1. SMAS: SMAS is an acronym for the superficial musculoaponeurotic system. This is a thin, yet strong, layer of tissue that covers and connects the muscles of the face and neck together as a continuous sheet.
2. Platysma: Continuous with the SMAS, this is a thin but superficial muscle, located within the neck, that creates vertical muscle bands and is a component of the “turkey neck” as we age. This fibrous layer is concealed below a layer of fat (adipose tissue) and skin.
3. There are multiple ligaments that additionally help to suspend the skin in the face, to include the Zygomatico-osseocutaneous ligament, Masseteric Ligaments, Cervical Retaining Ligaments, Mandibular Osseo-cutaneous ligament
The SMAS and its associasted ligmaments are the most important tissue in facial aging. This is the tissue that droops and becomes lax with time. As a result, it MUST be addressed during any type of face and neck lift procedure —(Dr. Lefkowitz strongly believes in the “Deep Plane Face/Neck Lift”).
To most effectively lift the face, Dr. Lefkowitz will release the above four major ligaments that are known to tether the SMAS and significantly contribute to the aged appearance. This is considered a true Deep Plane Facelift.
Does my Doctor do a Deep Plane Facelift?
A Deep Plane Facelift is a very specialized version of a facelift that has been shown to provide superior results. Just “entering” or “getting into the Deep Plane” DOES NOT mean your doctor does a deep plane facelift. The key to performing a Deep Plane Facelift is releasing the 4 major ligaments that tether the SMAS layer as this layer contributes most to the aging process. After release of these ligaments, Dr. Lefkowitz is able to more effectively reposition and lift the sagging tissue and muscles to produce a more natural yet effective result. Additionally, this removes all tension on the incision, which will lead to decreased appearance of scarring with more natural contours.
When facelifts are performed by other surgeons that do not release these ligaments, patients often notice more tightness of their face towards their ears but the sagging of their cheeks often remains which can then create an “operated on” appearance.
