-Aponeurotic System, which is the fibrous network of tissue that lies under the skin but over the facial muscles. The SMAS is a membrane composed of fibro-elastic connective tissue and muscle that attach through the subcutaneous fat to the superficial epidermal-dermal layer of the skin allowing them to move together as a unit.

Plastic surgeons modify the SMAS during a face lift procedure by lifting it up to hold the face in different positions. If you only lift the skin it will stretch, as skin is meant to, and everything will return as it was. By lifting the SMAS, which is the deepest (third) layer, it will reduce the appearance of sagging jowls, cheeks and neck without putting tension on the skin. Putting tension on the skin is what gives the “windblown” look that so many San Francisco and Northern California Bay Area patients are concerned about.


The SMAS face lift is far more advanced than a skin or endoscopic face lift and can give excellent long lasting results for 10 years or more. The ability to perform the SMAS face lift procedure requires fundamental knowledge in facial nerve, plastic surgery and microsurgery.