At Kensington Medical our GMC Specialist Registered facial plastic surgeons are experts in SMAS facelifts. Find out more about our consultations with one of our cosmetic surgeons to discuss your facial rejuvenation requirements.
The SMAS facelift is a popular surgical facelift. If you want a natural facelft with a shortere recovery time this may be the option for you. This type of facelift surgery is ideal for those seeking a longer-lasting youthful look of 10 to 15 years. The SMAS facelift is considered an advanced facial rejuvenation procedure compared to older facelift techniques. The SMAS facelift technique is a surgical procedure that tightens and lifts the middle and lower parts of your face.
SMAS stands for Superficial Musculo Aponeurotic System, which comprises muscles and fibrous tissue on the face that becomes loose when we age. It can treat the sagging loose skin around the cheek area, jowls and sad mouth look. It can also treat the upper neck if there is mild skin laxity.
At Kensington Medical our plastic surgeons are highly trained in performing SMAS facelifts. It is one of the popular options for the lower and mid face because a SMAS lifiting surgery has a lower downtime to more invasive options.
A SMAS facelift is a surgical procedure that targets the Superficial Musculo-Aponeurotic System (SMAS) (superficial musculoaponeurotic system), a layer of tissue that connects the facial muscles to the skin. A SMAS facelift targets the superficial muscular aponeurotic system to lift and tighten the face. The SMAS plays a crucial role in facial expression and is responsible for the sagging loose skin and loss of facial contours that occur with ageing. Above the SMAS lies the superficial fascia, a distinct anatomical layer that separates the skin and subcutaneous tissue from deeper structures. By lifting and tightening the SMAS layer, the procedure targets the underlying tissue beneath the skin creating a more natural result. In some cases, the SMAS facelift may involve working with deeper layers of facial tissue. This surgical procedure not only addresses sagging skin but also enhances the overall facial structure, providing a more defined mid and lower face and refreshed look.
The ageing signs that a SMAS can target include:
The lower half of your chin area (jowls)
Sad mouth lines or marionette lines at the sides of the mouth or nasolabial
Nasolabial folds, which are prominent lines running from the nose to the corners of the mouth
A drooping neck or turkey neck or skin laxity in the neck.
SMAS facelift patients want to look refreshed without the long downtime. Our patients achieve this in a short period of time with a recovery of around 2 weeks. Many of our patients go back to work after 1 to 2 weeks.
A natural-looking facelift result with minimal scarring
A SMAS facelift results last 10 to 15 years
It lifts the cheek area, Restoring volume to the cheek, reduced deep nasolabial folds, a full mid face, tighter neck area and defined jawline
The scars are hidden in the hairline and behind the ear
The recovery is faster than a full facelift and neck lift
Many consider the SMAS lift to be the best treatment for jowls
By lifting and tightening the SMAS layer, the procedure restores a more youthful and rejuvenated appearance to the face and neck
SMAS lifting helps restore a youthful facial contour by repositioning the underlying structures
The procedure can also help restore facial volume that is lost due to ageing, especially in the midface area
Repositioning the soft tissues of the face is key to achieving a natural, rejuvenated look
Studies show that more than 85% of patients are satisfied with the outcomes of their SMAS facelift procedure
At Kensington Medical our patients generally come because they have many signs of ageing and want to look refreshed and naturally younger. We have patients who see us because their non surgical dermal fillers or non surgical treatments are no longer working. They feel they are spending a lot of money to maintain something that does not give them the natural look they want.
We see individuals in their 40s, 50s and 60s. However, a SMAS can also be offered to someone in their 70’s provided they do not have moderate skin laxity.
Younger patients in their 30s and early 40s may benefit from less invasive techniques, while older patients typically do require more extensive procedures.
Having a face to face consultation with our experienced plastic surgeon should help answer any questions and concerns you have. They will look at skin
Selecting the right facelift procedure is an important step in achieving your desired outcome.
During your consultation your plastic surgeon will discuss all of the options, the time lines you may have along with showing you many of their SMAS face lifting before and after photos.
Our plastic surgeons will discuss their SMAS facelift results and highlight the areas that can benefit you.
In some instances our surgeons may recommend another type of facelift. If you have more extensive skin laxity, a deep plane facelift or a high SMAS facelift may be recommended.
A Deep Plane Facelift is an advanced facial plastic surgery procedure on natural-looking results for patients experiencing significant facial ageing. Unlike traditional facelift techniques that primarily address the superficial layers, the deep plane facelift targets the deeper facial tissues, including the superficial musculoaponeurotic system (SMAS) and underlying facial muscles. This surgical technique effectively lifts and supports the entire midface, lower face, and even the neck, providing dramatic improvements in facial definition and contour.
If you are unsure what is best for you seeing our plastic surgeon in a face to face consultation is the best option. They can examine your face and listen to what you want achieve.
To find out about the differences between a SMAS lift and Deep plane facelift see our information here.
At your consultation, your plastic surgeon will assess your facial anatomy, looking at skin laxity, facial volume loss, and the presence of deep wrinkles or nasolabial folds. Its at this stage your plastic surgeon will discuss the best facelift techniques to achieve what you are looking for and best one for your facial structure .
During your consultation you will be shown examples of SMAS facelift before and afters. The before and afters will give you an idea of what you can achieve and the real impact this procedure can achieve.
If you have mentioned that you would like to combine other facial cosmetic procedures it is at this stage your surgeon will help you decide about this. Other facial procedures, such as eyelid surgery, neck lift or fat grafting for fat loss, to achieve a more harmonious and comprehensive facial rejuvenation.
At your preoperative assessment you will be advised to make certain lifestyle adjustments. At Kensington Medical our surgeons will advise to stop smoking in advance of surgery, as smoking can affect circulation and increase the risk of delayed wound healing. You may also be asked to avoid specific medications and supplements that could increase bleeding or interfere with recovery such as anticoagulants, antiplatelets, and nonsteroidal anti-inflammatory drugs (NSAIDs). The thorough medical evaluation ensures you are in good health and ready for your SMAS lifting procedure.
The SMAS facelift procedure typically involves the following steps:
At Kensington Medical, we always start with a pre-operative medical assessment one week before the procedure. During which we will:
Preparation: The patient is prepared for surgery, which may include a general anaesthetic. The patient will be marked up along the incision sites. Before photos will be taken. You will also have a discussion with the anaesthetist about your general health. Although this will have taken place previously in your preoperative medical assessment.
Incision: The surgeon makes incisions in the hairline, just above the ears, and extends them downward along the natural creases along the edge of the ear. These scars are very discreet and with time they will fade.
SMAS Lift: The surgeon lifts and tightens the SMAS layer, repositioning it to a more youthful and elevated position.
Excess Skin Removal: Excess skin is removed, and the remaining skin is re-draped over the newly positioned SMAS layer.
Closure: The incisions are closed, and the patient is taken to the recovery room.
SMAS Facelift recovery takes 2 to 3 weeks. We find that most patients are able to go back to work in an office at the start of week 3. We have many patients who do work from home at the start of week 2. The general recovery will involve the following:
Swelling, bruising and numbness can last 6 weeks. They can be managed with pain medication and cold compresses and sleeping with two or three pillows to keep your head elevated.
A face band is worn for the first week. Making arrangements to relax is important.
Looking after your scars are crucial: Scarring can be minimised with proper wound care such as using the Keto silicon scar cream day and night for the first 6 weeks, keeping out of the direct sun by using SPF block out and a hat. Keeping your follow-up appointments are important to ensure the wound is healing correctly.
Avoid strenuous activities and exercise such as contact sport, heavy weights, ball sports.
Avoid smoking
Final results can take up to 12 months.
As with any surgical procedure, facelift surgery carries certain risks that patients should be aware of before proceeding. Common side effects include bruising, swelling, numbness, and mild discomfort, which last a few weeks. A potential complication is a hematoma, which usually requires prompt drainage. In very rare cases there is a risk of nerve injury that could result in temporary or, in very rare cases, permanent facial asymmetry or muscle weakness. Additionally, your overall health, skin quality, and the degree of facial ageing will play a role in determining your suitability for a facelift procedure. Open communication with your surgeon about your medical history and expectations will help ensure a safe and satisfying experience.
At Kensington Medical our team of plastic surgeons take great care to advise on the best facelft suited to your face, structure, skin laxity and muscle tone. Find out what facelft is best for you.
A SMAS facelift if well looked after, should last up to 10 to 15 years. Of course we can't delay natural ageing. This means following the following lifestyle choices:
· Keeping a healthy lifestyle, eating well avoiding too much alcohol.
· Regular exercise to ensure circulation.
· Avoiding the direct sunlight, using high SPF sunblock and wearing a hat.
· Having enough sleep.
· Looking after your skin ensuring you use the right moisturisers and actives.
· Drinking plenty of water and avoiding too much sugar.
Your plastic surgeon will provide detailed post-operative instructions, including how to care for your incisions, manage discomfort, and reduce swelling.
Knowing the potential risks and complications, such as facial nerve injury or delayed wound healing goes a long way to recovery. Attending your follow-up appointments with your plastic surgeon is an opportunity to cover off any concerns you may have.
A SMAS facelift is often combined with other procedures associated with ageing such as an upper eyelid lift (upper blepharoplasty) or an eye bag removal (lower blepharoplasty). A brow lift can also be considered to elevate the eyebrows, smooth the forehead, and achieve facial harmony.
SMAS facelifts are often carried out with upper or lower eyelid surgery (blepharoplasty) and other facial cosmetic procedures to achieve a more comprehensive rejuvenation.
A blepharoplasty removes excess fat and tightens the skin in the areas around the upper eyelids, the lower eyelids or eye bags, or both. This is a popular combination and we do many procedures with both the facelift and eyes.
A SMAS facelift can help the neck. However if the neck has a lot of skin laxity , or neck bands our plastic surgeon might suggest a neck lift. Sometimes the neck can age sooner than the face. To obtain a natural look so the face and neck both look natural, our plastic surgeon may suggest a SMAS facelift with a neck lift.
Patients often have skin laxity around the mouth as well as the cheek, mid face and jowls. This lip area of ageing may result in a slightly drooping upper lip which can give an ageing effect on the face. A lip lift with the SMAS facelift can address this surgically.
A SMAS facelift targets the superficial muscular aponeurotic system to lift and tighten the face, and combining it with fat transfer can help restore volume and create a more youthful look. A liposuction procedure will take the fat from other parts of your body, for example the stomach or thigh area.
Fat transfer into areas such as the cheeks or under-eye area adds volume, creating more youthful contours. It increases fullness in the cheek area, nasolabial lines or marionette lines, and the areas around the eyes.
The advantages of fat transfer over dermal fillers include:
There is no rejection issue because the fat comes from the patient
Between 50% and 70% of the amounts injected stay in place permanently
A SMAS facelift tightens the muscle and skin of the face. It will not however help with skin texture. If this is a concern our plastic surgeon can discuss combining a laser treatment with SMAS for smoother skin after surgery. Lasers can increase collagen production, reduce sunspots, or brown spots, resurface the skin to make scars less visible.
In some instances a smash facelift does not help with the brow and outer brow area. A lateral brow lift can help to rejuvenate and open up the eye area.
If you have had a prior facelift and are looking for advice on whether a SMAS surgery or an extended SMAs may help please follwing this link to read about Revision facelift surgery.
We offer specialist facial rejuvenation treatments in the heart of London. Our team of expert plastic surgeons is dedicated to providing you with a comprehensive and personalised experience. With our expertise in facial cosmetic surgery, we can help you fight back the years and delicately recover your facial freshness and youthful appearance.
Consultation
Your journey begins with a dialogue between you and your surgeon: the pre-operative consultation, which is central to the operation's success. At Kensington Medical, patients interested in surgery undergo several consultations with the surgeon. We are keen for our patients to be fully informed before deciding whether to proceed with surgery. So, we encourage them to see the surgeon more than once and ask as many questions as they wish. Typically, our patients go through two pre-operative consultations.
The first consultation tends to be face-to-face. During it, the surgeon will:
Following the first consultation, we will:
A second consultation is often necessary for the following reasons:
The second consultation can also be face-to-face. Alternatively, it can be via a video call.
Following your consultations, our medical team is always available should you have further questions before your surgery.
Pre-Operative Care
Once you have decided to go ahead with surgery, we will book your operation in one of our specialist cosmetic surgery hospitals.
Before your operation, you will be sent a health questionnaire. This will be reviewed by your anaesthetist, who may call you to discuss specific aspects of your medical history. In certain cases, you may be required to attend the clinic for blood tests. This will be discussed with you by one of our medical team members before your scheduled appointment date.
We will also issue you with preoperative instructions. In particular:
On The Day Of The Procedure
You will arrive at least one hour before the time of your procedure. The nursing staff at the hospital will monitor your blood pressure and other relevant essentials. You will then meet your anaesthetist and surgeon for a final markup.
The actual operation involves carefully sculpting and repositioning underlying tissue and fat within the face to create a more youthful contour around the eyes, chin, neckline, and jawline area. The result is smoother skin texture while preserving natural facial expressions throughout different movements. The incisions are then closed using sutures. This will leave small scars hidden along areas such as the hairline or scalp, which can fade over time depending on how well they are cared for.
We typically perform this procedure under general anaesthesia. It lasts 2.5h to 3.5h.
Post-Operative Care
Aftercare following a facelift is essential to ensure we achieve optimal results.
Following your surgery, you will be transferred to the hospital’s recovery room, where the nursing staff will ensure that your recovery is smooth. You should stay there for two to four hours, depending on the surgery. Once the nursing team are happy that you are in a fit state to go home, you will leave the hospital accompanied by a friend or a family member. You should also arrange for someone to stay with you overnight for the first night following your operation. Generally, post-operative pain is minimal, but you will be given pain killers in case you need them.
Once you have been discharged from the hospital, our nursing team will be available 24/7 to ensure your post-operative journey is comfortable and pain-free and to field any questions you may have.
Your surgeon will see you a number of times in the weeks following your operation to monitor the facial skin and scars and to support you:
Bruising and swelling can last up to one month following this surgery.
Post-Operative Instructions
Our medical team will provide detailed aftercare instructions based on your current health status and treatment received, including when it is appropriate for you to resume normal activities such as exercise, wearing makeup, and strenuous movements. It is essential to follow these instructions carefully to avoid complications or risks associated with the procedure.
Protecting your face from sun exposure is especially important, as it can cause scarring, discolouration, and other unwanted side effects. Wear sunscreen when outdoors and use hats or umbrellas if possible. It would be best to avoid strenuous activities involving facial movements, such as exercise and sports, until cleared by our medical team at Kensington Medical.
By following the instructions of our medical team and taking precautions to protect your face, you can ensure that you achieve the best results from facelift surgery. Following a healthy lifestyle with sufficient rest, nutrition, and hydration is essential for healing and maintaining long-term effects. It is strongly recommended to avoid smoking and alcohol consumption before and during the recovery period.
Mr David Gateley
Mr Amir Sadri
Mr Paul Tulley
What are the risks associated with a SMAS facelift?
The SMAS facelift, like any surgical procedure, does have risks. During your consultation, your cosmetic surgeon will discuss them with you along with any concerns you may have.
The most common potential complication of a facelift is hematoma, which usually requires prompt drainage.
Common side effects of a SMAS facelift include bruising, swelling, numbness, and discomfort, which usually resolve within a few weeks.
The general complications associated with any operation include:
The rare complications of a SMAS facelift include
What is the recovery time from a SMAS facelift?
You can go home on the day of a SMAS facelift. The recovery time follwing a SMAS facelift is around two to three weeks, after which time you can return to normal activities. We advise that you can start exercising after the healing is complete.
What scarring can be expected from a SMAS facelift?
Scars from a SMAS facelift are permanent, but the surgical procedure hides them within the hairline and in the normal creases of the skin. They will fade with time.
How soon will I see results / are they permanent?
As with most surgery, there will be some post-operative swelling, which will subside after about three weeks to one month. Results should be visible then and will look best from 6 months onward. The ageing process continues even with surgery. However, facelift results tend to be long-lasting.
How much does a SMAS facelift cost?
t Kensington Medical, an advanced SMAS facelift costs from £10,500. The best option is to get in touch and book a face to face consultation with our expert SMAS face lift surgeons.
They will advise on what facelift is right for you and will give you full details on the SMAS lifting price. They will discuss face lift timelines, recovery times and they will show you before and after photos. You will leave having a thorough understanding of what’s involved and how long it will take to looking as good as you feel.
The cost of a facelift procedure can vary based on several factors, including the complexity of the surgery, the surgeon’s expertise, anaesthetist and hospital fees which may or may not include an overnight stay in hospital, and any additional facial rejuvenation procedures you may choose to combine. After your consultation, you will receive a detailed quotation outlining all associated costs, including pre-operative and post-operative care.
For more details on facelift costs see our comprehensive page.
How should I prepare for this treatment?
Your plastic surgeon will give you specific advice on how to prepare for your treatment. This will be based on your pre-operative medical at Kensington Medical. It may include:
All the information will be provided and a 24 hour helpline is available. Your pre and post operative appointments will ensure you feel confident with the exciting journey ahead.
When will I see before and after images of a SMAS facelift?
During your consultation, your surgeon will share before and after images of previous surgeries that they have performed so that you can see the types of results you should expect.
At Kensington Medical, the journey to a fresher you can start today. The starting point of this journey is a consultation with your facelift surgeon. They will discuss the areas on your face that you are considering for cosmetic surgery. You may have another consultation to decide if there are any other procedures you may want such as an eyelift.
During the face-to-face consultation, your plastic surgeon will discuss facial structure, skin and muscle laxity. Photos of you when you were younger are helpful and we encourage you to bring them to the consultation. You will see our facelift SMAS before and after pictures so that we can create a plan for achieving your goals.
If you decide to have further procedures done at once, this plan will combine all aspects into one personalised program.
To find out if you are suitable book a consultation in our Harley street, London or Wimbledon clinic. Deciding to talk to an experienced plastic surgeon is the exciting first step to feeling and looking your best.
Our experts monitor facial plastic surgery and facial treatments information and update it when it is available.
This page was medically reviewed by Mr David Gateley MA, FRCS, FRCS (Plast), GMC number 2939470 on 05 May 2026.
Author: Louise Braham
