SMAS Facelift

The SMAS facelift, or SMAS rhytidectomy, is a popular cosmetic procedure in the UK. If you are seeking a longer lasting youthful look, this could be the facelift for you. The SMAS facelift is a surgical procedure that tightens and lifts the middle and lower parts of your face. It can treat the sagging skin around the cheek area, jowls and sad mouth look. It can also treat the neck if there is not a lot of skin laxity. 

The SMAS facelift is a popular procedure for patients who want an overall improvement in their appearance, as it treats sagging skin, muscle laxity and can target jowls. It can achieve a cheek and jowl lift. 

SMAS stands for Superficial Musculo Aponeurotic System, which comprises muscles and fibrous tissues on the face that becomes loose when we age. This area starts near our ears and moves down towards the neck, where looseness occurs in the middle of your face. 

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  • Over 90 years of collective experience
  • We focus exclusively on facial procedures
  • UK based GMC Specialist Register plastic surgeons
  • Experts - our surgeons have performed hundreds of facelifts and necklifts
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What can a SMAS facelift achieve?

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
  • A drooping neck or turkey neck if there is not a lot of skin laxity in the neck. If there is more skin laxity a neck lift may be recommended

SMAS facelift patients want to slow down the effects of ageing. We see patients in their 50’s, 60s and older achive lift and rejuvenation.

The benefits of a SMAS facelift are the following:

  • A natural-looking facelift result with minimal scarring
  • 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 facelift to be the best treatment for jowls

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SMAS Facelift - Key Information

Procedure time

2 to 3h


General anaesthesia

Hospital stay

Day care

Up & mobile

Same day

Sleeping position

On your back for around 2 weeks


1 week to 10 days

Sexual activity

Restricted for 4 weeks

Back to work

1 week to 10 days


4 to 6 weeks

Who is suitable for this treatment?

Many women and men come to Kensington Medical because they want to look refreshed and naturally younger. Others come because their non-surgical dermal fillers or non-surgical facelift are no longer working. They feel they are spending a lot of money to maintain something that does not give them the youthful and natural look they want.

A SMAS face lift candidate is looking for a facelift that will last for a good many years. Of course, we all age and this process does not stop when you have a SMAS or any facelift procedure.

A SMAS facelift is a common procedure that can take up to 10 years off the appearance of your face. A person's decision to have one should depend on their circumstances, such as lifestyle and facial structure.

We see individuals in their 40s, 50s, or 60s. However, a SMAS can also be offered to someone in their 70’s.

Consultations with our experienced facial plastic surgeon should help answer any questions and concerns. They will look at skin and muscle laxity and your lifestyle to give you the best options for what you want to achieve.

How does the procedure work?

At Kensington Medical, we always start with a pre-operative medical assessment one week before the procedure. During which we will:

  • Ask you to fill out a medical history form
  • Complete blood tests
  • Check your blood pressure, height and weight
  • Screen you for  MRSA

On the day of surgery, you will meet your anaesthetist, who will monitor and check that you are fit for surgery. You will see your plastic surgeon.

The operation takes place under sedation or general anaesthesia and will last between two and three hours.

Once under anaesthesia, the surgeon marks your face to show where they'll make the incisions. An opening starts at your temple, above the hairline. The downward cut will extend along the natural creases of the skin and curve behind the ears.

The surgeon will lift the facial and neck tissue and muscle beneath the skin higher and removes the excess skin. Then the skin is placed over the face, and the incisions are closed with sutures. The scars will be hidden in the hairline and the normal creases of the skin.

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What other treatments can complement a SMAS procedure?

A SMAS facelift is often combined with other treatments associated with ageing such as an upper eyelid lift (upper blepharoplasty) or an eye bag removal (lower blepharoplasty) . This option can often give you a better result and reduce the need to come back later for more surgery. Book a consultation in our Harley street, London, UK or Wimbledon clinic and find out if you are suitable. 

SMAS facelift with eyelid surgery (Blepharoplasty)

SMAS facelifts are often carried out with upper or lower eyelid surgery (blepharoplasty). This is because a SMAS facelift targets the middle and lower portions of the face, the eye area is not touched, especially the upper eyelids.

A blepharoplasty removes excess fat and tightens the skin in the areas around the upper eyelids, the lower eyelids or eye bags, or both. By combining this with a SMAS facelift, can produce an overall rejuvenated face.

SMAS facelift with a neck lift (platysmaplasty)

A SMAS facelift has a smaller effect on the neck. If the neck has a lot of skin laxity our plastic surgeon might suggest a neck lift. Sometimes the neck can age sooner than the face. To obtain a natural look, our plastic surgeon may suggest a SMAS facelift with a neck lift.

SMAS facelift with lip 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.  

SMAS facelift with fat transfer

A SMAS facelift may not be enough to stop the fat loss effects of ageing. Fat transfer to the face can help to restore the 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 change in 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:

SMAS facelift with lasers

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.

Deep Plane Facelift

At your consultation with our expert facial surgeons they will look at your facial structure, skin laxity and fat distribution and collagen supply. In some cases they will recommend a full facelift or deep plane facelift as they feel it will give you a better natural result. The deep plane facelift addresses the deep structures beneath the skin.  To find out more about deep plane facelift click here. 

Your Journey with Kensington Medical

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.

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:

  • Listen to your concerns and understand what you would like to achieve;
  • Examine you;
  • Show you examples of their work in the form of before-and-after photographs;
  • Suggest a treatment plan.

Following the first consultation, we will:

  • Write to you summarising the surgeon’s recommendations;
  • Quote for the treatment plan suggested by the surgeon;
  • Send you extensive information about the procedure, the risks involved and the precautions you should take pre- and post-operatively.

A second consultation is often necessary for the following reasons:

  • After the first pre-operative consultation, and once you have been through the information sent to you, it is likely that you will have more questions for the surgeon.
  • The surgeon often finds it necessary to speak to patients again to ensure they have fully understood the risks of surgery and they know exactly what to expect from surgery.
  • It is common that several treatment options are discussed at the first consultation, and another meeting is necessary to decide which is the most appropriate.

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.

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:

  • You should discontinue smoking for several weeks before your facelift, as smoking can increase the risk of complications during the healing process.
  • You should refrain from taking blood-thinning drugs (such as aspirin) for ten days before your procedure.
  • You should not eat six hours before surgery; you should not drink two hours before surgery.

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.

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:

  • The next day, the surgeon will remove the drains and check the wounds and dressings.
  • One week post-operatively, there will be another consultation and depending on your healing progress, the surgeon may decide to remove sutures then.
  • You will see the surgeon again two weeks post-operatively, at which stage all remaining sutures will be removed and your progress monitored.
  • The last post-operative consultation is at six weeks. Generally, you will be discharged from the surgeon's care at that stage.

Bruising and swelling can last up to one month following this surgery.

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.

SMAS Facelift Surgeons

Frequently asked questions

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 general complications associated with any operation include:

  • Blood clot
  • Bleeding
  • Infection
  • Pain
  • Unsightly scarring

The rare complications of a SMAS facelift include

  • Cosmetic problems
  • Facial nerve damage
  • Possible Hair loss
  • Hyperpigmentation / hypopigmentation (dark / light areas on your face)
  • Loss of skin near the scars
  • Blood under the skin

You can go home on the day of a SMAS facelift. The recovery time 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. 

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. 

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.

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At Kensington Medical, an advanced SMAS facelift costs from £7,650. 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.

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:

  • Taking certain medications or adjusting your current medications
  • Applying topical facial skin products
  • Stopping smoking
  • Avoiding aspirin, anti-inflammatory drugs, or those herbal supplements that increase bleeding and bruising
  • Arranging for a family member or friend to:
    • drop you to, and pick you up from hospital; and
    • stay with you for the first-night post-treatment.

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.

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.

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The next step to a refreshed you

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. 

Medically reviewed by Mr David Gateley MA, FRCS, FRCS (Plast), GMC number 2939470 on 16 May, 2024.