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When it comes to facelifts, not all techniques are the same. Some facelifts lead to pulled looks, while others look remarkably natural. What makes one facelift better than another? What is the difference between the techniques? Could it all be in the muscle? The most common techniques, discovered by Thomas Skoog in 1972 is the SMAS technique. SMAS is short for supra muscular aponeurosis system, which is the fascia or fibrous layer on the face. His technique was to pull the muscle tight, lifting the fascia rather than the skin. This was indeed an improvement from the facelifts before, which pulled the skin itself, but it still did not create optimal results. The look tended to be artificial and pulled, and in addition, the results tended not to last. A recent study published in the Archives of Facial Plastic Surgery has taken a look at the platysma muscle and found that this muscle, previously thought to be a only a neck muscle, actually has a significant facial contribution. Why is this important? By going under this muscle, both the face and neck can be rejuvenated creating a younger looking face without that artificial pulled or "windtunnel" look. Dr. Anil Shah, a facial plastic surgeon in Chicago who helped discover this muscle, claims that this muscle can not only create a more youthful look, but it will allow for less downtime for the patient after surgery. "Underneath the muscle is an embryonic glide plane. This means that there are no blood vessel and it is a natural separation. By sliding this muscle back, the face, neck and jawline can look dramatically younger with minimal impact on swelling." This technique requires exquisite knowledge of facial anatomy. Critical structures such as nerves lie millimeters away, so this technique should not be attempted by an inexperienced surgeon.
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