Aging affects every part of our face, from drooping cheeks and deepening smile lines to the formation of jowls and a sagging neckline. While many people assume facelifts are outdated procedures that create unnatural results, modern techniques like the High SMAS facelift have revolutionized facial rejuvenation surgery.
At Wave Plastic Surgery, our expert surgeons, including internationally renowned Dr. Peter Lee and Dr. Ben Lee, use advanced methods to restore a natural, youthful appearance that can last over a decade.
What Is a High SMAS Facelift?
The High SMAS facelift at Wave Plastic Surgery represents a significant advancement over traditional skin-only facelifts. SMAS stands for Superficial Musculoaponeurotic System—the underlying muscle layer that provides structural support to your face. Rather than simply pulling and tightening skin, this technique focuses on repositioning and lifting the SMAS muscle itself.
“Rarely are there any surgeons pulling just on the skin because pulling on the skin always leads to less results and quicker sagginess,” explains Dr. Peter Lee, founder of Wave Plastic Surgery. “What we are trying to do is we’re trying to use the muscle as a carrier for the skin.”
This muscle-focused approach delivers three critical advantages:
- Natural-looking results that don’t appear “over-pulled”
- More definitive improvement in facial contours
- Exceptional longevity—results that can last 10+ years
The key difference lies in muscle release and repositioning. By carefully dissecting and freeing the SMAS muscle before lifting, surgeons can achieve more dramatic results without the tension and resistance that leads to premature sagging.
How a High SMAS Facelift Improves Aging Signs
As we age, several predictable changes occur that create an older appearance. The High SMAS facelift addresses each of these concerns systematically:
- Drooping Cheeks: Fat around the cheek area descends, creating deeper smile lines and nasolabial grooves. The facelift repositions this tissue upward, restoring midface volume and smoothing these lines.
- Jowls and Heavy Jawline: The formation of jowls obscures the clean jawline that epitomizes youthfulness. The High SMAS technique specifically targets this area, creating what Dr. Lee calls “that clean jawline because that epitomizes the youthful appearance.”
- Sagging Neck and Double Chin: The platysma muscle in the neck is lifted and tightened, restoring the sharp angle between the chin and neck. “The cleaner the neckline is, the better everyone looks. It doesn’t look unnatural,” notes Dr. Lee.
- Marionette Lines: These lines from the corners of the mouth downward are softened as the muscle repositioning naturally lifts the corners of the mouth slightly.
The strategic direction of pull—straight up for the face and straight back for the neck—ensures natural-looking results that enhance rather than alter your fundamental appearance.
What Makes the High SMAS Technique Different?
The High SMAS approach differs fundamentally from older facelift methods and even some contemporary techniques. The critical difference lies in extensive muscle release before lifting.
“If we try to just pull on the muscle without releasing it, what ends up happening is that number one, it’s going to look unnatural because it’s been forcibly pulled,” explains Dr. Lee. “And because there’s resistance, there’s not gonna be as much result. And because there’s less resist, there’s more resistance, the result won’t last as long and things will fall down quicker.”
Unlike a deep plane facelift, which involves more extensive dissection in deeper tissue layers, the High SMAS technique focuses specifically on the SMAS layer while maintaining safer surgical planes. This approach provides excellent results with reduced risk and recovery time.
Many patients also benefit from combining the High SMAS facelift with fat grafting to address volume loss that occurs with aging. “For a lot of patients, it’s not just the sagginess that happens as we get older. We also lose fat around our face,” notes Dr. Lee. This can be performed simultaneously or in two stages, depending on the extent of volume loss.
Who Is a Good Candidate?
Age is not the primary determining factor for High SMAS facelift candidacy. “It’s not the age that’s important with the face and neck lift. It’s really the condition and the type of result that the patient is looking for,” emphasizes Dr. Lee, who has performed the procedure on patients ranging from their mid-20s to mid-90s.
Ideal candidates typically include:
- Patients with Diminishing Non-Surgical Results: Those who have tried injectables, threads, or energy-based treatments but notice decreasing effectiveness over time.
- Individuals with Moderate to Severe Facial Sagging: People with pronounced jowls, deep nasolabial folds, or significant neck laxity who want comprehensive improvement.
- Those Seeking Long-Term Results: Patients who prefer a single procedure with decade-long results rather than ongoing maintenance treatments.
- Healthy Adults at Any Age: The procedure is more about facial anatomy and desired outcomes than chronological age.
The best results occur in patients who maintain realistic expectations and understand that the goal is restoration to a more youthful version of themselves, not dramatic facial alteration. For more detailed information about candidacy and techniques, visit our comprehensive facelift surgery page or explore our complete facelift and neck lift guide.
Facelift Recovery Timeline
Understanding the recovery process helps patients plan appropriately and set realistic expectations for their High SMAS facelift journey.
- Surgery Duration: The procedure typically takes 2.5 to 3 hours and can be performed under IV sedation or general anesthesia, depending on patient and anesthesiologist preference.
- Immediate Post-Operative Period: Small drains are placed to prevent fluid accumulation and are typically removed after two days. Patients can shower and wash their hair after 48 hours.
- Three-Week Milestone: “For most patients, it does require about three weeks for about eighty percent of the swelling to go down,” explains Dr. Lee. At this point, with makeup, most evidence of surgery is no longer apparent to casual observers. Research supports this timeline, with studies showing most facelift swelling resolves within 2-3 weeks post-operatively.
- Complete Healing: Full results are visible at six months when all swelling has resolved and scars have matured to their final appearance.
- Return to Activities: While individual healing varies, most patients can gradually resume normal activities within the first month, with full activity clearance typically given by six weeks.
The recovery experience is generally well-tolerated. “There’s really no pain associated with the surgery afterwards, but there is swelling. And at least for the first one or two months, there will be numbness to the skin around the face.”
Get Your Consultation Today
Give us a call today to schedule your consultation with one of our plastic surgeons at Wave Plastic Surgery.
Safety and Risks
The High SMAS facelift has an excellent safety profile when performed by experienced surgeons who understand facial anatomy and proper surgical planes.
- Bleeding Prevention: While not life-threatening, even minor bleeding can affect healing in the tight surgical space of a facelift. Small drains prevent fluid accumulation, and careful surgical technique minimizes bleeding risk.
- Nerve Protection: Facial nerves control movement and sensation. “The important thing about the nerves is that they lie deep. And as long as we’re in the right space and right plane, there is no chance that it will be injured,” assures Dr. Lee. Clinical studies confirm that when performed by experienced surgeons using proper surgical planes, SMAS techniques have low rates of permanent nerve injury.
- Wound Healing: Stitches are removed after two weeks, and proper post-operative care ensures optimal scar healing along the hairline and around the ears.
- Temporary Effects: Numbness and swelling are expected and temporary. These effects gradually resolve over the first few months following surgery.
A comprehensive pre-operative evaluation, including physical examination and cardiac and pulmonary testing when indicated, ensures patient safety and optimal outcomes.
Schedule Your Personalized Consultation
Wave Plastic Surgery’s world-renowned surgeons specialize in advanced facelift techniques, including the High SMAS facelift. Our expertise in facial anatomy, combined with state-of-the-art surgical methods, ensures natural-looking results that stand the test of time.
Dr. Peter Lee and our expert surgical team have performed thousands of successful facelifts, helping patients achieve their aesthetic goals with safety and precision. Our High SMAS Face and Neck Lift represents the pinnacle of modern facelift techniques. Schedule your consultation today at our Los Angeles, Orange County, or San Francisco locations to discover how a High SMAS facelift can restore your youthful confidence.
Ready to turn back the clock? Contact Wave Plastic Surgery to begin your transformation journey with California’s leading facial rejuvenation experts.
Frequently Asked Questions
High SMAS facelift results typically last 10-15 years, with some patients enjoying benefits for even longer. Dr. Lee explains that “these are the type of results that should last at least ten years” due to the comprehensive muscle repositioning technique. Unlike skin-only facelifts that may sag within 5-7 years, the High SMAS approach addresses deeper structural layers for enhanced longevity. Individual factors like skin quality, lifestyle habits, and age at surgery can influence duration.
The High SMAS technique involves more extensive muscle release and repositioning compared to standard SMAS procedures. While both approaches target the SMAS layer beneath the skin, the High SMAS method provides greater muscle mobility through more comprehensive ligament release. This results in more dramatic lifting capability, particularly for the midface and jowl areas, and typically longer-lasting results. The technique requires advanced surgical expertise but offers superior outcomes for appropriate candidates.
High SMAS facelift recovery follows a predictable timeline, with most patients feeling comfortable in public after 3 weeks. While the initial healing period involves expected swelling and bruising, many patients find the recovery manageable with proper care. Unlike some deeper plane techniques that may have extended swelling, the High SMAS approach balances comprehensive results with reasonable downtime. Most patients can return to work within 2-3 weeks and resume full activities by 6 weeks.
SMAS Facelift Before & After
Learn about the techniques that helped this 70-year-old woman look 20 years younger. In this video, Dr. Peter Lee of Wave Plastic Surgery breaks down the procedures that lead to this amazing full Face Transformation.
Quick Take Aways:
- The High SMAS facelift at Wave Plastic Surgery targets the underlying muscle layer, not just skin, delivering natural results that last 10+ years compared to skin-only lifts.
- Recovery follows a predictable timeline: 3 weeks for most swelling to resolve, 6 months for complete healing, with most patients comfortable in public after 3 weeks.
- The advanced technique used by the surgeons at Wave Plastic Surgery addresses comprehensive facial aging including jowls, sagging neck, and marionette lines while maintaining natural facial expressions.
- Wave Plastic Surgery's expert surgeons perform High SMAS facelifts across Los Angeles, Orange County, and San Francisco with proven safety and exceptional results.
