Name of the Procedure:

Rhytidectomy; Superficial Musculoaponeurotic System (SMAS) Flap
Common Name(s): Facelift with SMAS Flap

Summary

A facelift with a SMAS flap is a surgical procedure aimed at reducing visible signs of aging on the face and neck. It involves tightening and lifting both the skin and the deeper layers of muscle and connective tissue.

Purpose

The procedure addresses sagging skin, deep creases around the nose and mouth, jowls, and loose skin or excess fat around the neck. The goal is to provide a more youthful and rejuvenated facial appearance.

Indications

• Visible signs of aging in the face and neck.
• Sagging skin.
• Deep nasal labial folds.
• Jowls or lack of definition in the jawline.
• Loose, sagging skin on the neck.
• Good overall health and realistic expectations about the outcome.

Preparation

• Preoperative consultation to discuss medical history, expectations, and potential risks.
• Avoidance of blood-thinning medications and smoking for several weeks prior to surgery.
• Fasting after midnight the night before surgery.
• Preoperative lab tests and medical evaluations as needed.

Procedure Description

1. Anesthesia: The patient is administered general anesthesia or intravenous sedation with local anesthesia.
2. Incisions: Incisions are typically made at the hairline, around the ear, and sometimes under the chin.
3. SMAS Flap: The superficial musculoaponeurotic system (SMAS) layer is lifted and repositioned, tightening the deeper structures of the face.
4. Skin Re-draping: Excess skin is trimmed and re-draped smoothly over the newly repositioned contours.
5. Closure: Incisions are closed with sutures, and the surgical area is bandaged.

Duration

The procedure typically takes 3 to 6 hours.

Setting

The procedure is performed in a hospital or accredited surgical center.

Personnel

• Plastic or Cosmetic Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Staff

Risks and Complications

• Common: Bruising, swelling, numbness, and discomfort.
• Rare: Infection, hematoma, skin necrosis, nerve injury, or asymmetry.
• Management includes antibiotics, pain medications, and, if necessary, further corrective procedures.

Benefits

• A more youthful, refreshed facial appearance.
• Improved facial contours and reduction of sagging skin.
• Results are typically noticed once swelling subsides, within a few weeks.

Recovery

• Bandages are removed within a few days, but swelling and bruising may persist for weeks.
• Stitches are usually removed 5 to 10 days post-surgery.
• Limited physical activity and protection of incisions from excessive motion.
• Follow-up appointments to monitor healing.

Alternatives

• Non-surgical options: Dermal fillers, Botox, or laser treatments.
• Surgical options: Mini-facelift or neck lift.
• Pros: Less invasive options have reduced recovery time but may offer less dramatic results.
• Cons: Non-surgical options often require repeat treatments and may not address deeper tissue issues.

Patient Experience

• During the procedure: Patient is under anesthesia and will not feel pain.
• After the procedure: Expect some discomfort, manageable with prescribed pain relief medications.
• During recovery: Patients might experience tightness, numbness, or swelling, with most discomfort subsiding within a few weeks.