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The Extended SMAS Controls Submandibular Gland Ptosis
Jadyn Heffern1, Harvak Hajebian2, Tatjana Mortell1
1Tulane University School of Medicine, New Orleans, LA.
Annals of Plastic Surgery
|December 19, 2025
Summary
The extended SMAS facelift technique significantly improves submandibular gland ptosis (SMGP) and neck contour. This approach effectively rejuvenates the lower face and neck, potentially avoiding submandibular gland resection.
Area of Science:
- Plastic Surgery
- Facial Rejuvenation
- Aesthetic Surgery
Background:
- Submandibular gland ptosis (SMGP) is a challenge in conventional facelifts, sometimes necessitating gland resection.
- The extended SMAS technique offers lower facial and neck rejuvenation while preserving the submandibular glands.
Purpose of the Study:
- To quantify the effectiveness of the extended SMAS technique in correcting SMGP.
- To evaluate the impact of this technique on cervicomental angle (CMA).
Main Methods:
- Retrospective cohort study of 53 patients undergoing extended SMAS facelift.
- Photographic analysis to measure SMGP and CMA changes over a mean follow-up of 8.4 months.
Main Results:
- Mean SMGP decreased from 8.9 mm to 0.1 mm (8.01 mm improvement, P < 0.001).
- Mean CMA improved by 30.8° (from 152° to 121°, P < 0.001).
- High patient satisfaction with minimal revisions (3.8% dissatisfied, 5.7% revisions).
Conclusions:
- The extended SMAS technique effectively controls SMGP and enhances neck angularity.
- Thorough ligament release and flap mobilization contribute to improved digastric triangle support.
- This technique may obviate the need for submandibular gland resection in facial rejuvenation procedures.
