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  • It is currently Sat May 25, 2013 10:03 pm

SMAS or Deep Plane.?

This section of the forum is dedicated to discussions on various surgical techniques for facial rejuvenation, including fat transfer/fat grafting, browlift, blepharoplasty (cosmetic eyelid surgery), facelift, etc. Also, this category includes questions on hand rejuvenation via fat grafting. (Of note, Dr. Lam does not perform body rejuvenation except for hand fat grafting)
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SMAS or Deep Plane.?

Postby charlie » Sat May 03, 2008 12:18 pm

there seems to be some folks prefering SMAS and some Deep plane.......is it true that deep plane is more invasive ,but much longer lasting.?

although i believe that many doctors use 'parts' from several precedures ,to achieve a successful result.!
charlie
 
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MACS LIFT, SMAS LIFT, DEEP PLANE

Postby dr. lam » Sat May 03, 2008 3:55 pm

Deep plane in my opinion is truly unnecessary nowadays for several reasons:

1. deep plane/composite flaps are better for lifting the eyelid and cheek complex. i truly think that area is overlifted nowadays. i believe that the upper and midface should be addressed through volume not lifting. remember that taking your fingers and pulling up on your cheek is NOT equal to a facelift. that is a skin pull. so don't lift your cheek and go, "Oh, I need a deep plane lift."
2. deep plane procedures do carry a higher risk but in experienced hands not that much more. the nerves are exposed in front of you, which i personally do not want to see (and as in point 1 do not believe you have to see).

I also do not believe in a standard SMAS lift anymore. I think the results do not hold as well. I perform a modified MACS lift in which the SMAS is supported in a purse string vertically (a more natural vector than posteriorly) to the zygomatic bone lining so that it does not slip. I also do a redundant suture to hold tissues better. My new textbook, Aging Face: The New Paradigm will focus on this lift among other new ways of looking at aging.
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery
dr. lam
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