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** What’s SMAS Lifting?
Typically SMAS Lifting refers to a technique that removes wrinkles by pulling the tissues called Superficial Muscular Aponeurotic System (SMAS) under the skin of the face. By comparing to the lifting that elevates (pulls) only skin tissues, it can obtain the fundamental lifting effect.
SMAS Lifting is classified into more detail depending on the incision site. In here, we will discuss the SMAS lifting procedure performed at Cheongdam Beautyline clinic that elevates mid face region in conjunction with lower eyelid surgery without a separate incision.
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** Limits of the general lower eyelid surgery and fat relocation surgery
The lower eyelid surgery and fat relocation surgery that we typically speak of refer to a surgery that cuts and pastes after making an incision to the under eye skin. If necessary, the under eye fat is removed or only the under eye lipectomy is performed by removing the fat through an under eye incision.
1. In order to get a more firm look of the under eye if the skin of the lower eyelid is cut a little more, the under eye can be flipped and even though it is not identifiable with the naked eye, due to the effect of pulling down the skin, it can reduce the tears and eyes can be tired and dried.
2. There is not much effect if the skin of lower eyelid is cut too little.
3. If the fat is removed a little bit too much, under eye could be caved in.
4. The effect is only around the eyes and recurrence often occurs over time.
5. If the lipectomy is performed only, it has no effect on people who has reduced skin elasticity due to aging.
6. If surgery is not properly performed, the structure of the orbital septum becomes weaker and wrinkles reoccur so wrinkles in the eye may get worse in the future.
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** The structure of mid face
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A cross-sectional view of the facial skin
The visible part is SMAS tissue. SMAS is the abbreviation of Superficial Muscular Aponeurotic System. The SMAS layer can be a solid film situated in the most superficial part of the muscle and it plays a great role in making a person’s look and this layer is the main target of surgical face lift. To pull this SMAS layer effectively, professional anatomical knowledge and techniques are required.
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Anatomy of Lower Eyelid
With aging the orbital septum is weaker and the orbital fat will be gradually pushed down. Therefore, under eye wrinkles increase.
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| ** SMAS lifting surgery scenes |
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Surgery scene 1
This scene is showing that after incision of the immediate lower part of eye, the several tissues of under eye were pulled delicately and then is firmly attached to the periosteum of the bone below the eye. At this time, SMAS tissue is pulled and attached together. This pulls and lifts the area of under eye as well as the mid face region below.
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Surgery Scene 2
In this scene, the surgery is completed by cutting the drooping excess skin and suturing meticulously. The orbital septum is pulled and orbital fat that was sticking out is back to its original position and thus under eye wrinkles will disappear and the skin will be firm.
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** Case study
The case study of elderly patient
In this case, the patient is 62-year-old woman. She is showing adjusted ptosis of lower eyelid and mid face region at the same time. It is only 2 weeks after surgery so you can see the overall swelling.
Persistence of Effect
In this case, the surgery was performed when the patient was at the age of 40 (Left) and the photo was taken when she was 48 years old (Right). If this patient underwent lower eyelid surgery or fat relocation surgery, recurrent may have been occur or aging around the eyes may have been progressing caused by thinning skin, but since the muscle area that went down by gravity was pulled up to the extent of not changing the eyes and was fixed firmly to periost, the aging did not progress much even after 8 years and she looks rather younger than 8 years ago.
Overall elevation of mid face region
This photo shows 1 week after surgery. SMAS lifting aims at a fundamental lifting effect rather than temporary wrinkle removal.
Surgery Case
This photo shows 2 week after surgery. The lower eyelid and mid face region were lifted. Hollow eyes that are often difficult to remove with other surgery are removed in this case.
Side view
This view is taken 2 week after surgery. You can see that orbital fat has disappeared and the face is pulled tightly. SMAS lifting can be a highly successful method to pull and lift the under eye and mid face region basically.
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