It's All in the Muscle

It's All in the Muscle

It's All in the Muscle

Did you know that one of the biggest secrets in facelifting was published in Archives of Facial Plastic Surgery? The revolution of facelifting has always been about the anatomy of the face, plain and simple. First surgeons tried lifting the skin. Pulling skin resulted in patients looking the same but with big scars from skin being placed under tension.

Then, a layer in the face was discovered in 1972 called the SMAS by Thomas Skoog. SMAS stands for supra muscular aponeurosis system, which is the fascia or fibrous layer on the face. Skoog found that if he pulled the SMAS fascia tight enough, faces and necks were improved, and the tension of this pulling was placed on the fascia layer, rather than on the skin of the face. This discovery was not fully embraced until the mid to late 1980's and today. While this represented a major advance in facelifting at the time of its discovery, many patients still had mixed results. The SMAS facelift could led to a windswept look in the face and often times pulled look. The SMAS facelift is still the most popular facelift technique in the world, with more than 90% of surgeons using this technique. While the SMAS technique has many benefits, patients can still look pulled and unnatural.

So what is the newest and latest technique that all facial plastic surgeons will be using 20 years from now? Several months ago, 2 facelift surgeons, Dr. Anil Shah of Chicago and Dr. David Rosenberg of New York, published a paper discussing the role of a muscle called the platysma in the face. This muscle, previously thought to only be a neck muscle, was found to have a major contribution to the face. Similar to 1972, few people have embraced or highlighted this article. Pay attention, this technique may become the revolution to facelifting for the next 20 years.

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