Facelift Before & After
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The SMAS facelift — named for the superficial musculoaponeurotic system, the fibromuscular layer just beneath the skin — is the gold standard of traditional facelift surgery. Unlike a skin-only lift, which simply pulls and tightens the outermost layer, the SMAS facelift addresses the deeper muscular layer that directly causes facial descent. The result is a more durable, natural correction that avoids the tight or windswept appearance associated with less sophisticated techniques.
For patients considering a SMAS facelift in New Jersey, Dr. Rafizadeh’s four decades of experience and American Board of Plastic Surgery board certification offer the confidence of working with a surgeon who has performed this procedure hundreds of times, with consistently natural results.
“The SMAS facelift has an exceptional track record for a reason. When the anatomy is right, it delivers lasting, natural-looking rejuvenation with a recovery patients consistently describe as manageable.”
— Dr. Farhad Rafizadeh, MD FACS
The SMAS is the fibromuscular sheet that connects the facial muscles to the overlying skin. As we age, this layer descends along with the fat compartments above it, causing jowling, deepening of the nasolabial folds, and loss of jawline definition. A skin-only lift cannot adequately address this descent because it doesn’t correct the SMAS — it simply drapes skin over tissue that has shifted.
In a SMAS facelift, Dr. Rafizadeh elevates the skin off the SMAS and then tightens the SMAS itself through either plication or imbrication (see below). The skin is then re-draped without tension, which is what produces a natural-looking result. Because the SMAS is doing the structural work, there is no pulling force on the skin and no telltale tightness.
SMAS plication folds the SMAS back on itself and secures it with sutures in a tightened position — no tissue is excised. This is a straightforward, well-tolerated technique appropriate for most patients.
SMAS imbrication removes a small strip of SMAS before suturing the edges together, which can achieve a slightly greater degree of tightening in patients with more significant laxity. Dr. Rafizadeh selects the appropriate method based on the individual patient’s anatomy and tissue characteristics during surgery.
→ Schedule a ConsultationMeet with Dr. Rafizadeh personally to discuss your goals and a personalized plan. Call (973) 267-0928 or request a consultation online.A variation called the high SMAS facelift extends the SMAS dissection further superiorly toward the malar fat pad, allowing greater repositioning of the midface. For patients with early midface descent who don’t yet require the full ligament release of a deep plane technique, the high SMAS can offer meaningful midface improvement while remaining less technically demanding than the deep plane approach.
ComparisonThe most common question patients researching facelift options in North Jersey ask is: how does the SMAS facelift compare to the deep plane?
The SMAS facelift tightens the SMAS layer while the deeper facial retaining ligaments remain intact. This makes it an excellent choice for patients with moderate laxity, well-preserved midface volume, and concerns primarily in the lower face and jawline. For these patients, a well-executed SMAS facelift delivers reliable, natural results that last 7–10 years.
The deep plane facelift goes further by releasing those retaining ligaments entirely, allowing comprehensive repositioning of the deeper facial tissue composite. It is the better option when there is significant midface descent, deep nasolabial folds, or more advanced overall laxity requiring treatment across all facial zones. Learn more about the deep plane facelift →
Dr. Rafizadeh will evaluate your anatomy and recommend the technique that will genuinely achieve your goals — not the more involved procedure by default, and not the simpler one if it won’t deliver the result you want.
What to ExpectDr. Rafizadeh personally evaluates every patient at his Morristown, NJ office. He will assess your facial anatomy in detail, discuss the degree of laxity present, and explain exactly which technique — SMAS plication, imbrication, high SMAS, or deep plane — is most appropriate for your specific presentation and goals.
A SMAS facelift is performed under general anesthesia or IV sedation at a fully accredited Morristown surgical facility and typically takes 3–4 hours. Incisions follow the same pattern as all facelift approaches: along the hairline at the temples, around the ear, and into the posterior hairline.
Days 1–7: Swelling and bruising gradually subside. Sutures are removed by day 5–7. A compression garment is worn initially.
Weeks 2–3: Most patients return to work and social activity. Bruising has largely faded. Light exercise can be resumed.
Months 3–6: Final results are fully visible. Scars continue to mature and fade for up to 12 months.
The cost of a SMAS facelift in New Jersey varies based on procedure complexity, anesthesia fees, facility fees, and whether additional procedures are performed simultaneously. Personalized pricing is provided during Dr. Rafizadeh’s consultation after a thorough evaluation. Financing through CareCredit and Alphaeon Credit is available. Call (973) 267-0928 or request a consultation online.
The ideal SMAS facelift candidate presents with moderate facial laxity — jowling, loss of jawline definition, and lower face descent — with relatively preserved midface volume. They are in good general health, non-smokers or willing to quit prior to surgery, and have realistic expectations. Patients with more significant midface descent or deep nasolabial folds may be better served by the deep plane technique; Dr. Rafizadeh will give you an honest assessment during your consultation.
The SMAS facelift tightens the superficial musculoaponeurotic system — the fibromuscular layer beneath the skin responsible for facial support — via plication (folding) or imbrication (partial resection). By addressing this deeper layer rather than just the skin, the SMAS facelift produces a more durable, natural result. The skin is re-draped without tension over the tightened SMAS, which is why well-performed SMAS facelifts avoid the tight, pulled appearance of older techniques.
Both techniques address the SMAS layer, but at different depths. The SMAS facelift tightens the SMAS without releasing the deeper facial retaining ligaments. This is effective for moderate laxity, particularly in the lower face and jawline. The deep plane facelift releases those ligaments entirely, allowing the entire deeper facial tissue composite to be repositioned — a more comprehensive correction for patients with significant midface descent, deep nasolabial folds, or advanced overall laxity. Dr. Rafizadeh will recommend the appropriate technique based on your anatomy at your consultation.
SMAS plication folds the SMAS back on itself and secures it in a tightened position with sutures — no tissue is removed. It is straightforward and appropriate for most patients. SMAS imbrication removes a small strip of SMAS tissue before suturing, allowing a somewhat greater degree of tightening in patients whose tissue quality or degree of laxity warrants it. Dr. Rafizadeh selects the method best suited to your anatomy during surgery.
A well-performed SMAS facelift by Dr. Rafizadeh typically lasts 7–10 years. Longevity is influenced by genetics, skin quality, sun exposure, smoking history, and whether maintenance treatments such as skincare, BOTOX, or fillers are used to slow the progression of aging. Many patients return for a secondary procedure to refresh their results years later.
Recovery from a SMAS facelift generally follows the same timeline as a full facelift. Swelling and bruising peak in the first 3 days and progressively subside. Sutures are removed around day 5–7. Most patients are socially presentable with makeup by the end of week two and return to normal activity within 2–3 weeks. Final results become visible as all swelling resolves at 3–6 months, with scars fading over 12 months.
The cost of a SMAS facelift in New Jersey depends on the complexity of your surgery, whether additional procedures such as blepharoplasty, brow lift, or fat grafting are performed at the same time, anesthesia fees, and facility fees. Personalized pricing is discussed during your private consultation with Dr. Rafizadeh. Financing is available through CareCredit and Alphaeon Credit. Schedule a consultation or call (973) 267-0928.
He listened carefully to what I wanted — tightening my jowl area without looking pulled or overdone. My goal was to still look like myself, just refreshed … and that’s exactly what he achieved.
My experience with Dr. Rafizadeh could not have been any better. He has a kind and caring personality. I felt completely at ease throughout the entire process. The results speak for themselves — I look and feel years younger.
His natural approach to plastic surgery is exactly what I was looking for. I still looked like myself but a younger, more rested version of me.
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Schedule a private consultation with Dr. Rafizadeh in Morristown, NJ. He personally evaluates every patient and will recommend the technique — SMAS, deep plane, or mini — that is genuinely right for your anatomy and goals.