DEEP PLANE, SMAS AND SHORT SCAR FACELIFT SURGERY AT PANTHEA SYDNEY
There is still a lot of confusion about facelift surgery. This is mostly born out of the fact that terms and definitions are often used interchangeably by experts to mean different things. Let’s try to clarify some of those so it makes sense. Let’s start with history and development of facelift surgery by surgeons. I should know, I wrote the book on this, with two recent facelift chapters in our standard international reference textbook.
BACKGROUND ON FACELIFT SURGERY
Before the prodigious all rounder plastic surgeon recognised the role of deeper tissues in 1974, facelift consisted of pulling the skin as tight as possible once it was undermined from in front of the ear to the corner of the mouth. The problem with this approach is that skin relaxes over time as any mother who has undergone pregnancy will tell you. Repeated excisions of redundant skin merely result in ear lobes moving towards the chin and the wind tunnel appearance, not a good, natural or lasting look.
Meitz and Peyronie are credited with describing the Superficial Musculo Aponeurotic System (SMAS) in 1976. This led to the revolutionary understanding that the “parenchymal” could be manipulated with ligaments connecting the skin to underlying bones divided to achieve a rejuvenated look with minimal skin excision. From this revolution sprang up a series of surgical approaches modern surgeons can undertake. So let’s dissect them a bit.
UNDERSTANDING FACELIFT PROCEDURE BY PANTHEA’S SURGEON IN SYDNEY
A standard facelift incision, starts in the temporal hairline, skirts in front of the ears, moves behind the ear and then extends down the hairline as far needed. That is the skin incision. What happens to the underlying SMAS then defines the variations of what is called the “deep plane”. In essence any facelift surgery that manipulates the SMAS layer by dissecting under it is a form of “deep plane” surgery. These are divided into:
1. SMAS plication (Fig 1)
2. Lateral SMASECTOMY (Fig 2)
3. Extended SMAS (Fig 3)
4. High SMAS(Fig 4)
A variation on skin incision was then developed called the short scar facelift. Here the skin incision is shorter, starting at hairline sideburns and ending behind the ear. See the black line in (Fig5).
A further variation and optimisation of this process has come from recognising the spaces of the face under the SMAS and the ability to undermine less and less skin to aide a quicker recovery and less postoperative swelling with reduced risk profile. The short car composite high SMAS surgery (Fig 5 & 6)
Here the skin is undermined to the bare minimum, the SMAS is accessed through its spaces and then anchored higher to give a natural rejuvenated look. You can see the outcomes in our gallery.
For some further reading, see our facelift page.
Speak to us for more information
Contact Panthea’s Sydney or Canberra clinics today to book your initial consultation or have your questions answered by our dedicated surgeon and team of surgical professionals.
Our Sydney clinic is conveniently located in Darling Point while our Canberra clinic is located in National Capital Private Hospital.
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