There comes a time when the mirror no longer reflects our self-image. Gradual sagging of the skin, sagging of the cheeks, loss of firmness in the neck, and those wrinkles that become more pronounced over time, end up altering our self-confidence. Beneath the surface of the face, the superficial musculoaponeurotic system (SMAS) also loses its tonicity, leading to tissue ptosis and a silent transformation of the anatomical structure.
However, today there are solutions for facial surgery to restore facial youthfulness without freezing natural expressions. The SMAS facelift, High SMAS and Deep Plane Lifting reposition sagging muscles and tissues in depth. These techniques tighten structures, treat excess skin and deliver precise, long-lasting results. Each procedure acts as a genuine reconstruction, restoring the patient's natural, harmonious face.
This comprehensive guide introduces you to the treatments, technologies and milestones you need to feel confident about your transformation.
The SMAS, or superficial musculoaponeurotic system, is a fibrous and muscular layer of the musculoaponeurotic system. located under the skin of the face. A veritable «framework» for the face, it supports the soft tissues and maintains the tension necessary for firm features, while also playing a crucial role in facial expression. Over time, this system loses tone and tension, leading to sagging features, creases and a slack neck.
The smas lift therefore redefines the superficial musculoaponeurotic system.
The SMAS contributes to the mobility and expressiveness of the face, supporting key areas such as the cheeks, the eye contour, the oval of the chin and the cervical zone. Its progressive deterioration, caused by loss of elasticity and the melting of subcutaneous fat, amplifies the appearance of wrinkles and tissue relaxation in these different areas. The quality of this system depends on factors such as genetics, exposure to the sun or smoking.
Introduced in the 1970s, the SMAS facelift has rapidly become a benchmark in cosmetic surgery of the face. Thanks to technological advances and a better understanding of anatomy, today's techniques enable more precise and natural repositioning of facial structures.
The SMAS facelift is a plastic surgery procedure that targets the deep layers of the face. It repositions the SMAS, tightens tissues and restores youthful contours to the lower face. Unlike more superficial approaches, this method acts deep down for a more lasting, natural look.
The surgical procedure is performed under general anaesthetic. After a discreet incision around the ear, the surgeon frees the SMAS, tightens it and removes the excess skin. The duration of the operation varies eetween 2 and 4 hours depending on complexity. Dr. Djian, a recognized SMAS facelift specialist, adapts the surgical procedure to the patient's muscular structure to ensure a harmonious transformation.
The SMAS lift is considered one of the best advanced techniques facelift to target the facial aging.
It's a facelift technique particularly suitable for people seeking rejuvenation visible from the face, while maintaining the naturalness facial expressions.
The SMAS facelift acts on the lower part of the face, while the High SMAS lifting also targets the malar region, for a more global treatment of the face. The latter is ideal for repositioning volumes and restoring facial harmony.
The extended version (or high SMAS extended) acts beyond the classic zones for an even more pronounced rejuvenating effect, particularly on the neck area and décolleté. The Doctor Djian recommends this option in cases of advanced tissue loosening and ptosis of cervico-facial tissues.
Renuvion is an innovative, minimally invasive aesthetic technique that combines helium gas with radiofrequency energy to create a targeted plasma. This technology heats skin tissue deep down, stimulating collagen production and tightening the skin. It effectively treats sagging of the face and neck. This method is ideal for moderate skin sagging, It complements liposuction, but is limited in the case of deep ptosis.
The cervico-facial lift traditional acts primarily on the skin. It aims to correct visible sagging of the face and lower face by tightening the skin layer. While this approach produces immediate visible effects, they may fade more quickly. This is because it does not correct the underlying causes, i.e. the laxity of the underlying muscular and fascial tissues.
In comparison, thee lifting SMAS goes even further. It acts in depth on the musculoaponeurotic structure, the true «framework» of the face. By repositioning these internal tissues, it restores volume and redefines facial contours. This technique corrects loss of cheek firmness, chin sagging and tissue ptosis.
It also avoids the «pulled» appearance sometimes observed with facelifts limited to the cutaneous layer. It's a complete approach that combines aesthetic benefits with long-lasting results.
The deep plane lifting is considered one of the most sophisticated techniques for rejuvenating the face and neck. Unlike more superficial methods, it acts on the deeper layers of the face, beneath the musculoaponeurotic system, where the muscles and adipose tissues responsible for facial volume are located.
This facelift precisely repositions sagging structures such as the cheekbones and jowls, restoring a more harmonious facial oval. The result is particularly natural, as it respects facial movements and expression. This technique is recommended for patients whose tissue relaxation is more advanced, with a marked loss of firmness and structure.
In addition to lifting the deep tissues, the deep plane lift stimulates the collagen production and improves local blood circulation. The result is better hydrated, more toned skin, and longer-lasting effects.
The SMAS facelift is designed for for men and women with moderate to severe sagging of the skin and deep tissues of the face and neck, often from the age of 40. Good general health is essential to limit the risks of surgery.
It is crucial to consult an experienced plastic surgeon to assess the quality of SMAS and define the best approach. Expectations must be realistic, taking into account the level of sagging and skin tone.
Preparing for a SMAS facelift is an essential step in ensuring a smooth operation and optimizing recovery. The surgeon will give you precise instructions, including:
This preparation phase is crucial to the safety of the operation and to achieving a harmonious final effect.
The procedure lasts approximately 2 to 3 hours, depending on the extent of the area treated. The operation is performed under general anaesthetic, to ensure patient comfort and safety throughout the procedure.
Techniques used :
The patient is usually discharged home the same day, or after an overnight stay in hospital.
The recovery period takes several weeks. This convalescence phase is essential to ensure optimal, long-lasting results. Bruising and swelling are common, but disappear gradually. Careful post-operative monitoring is essential.
After a SMAS facelift, the recovery process is gradual. Here's a week-by-week overview:
SMAS Lifting recovery process - Dr Djian
After the operation, the facial muscle re-education plays a key role in restoring optimal mobility and preventing stiffness. Gentle, progressive exercises help to soften tissues, boost blood circulation and maintain facial muscle tone. Depending on the case, your surgeon may refer you to a professional specialized in facial re-education for personalized support. This re-education work also helps prolong the effects of the SMAS facelift, preserving a harmonious, balanced appearance over time.
As with any surgery, SMAS facelift surgery carries risks, albeit rare ones: hematoma, infection, hypertrophic scarring or temporary asymmetry. Choosing an experienced surgeon and following the post-operative recommendations limits these complications. Careful follow-up and good communication with the practitioner enable any anomalies to be detected early.
Maintaining the benefits of the SMAS facelift depends on the condition of the SMAS and follow-up care after surgery. On average, the effects of a SMAS facelift last 10 to 15 years.
SMAS quality varies from one individual to another. Genetic factors, sun exposure, smoking and skin quality all influence how well it holds up over time. The surgeon assesses the structure during the consultation to adapt the technique.
Compared with other approaches, the SMAS facelift stands out for its long-lasting effect, thanks to its in-depth action on the muscular and aponeurotic layers. Dr. Djian insists on the importance of personalized follow-up to prolong the effects of the facelift and preserve facial harmony.
At Docteur Jérémy Djian, the price of a SMAS facelift starts at €10,000. The final price depends on the level of correction of the face and neck, as well as the care required after the operation. The overall cost includes:
To find out more, visit the page on face lift price list or contact Dr Djian's practice directly.
The expertise of a certified plastic surgeon is essential to guarantee a harmonious, natural face. Check diplomas, opinions, before-and-after photos and opt for personalized support. For tailor-made advice and highly specialized care, you can consult the Doctor Djian, a recognized expert in face lifting and SMAS techniques in Paris.
Technologies such as Rainwater, hyaluronic acid injections or botox injections in Paris, offer temporary solutions to improve facial appearance without surgery.
In addition to the SMAS facelift, other surgical techniques are also available. The mini-lifting corrects the first signs of sagging. The cervico-facial lift targets the neck and the oval of the face. Finally, the lifting deep plane enables deep repositioning of sagging musculoaponeurotic structures.
By directly targeting deep facial structures, the SMAS lifting offers a tailored response to the effects of time on skin and muscles. This surgical technique restores tension and definition to facial contours, while preserving the natural expression. Complemented by post-operative procedures and appropriate skin care, it delivers visible, long-lasting results, particularly on the ptosis, volume loss or neck sagging.
Each intervention is personalized according to the morphology and expectations of each individual. For precise, secure support, contact Dr Jérémy Djian. He will guide you through your facial rejuvenation project while preserving the harmony and balance of your face.
Recovery time after a SMAS facelift varies from person to person, but generally takes about 2 to 4 weeks to resume normal activities. The post-operative period includes swelling, bruising and sometimes slight pain, well controlled by appropriate care. The final result begins to be visible after 1 to 3 months.
Yes, it is common to combine the SMAS facelift with other procedures such as the hyaluronic acid injections, décolleté treatment, or even eyelid surgery (Blepharoplasty). This comprehensive approach treats all the signs of aging for a more harmonious, longer-lasting result.
The SMAS facelift is generally considered from age 40-50, This is when skin and muscle sagging becomes visible. However, this varies from person to person, depending on skin quality and the signs of aging. If you notice the following signs, you could be a candidate for a SMAS lift. :
Yes, the SMAS facelift stimulates collagen production thanks to the natural healing process after surgery. Although not its primary objective, the re-tensioning of deep tissues triggers cell regeneration that boosts collagen. This phenomenon improves skin quality, but remains secondary to the lifting effect.
Facelift for men takes into account anatomical specificities such as thicker skin, hair growth and more pronounced jaw lines. The aim is to correct sagging while preserving the structure and virility of the face. The technique can be adapted to achieve a result without a «lifted» effect.
Dr Jérémy Djian is a plastic surgeon based at 5 square Thiers, near the Victor Hugo roundabout, in the 16th arrondissement of Paris.
He trained in Paris and remains attached to the hospital in the prestigious department of Pr Laurent Lantieri.
