Extended sub-SMAS dissection and cheek elevation

The extended SMAS facelift techniques gave plastic surgeons the ability to correct the nasolabial fold and medial cheek. Retensioning the SMAS transmits the benefit through the multilinked fibrous support system of the facial soft tissues. The effect is to provide a recontouring of the ptotic soft tissues, which fills out the cheeks as it reduces nasolabial fullness. Indirectly, dermal tightening occurs to a lesser but more natural degree than with traditional facelift surgery. Although details of current techniques may be superseded, the emerging surgical principles are becoming more clearly defined. This article presents these principles and describes the author's current surgical technique.