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High SMAS Facelift from Hessler Plastic Surgery

As a double board-certified facial plastic surgeon, Dr. Jill Hessler performs exceptional high SMAS facelift procedures that achieve beautifully natural-looking results. 

What is a high SMAS facelift?

SMAS stands for “superficial muscular aponeurotic system”, which refers to the fibrous network that connects the facial muscles with the subcutaneous fat layers of the face to the outermost layer of the skin. This network allows the layers of skin to move together as one unit. As we age, the elasticity in the SMAS layer begins to decrease, causing the cheeks to sag and the jowl area to appear more aged. A high SMAS facelift elevates the SMAS tissues at a very high level and re-distributes the fatty tissues of the face to achieve a more youthful appearance.

What can a high SMAS facelift do?

  • Remove the jowls
  • Soften nasolabial folds
  • Provide volume to the cheeks
  • Tighten the neck

What’s the difference between a high SMAS facelift and a traditional facelift?

A traditional facelift only corrects the lower third of the face and the superficial loose skin, whereas a high SMAS facelift lifts the tissue from a deeper level, creating a more natural and rejuvenated appearance.  A traditional facelift can pull the skin and mouth backward, creating an unnatural flattening of the contours of the face.  A high SMAS facelift resuspends the soft tissues in a more vertical direction while restoring volume to the cheeks.

Procedure Details

A high SMAS facelift is performed under IV sedation and takes a few hours depending upon whether other procedures are performed simultaneously. Dr. Hessler will make an incision around the ear and into the hairline and carefully dissect the SMAS and facial musculature.  The SMAS provides a strong and sturdy level of support to the facial muscles.  

Once this is dissected, the restraining ligaments are carefully released to allow unparalleled elevation and rejuvenation compared with traditional facelifting techniques.  The neck muscles will also be tightened and lifted to create a youthful contour to the neckline.   If there is any excess fat in the neck, this can be sculpted and then the redundant skin is removed.


Following surgery, a gentle compression dressing will be placed to wear overnight.  You will be seen the next morning, where your dressings will be removed and incisions cleaned and the bandage replaced for you by the outstanding clinical team at Hessler Plastic Surgery. As with all facelift procedures, you will experience some swelling and numbness around the incisions.  Mild discomfort is common and is generally relieved with over-the-counter Tylenol for most patients, but stronger pain medicines can also be prescribed to help with sleep or pain control for the first few days.  Patients can eat and drink the day of surgery after arriving home and are able to be up walking around the same day.  After 4 days, our high SMAS facelift patients can shower and shampoo their hair.  You will return to the office one week after your surgery to have sutures removed.  The majority of the swelling will resolve after two weeks.  Once two weeks have gone by, you should be able to return to work and moderate exercise, resuming full exercise at one month. 

Hessler Plastic Surgery for high SMAS facelift surgery

Dr. Hessler Jill is known for delivering facial enhancement results that look natural and bring out her patients’ existing beauty. The high SMAS facelift, along with the deep plane facelift, is one of her top procedures, and is also one of her areas of specialized focus. Dr. Hessler is an award-winning, double board-certified facial plastic surgeon with over a decade in practice, and she currently holds a position as Chair of the Women on the Facial Plastic Surgery committee at the American Academy of Facial Plastic and Reconstructive Surgery. Under her guidance at Hessler Plastic Surgery, you will experience a team of highly trained registered nurses and staff who make it their goal to take excellent care of you, from your first consultation to your last follow-up. To learn more about the high SMAS facelift or schedule a consultation, please contact us.

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