SMAS Facelift Turkey

Read enough facelift forums and you'll come away thinking SMAS is yesterday's technique and deep plane is the upgrade. It's a tidy story. It's also mostly wrong. For a large share of faces, a SMAS facelift in Turkey isn't the compromise option at all. It's simply the right operation.

The question under our heading points at who it suits best: jowls forming, the lower face starting to droop, often the neck going with it. So let's look at what it actually does to a face, and whether yours is the sort it suits.

What is the SMAS, anyway?

The letters stand for superficial musculoaponeurotic system. Hardly anyone says it out loud, surgeons included. Here's the version we use in clinic. Your face is a bit like a lined jacket. Skin's the outer fabric. Tucked beneath sits the lining, a thin, tough mix of fibre and muscle, and that's what actually gives your face its shape. Years go by, the lining sags, and it takes the skin down with it.

Pull only on the outer fabric and it puckers; that's the windswept look everybody's seen on someone. Take in the lining instead, and the jacket hangs right again. SMAS lift, in a nutshell.

How a SMAS facelift is done

Step one is easing the skin off the SMAS, so each layer can be dealt with on its own. Then the SMAS itself is tightened and moved up and back, before the skin is laid back over it and the extra trimmed.

There are two main ways to tighten that layer. In plication, the surgeon folds the SMAS over on itself, like taking in a seam, and stitches the fold. Nothing is removed. In excision, a strip of SMAS is cut away and the edges sewn together, a bit like shortening a belt. Both have long, solid track records. Whether you get the seam or the belt comes down to your own SMAS: how thick it is, how much give it has. We decide that at examination and write it into your plan before you fly.

You'll be under a general anaesthetic for something like three to four hours, temple lift included.

Are you a SMAS facelift candidate?

The classic SMAS face has proper jowls, not just a hint of one. The jawline has lost its edge. The lines from nose to mouth have deepened. Quite often there's some looseness under the chin as well. What it usually doesn't have is a cheek that has collapsed downwards; the cheekbones still look reasonably full from the front.

If that sounds like you, a SMAS facelift in Turkey is likely in the frame. If your cheeks have flattened and slid towards your mouth, a deep plane facelift reaches further. And if all you've got is a softening jaw with the neck still neat, a mini facelift may do the job with less surgery. The facelift overview lays the three side by side.

SMAS vs deep plane: the honest comparison

Here's where the "old versus new" story trips people up. The real difference is a ligament or two.

Deep within the face, small ligaments anchor the soft tissue to the bone. A deep plane lift cuts some of them, so the cheek can be moved as one block. A SMAS lift leaves them where they are and tightens the layer around them instead. For jowls and the lower face that's usually plenty. For a midface that has properly fallen, it isn't, because a layer that's still tethered can only travel so far.

So the useful question isn't "which is more advanced?" It's "where has my face dropped?" If it's the jaw and neck, deep plane's extra reach mostly buys you a longer recovery. If it's the cheek, SMAS will leave something behind.

Doesn't SMAS give a tight, pulled look?

Not when it's done well. The pulled look people fear comes from stretching skin hard to do a job the deeper layer should have done. Because the SMAS takes the strain here, the skin can be laid back with very little tension.

What does sometimes happen in the first weeks is a feeling of tightness, and some faces look slightly "set" while the swelling goes down. That's temporary. By two or three months, expressions move naturally again.

A technique with a long memory

Surgeons have been doing and tweaking SMAS lifts for decades, and somehow that's become a mark against it. We'd argue the opposite. When a technique has that many years of patients behind it, nobody's guessing about how it heals, what can go wrong or how faces look ten years on. Most of the facelifts we do are SMAS, as the page above mentions, so it's also the one our team has had the most practice at.

Does a SMAS facelift hurt?

Sore, yes. Agonising, rarely. Ask people a week later and the words they reach for are tight, puffy, achy, mostly round the jaw and behind the ears. Sharp pain doesn't usually come into it. Prescribed painkillers handle it for most. The odd part is the numbness: patches of the cheeks and ears can feel woolly for weeks while the small sensory nerves recover.

SMAS facelift after a previous lift

Some people come to us for a SMAS lift having had a mini lift six or seven years earlier that's now wearing off, jowls and all. SMAS is often the natural next step. The surgeon can usually work through the old incision lines, lengthening them where needed, so you don't collect a second set of scars. Scar tissue left under the skin from the first operation makes the dissection slower and a little more delicate, so we'll want to know exactly what was done before, ideally with the original surgical notes.

When SMAS isn't the answer

A few situations make us pause before booking a SMAS facelift in Turkey. If you smoke and can't stop for the weeks around surgery, the skin lifted during a SMAS lift may not heal well. Uncontrolled diabetes or blood pressure need sorting first. And if your sagging is still at the very early stage, SMAS is more surgery than you need. We'd say so, and the price wouldn't change our advice.

SMAS facelift scars

The incision is longer than a mini's. Usually it begins up in the hair at the temple, follows the crease in front of the ear, goes round under the lobe and carries on behind the ear, occasionally creeping a short way into the hair behind. Length-wise, it's much the same as a deep plane scar.

Fair hair hides a line differently from dark hair, thin hair differently from thick, and someone who lives in a high ponytail has different needs from someone with a bob. Tell us early. By the end of the first year, plenty of patients struggle to find their own scar in the mirror.

SMAS facelift recovery

You'll spend the first night on the ward, with nurses checking your blood pressure and dressing. If small drains were used to stop fluid collecting under the skin, they usually come out after a day or two.

Then come the puffy days. The bruises have a habit of pooling along the jaw before sliding down the neck. Week one they're dark; week two they yellow and fade. Somewhere around day fourteen most people feel up to light activity. By six to eight weeks, people tell us they've stopped thinking about it. A little puffiness can linger under the jaw beyond that, mostly noticeable to you.

How many nights in Istanbul?

A SMAS facelift in Istanbul usually means eight to ten days here. The exact number sits in your written plan, because it partly depends on how your first few days go. You'll meet the surgeon and the anaesthetist, have the operation, sleep one night on the ward, and then spend most of a week being checked on before we sign you off to fly. One tip from patients who've done it: the bruising tends to travel down onto the neck, so a high collar or a button-front shirt saves a lot of explaining at the airport.

Adding a neck lift

The neck is SMAS's most common companion. If loose skin or bands below the jaw are a big part of what bothers you, a neck lift is usually done in the same operation, through the same incisions extended slightly behind the ears. On its own, a neck lift is listed at €4,000. Before anything gets added, our anaesthetist looks at how long you'd be asleep in total, and has the last word.

How long does a SMAS facelift last?

Most SMAS results hold for eight to ten years before the jowls are obviously back. Where you land in that range depends largely on family genes. Sun damage shortens it. So do big swings in weight. It outlasts a mini because the deeper layer itself was moved, not just the skin. Ageing carries on, of course, just from a better starting line, and some people come back years later for a smaller top-up.

SMAS facelift before and after: what's worth checking

Look at the gallery above. Cheeks, jaw and neck all rise together there, which is exactly what you'd hope to see from a SMAS facelift before and after. Then go to a profile view. Below the jaw there should be a clear, sharp turn into the neck, not a soft slope. Folds from nose to mouth? Softer, yes. Gone completely, no. A face without them looks strangely blank. And look at the ear lobe and sideburn, which should sit where they always did.

As the page notes, wait until the six-to-eight-week recovery has run its course before judging the neck angle; before and after photos taken sooner flatter nothing but the swelling. Reviews from SMAS patients, read alongside their before and after photos, are useful for the practical side, such as how long the bruising on the neck actually lasted.

SMAS facelift price in Turkey

€5,000 is our SMAS facelift price, the very same figure you'd pay for a mini or a deep plane, and the temple lift, the anaesthetic and your night on the ward are all inside it. The comparison table above shows what the same operation runs to abroad: €9,350 to €11,700 in Britain, €8,500 to €12,500 in Germany, and in the US somewhere between €9,500 and a startling €27,600.

In most countries SMAS is priced below deep plane, which is how it picked up its reputation as the budget choice. With one price line, that reasoning disappears, and what's left is the only question that matters: which depth does your face need? That's also the honest way to compare any SMAS facelift cost quoted elsewhere.

Photos for your SMAS plan

Daylight, hair back, no make-up. Take a straight-on photo, both profiles and both three-quarter views, then one in profile with your chin slightly raised so we can see the neck. Let us know how old you are, anything previously done to your face, which medicines you're on and whether you're a smoker. Our Istanbul team will tell you whether a SMAS facelift in Turkey suits you, whether plication or excision is likely, whether a neck lift belongs in the plan, and what it would cost.