What is SMAS?
SMAS means Superficial Musculoaponeurotic System. It’s a layer of fibrous tissue that connects facial muscles to the skin and subcutaneous tissue. It functions as a “network” that supports facial structures.
Why Is It Important?
- • Connects skin to deep structures — moving SMAS moves face
- • Supports tension — unlike skin, it doesn’t sag over time
- • Contains nerves superficially — safety reference
- • Defines surgical planes — supra-SMAS, sub-SMAS, etc.
SMAS in Facelift Techniques
SMAS Plication: Folds and sutures SMAS without dissecting below it. SMASectomy: Removes SMAS strip and sutures edges. Extended SMAS: Wider dissection over SMAS. Sub-SMAS (Deep Plane/Endomidface): Goes below SMAS for deep mobilization.
SMAS and Aging
Over time, SMAS loses elasticity and the ligaments that connect it to bone weaken. This allows fat and tissues to “descend” through the SMAS, causing signs of facial aging.
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