SMAS Facelift

The SMAS is the layer of muscle and connective tissue beneath the skin that supports the face. An SMAS facelift repositions and supports this deeper layer rather than relying on the skin alone, which helps the result last and avoids a pulled, tight appearance. It addresses the lower two thirds of the face and the jawline, and is often combined with neck surgery when the aim is a uniform result. It is a widely used and well established technique that can be adapted to a range of patterns of ageing.

At your consultation, Dr Ricketts examines your face and neck and assesses your skin and the deeper tissues. She explains why she would recommend an SMAS approach for you, and how it compares with a mini facelift or a deep plane facelift, so you understand the options and the reasons for her recommendation.

Facial ageing is not only about loose skin. Over time the deeper tissues descend, fat compartments shrink or shift, and the skin loses elasticity, which creates jowls, deepening folds and loss of definition at the neck. Rather than pulling the skin tight, an SMAS facelift lifts and secures the SMAS layer underneath, then redrapes the skin over the new foundation and removes the excess without tension. Working on the deeper layer is what helps the result last and avoids a pulled, tight or operated look.

An SMAS Facelift may suit you if you have jowls, sagging along the jawline, deep folds or loss of definition at the neck, and if you are in reasonable general health. It is not a treatment for skin texture, fine lines or pigmentation, which are caused by other factors, and it does not stop the aging process. Smoking significantly increases the risk of healing problems, so stopping well before surgery is necessary. The best candidates understand that the result depends on their own tissues and healing and have realistic, balanced expectations.

At your consultation, Dr Ricketts examines your face and neck, assesses your skin, the deeper tissues and your bone structure, and listens to what concerns you. She explains why she would recommend an SMAS lift, where the scars would sit, the recovery and the risks, and whether procedures such as eyelid surgery, a brow lift or fat transfer would balance your result. She gives you written information and encourages you to take your time, and this discussion can take more than one consultation.

An SMAS Facelift is performed under general anaesthetic and usually requires a one night stay. On the day Dr Ricketts meets you before surgery, confirms the plan and marks the surgical areas with you in the upright position. A dedicated team cares for you through your operation and early recovery, and you transfer to the ward for your overnight stay. Dr Ricketts reviews you in the morning before you are discharged in dressings or a face garment, with clear instructions. Your first review is usually about a week later.

Facelift recovery happens in stages. In the first week or two, swelling, bruising and tightness are at their worst. Drains may be used overnight while you are in hospital, and a supportive dressing is usually in place for a short period. Discomfort is manageable with the medications prescribed, and keeping your head elevated and following the activity restrictions in the early days helps you heal.

Most people take around two to three weeks before they feel ready to return to work or socialise, though bruising does not always clear that quickly. The neck and lower face generally settle more slowly than the upper face, and some numbness can persist for weeks or months before gradually improving. Strenuous exercise is avoided for about three to four weeks. The aesthetic result continues to improve as swelling resolves, with healing on average taking around three months. Dr Ricketts will see you at review appointments. Everyone heals at a different rate, the timeframes given are a guide only, and the outcomes one person experiences do not necessarily reflect what another will experience.

Dr Sophie Ricketts is a specialist plastic surgeon based in Richmond, Melbourne, with a focused practice in facial surgery, including the SMAS Facelift. She is a Fellow of the Royal Australasian College of Surgeons (FRACS) and a member of the Australian Society of Plastic Surgeons (ASPS) and the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the peak professional bodies for plastic surgery in Australia. You can also find her on RealSelf. Each of these listings is maintained by independent organisations and provides patients with a straightforward way to check the qualifications, training, and scope of practice of the listed providers before booking a consultation.