During the SMAS facelift, an incision is made at the temple above the hairline and is extended downward. This cut is made along the creases in the patient’s skin, in front of the ear, below the ear lobe, and behind the ear. Making the incision on a person’s natural creases helps to hide the scars.
The surgeon then separates the skin and muscles of the face from the deeper facial tissues. In some cases the skin is removed, and in other situations, the skin and muscle tissues are reshaped. The underlying muscle may be tightened with the skin, or separately. After the tightening, or removing the excess skin, the skin is redraped and sutured or stapled in place.
The SMAS procedure addresses lower face and jowl problems in patients, although is less effective in treating sagging upper cheeks and areas around the nose and mouth.