High SMAS Facelift: Combined Single Flap Lifting of the Jawline, Cheek, and Midface

The traditional low cheek SMAS flap elevated below the zygomatic arch suffers the drawback that it cannot, by design, exert an effect on tissues of the midface and infraorbital region. Low designs target the lower cheek and jowl only and produce little if any improvement in the upper anterior cheek and midface area. Planning the flap higher, along the superior border of the zygomatic arch, and extending the dissection medially to mobilize midface tissue overcomes this problem and allows a combined, simultaneous lift of the jawline, cheek, and midface with a single unified flap. An improved outcome is obtained, and no separate midface lift procedure is needed.