SMAS facelift is the most common type of facelift performed today. It is a very effective way to achieve long-lasting facial rejuvenation while maintaining a natural and un-operated appearance. Reducing the jowls, tightening up the neck, and lifting the cheeks are just a few of the beneficial effects of this type of facelift. Dr. Konstantin is considered one of the best facelift surgeons in Manhattan due to his expertise with procedures such as the SMAS facelift and deep plane facelift. Having performed more than 2,000 facial rejuvenation procedures, Dr. Konstantin has an extensive expertise and the intricate knowledge of the facelift techniques that could be used to achieve the best result for each individual patient.

What Is a SMAS Facelift?

SMAS (Submuscular Aponeurotic System), is a layer that envelops the muscles of facial expression and is located directly under the skin. Although it often seems that it’s our skin that begins to sag with age, in actuality, it is the SMAS that is responsible for most of the visible aging of the face. Over the years the SMAS begins to stretch and the ligaments connecting it to the deeper structures of the face become loose. These changes result in soft tissue laxity and the appearance of age. In order to reverse these aging changes and rejuvenate the face, the SMAS needs to be tightened and lifted up to a more youthful position with an SMAS facelift. 

How Much Does a SMAS Facelift Cost in NYC?

When performed by a facelift expert, the price of a facelift generally ranges from $25,000 to $100,000 and up. Paying top dollar for your facelift does not guarantee you the best result, but more experienced and established surgeons typically charge higher prices for their facelifts. For the best outcome, seek a SMAS facelift performed by a top facial plastic surgeon who specializes in facial rejuvenation and has extensive experience with this procedure. The cost of a face and neck lift in Dr. Konstantin’s practice is $35,000. Additional procedures such as blepharoplasty or brow lift could be recommended in conjunction with a facelift to enhance the results. The cost of a full facial rejuvenation might run over $50,000.

Your SMAS Facelift Procedure


There are two different types of anesthesia that we offered to our patients: local anesthesia with a mild sedation and deep IV sedation. The choice of anesthesia depends on the patient preferences. Some of Dr. Konstantin’s facelift patients prefer to be completely asleep under IV sedation, while others would rather have a lighter form of anesthesia and not be fully sedated. The choice of anesthesia is a personal preference and does not change the type of a facelift or the final result.


The SMAS procedure begins with making incisions. A typical incision will be hidden around the ear. It starts at the temple hair tuft, curves in the creases of the ear and at the edge of the cartilage (called tragus), goes down to the ear lobe, comes up on the back side of the ear, and turns down again at the hairline behind the ear. Another small incision is placed in the natural skin crease under the chin. This incision allows to remove the excess fat in the neck and tighten up the platysma muscle (platysmaplasty). This placement of the facelift incisions allows for the removal of the sagging skin and at the same time makes the resulting incision lines look inconspicuous and well-hidden.

SMAS Elevation

Once the incision is made, the SMAS layer is exposed, pulled upwards and slightly backward, and is held in place with special stitches. The two most commonly employed methods of lifting the SMAS layer are SMAS plication and SMAS imbrication. Plication will fold the SMAS on itself and imbrication will cut into the SMAS and overlap the SMAS layers. Although many surgeons might prefer one of these SMAS lifting techniques over the other, there is very little evidence to suggest that either one is substantially better than the other. In Dr. Konstantin’s experience both achieve very good results.

Closure & Dressing

Once the SMAS is lifted and held in place with the stitches, Dr. Konstantin removes the excess skin and closes the incisions with specially designed sutures. No staples are used in the incision closure. Bacitracin ointment is applied and contour dressing consisting of cotton and soft bandages is then placed. Drains are typically not required for this type of facelift, although they could be used on as needed basis.

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Maria is so amazing and helpful. She did my Botox and fillers. She’s so nice and kind. I had a consult...
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What Is the Difference Between an SMAS Facelift and a Deep-Plane Facelift?

The difference between an SMAS facelift and a deep-plane facelift is in how deep the surgery will go to lift the sagging tissue of the face. Neither SMAS plication nor imbrication involves releasing the deep facial ligaments. These ligaments hold the SMAS in place and unless released, would limit how much the facial tissue could be elevated.

This seemingly small difference explains why many doctors who specialize in facelifts will use the SMAS facelift technique for patients of younger demographic (such as mini facelift) and use deep-plane facelift in patients with more significant aging changes. Releasing the ligaments allows for non-hindered elevation of the soft tissue laxity in patients with moderate to severe aging changes and might be the best choice for a patients of older demographics or those with more significant facial laxity and neck sagging.

Another difference between these procedures is that the SMAS facelift is nearly as good as the deep-plane facelift at tightening the jowls, but has a limited ability to elevate sagging cheeks. A deep facial facial ligament called the zygomatic cutaneous is located right at the notch in the bony part of the cheek. This ligament is attaching the SMAS to the cheek bone and unless released will prevent lifting of the SMAS in the mid-cheek region. As a result, SMAS facelift is most appropriate for patients whose cheeks’ contour still does not display a significant descent, hollowness, and laxity.

Both, incision lines and recovery would be slightly shorter with a SMAS facelift than with a deep-plane facelift. During recovery, deep-plane facelift might result in a little more swelling in the cheeks and have a slightly higher chance of bruising in the face when compared to a SMAS facelift. Otherwise the procedures could be performed in a very similar way and have a compatible recovery process. 

Dr. Konstantin smiling in a dark suit

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If you are searching for the best facial plastic surgeon in NYC to perform your SMAS facelift, request a consultation using the online form, or call us at (212) 380-3634 to speak to a member of our team.

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