SMAS Facelift at a Glance
| Detail | Information |
|---|---|
| Surgeon | Dr Scott J Turner, Specialist Plastic Surgeon (FRACS) |
| AHPRA registration | MED0001654827 |
| Procedure category | Facelift on the SMAS layer (plication, SMASectomy, high SMAS or extended SMAS variants) |
| Lifting vector | Lateral or vertical (depending on technique selected) |
| Areas treated | Lower face, jowls, jawline (limited midface reach) |
| Anaesthesia | General anaesthesia in an accredited private hospital |
| Surgical time | 2 to 3.5 hours |
| Hospital stay | 1 night (longer techniques) or day surgery (shorter techniques) |
| Return to desk work | 2 weeks |
| Final result visible | 6 to 12 months |
| Longevity | Long-lasting, with individual variation based on age, skin quality and technique selected |
| Typical candidate age | Late 40s through 50s primarily (candidacy depends on anatomy, not chronological age) |
| Sydney clinics | Bondi Junction (39 Grosvenor Street), Manly (Suite 504, Level 5, 39 East Esplanade) |
| Surgery performed at | Bondi Junction Private Hospital, Delmar Private Hospital (Dee Why) |
| GP referral | Required (Medical Board and AHPRA requirement) |
| Medicare and private health rebate | Not applicable for cosmetic facelift surgery |
| Indicative cost | From around $25,000 all-inclusive (SMAS facelift alone) |
What is a SMAS Facelift?
The Superficial Musculoaponeurotic System (SMAS) is a continuous fascial layer that runs from the platysma muscle in the neck, up through the cheek, and connects with the frontalis muscle in the forehead. It carries the facial fat compartments and is continuous with the muscles of facial expression. With age, the SMAS descends, contributing to jowling, loss of jawline definition and lower-face laxity.
A SMAS facelift addresses this descent by acting on the SMAS layer itself. The skin is elevated as a separate flap, and the SMAS is then either folded on itself, partially excised and re-sutured, or released and elevated as a flap depending on the technique selected. The skin is then redraped over the lifted SMAS and excess is trimmed.
The SMAS technique works on the symptomatic layer rather than the layer beneath (the deep plane, where the retaining ligaments are located). This distinction is the basis for selection between SMAS and deep plane approaches.
SMAS Facelift Techniques
SMAS facelift is a category. The term covers several technique variations that differ in how the SMAS layer is treated.
SMAS Plication
The SMAS is folded on itself and secured with permanent sutures, tightening the SMAS without cutting or removing tissue. It is the simplest SMAS technique. Suitable for patients with mild laxity who do not require more extensive SMAS work.
SMASectomy
A strip of SMAS is excised, and the cut edges are sutured together. This produces a tightening effect with reliable, established results. Suitable for moderate jowling and lower-face laxity.
High SMAS
The SMAS is released and elevated as a flap, then re-suspended under tension at a more cephalad (higher) position. The high SMAS technique provides more elevation than plication or SMASectomy. Suitable for moderate to more significant lower-face changes.
Extended SMAS
The SMAS flap is extended forward, beyond the standard SMAS facelift dissection limits, allowing more correction of the jowls and approaching (without releasing) the retaining ligaments. The extended SMAS technique approaches deep plane territory in extent without crossing into sub-SMAS dissection.
Short Scar SMAS
The SMAS work above is performed through a shorter incision pattern (in front of the ear, around the earlobe, without extending into the posterior hairline). Suitable for patients with early-to-moderate lower-face changes who do not have significant skin excess or neck involvement.
SMAS Technique Comparison
| Variant | What it does | Best suited for | Trade-offs |
|---|---|---|---|
| SMAS Plication | Folds SMAS on itself with sutures | Mild laxity, simpler technique | Less long-lasting than deeper techniques |
| SMASectomy | Removes strip of SMAS, sutures edges | Moderate laxity, reliable results | Limited midface reach |
| High SMAS | Releases SMAS as a flap, re-suspends higher | Moderate to more significant lower-face changes | More complex dissection |
| Extended SMAS | High SMAS flap extended further forward | More significant jowling | Approaches deep plane in extent without sub-SMAS release |
| Short Scar SMAS | Any SMAS technique through limited incision | Early-to-moderate changes, late 30s to early 50s | Limited skin redraping |
Selection is made at consultation based on the degree of SMAS descent, skin quality, the patient’s anatomy and recovery time available.
SMAS Facelift vs Deep Plane Facelift
| Feature | SMAS Facelift | Deep Plane Facelift |
|---|---|---|
| Anatomical layer addressed | SMAS layer (above) | Sub-SMAS layer (releases retaining ligaments) |
| Lifting vector | Lateral or vertical | Vertical with composite tissue movement |
| Reaches midface | Limited | Yes |
| Reaches nasolabial fold | Limited | Yes |
| Surgical time | 2 to 3.5 hours | 3.5 to 5 hours |
| Return to desk work | 2 weeks | 2 to 3 weeks |
| Indicative cost | From around $25,000 | Around $35,000 (with neck lift) |
| Best for | Mild-to-moderate lower-face changes, jowling | Moderate-to-significant midface descent and jowling |
A SMAS facelift works on the SMAS layer itself. A deep plane facelift dissects beneath the SMAS, releases the retaining ligaments that anchor the SMAS to the facial skeleton, and lifts the SMAS, fat compartments and skin as a single composite. Because the deep plane technique works one layer deeper, it reaches the midface and nasolabial fold in a way that SMAS techniques do not.
Neither technique is universally “better”. The right technique depends on which anatomical layer is responsible for the patient’s specific ageing pattern. SMAS techniques are appropriate when the lower face and jowls are the primary concern and midface descent is minimal. Deep plane is appropriate when midface descent is a significant component.
SMAS Facelift vs Vertical Restore Facelift
| Feature | SMAS Facelift | Vertical Restore Facelift |
|---|---|---|
| Scope | Lower face, jowls | Whole face: brow, eyelids, midface, jowls, jawline, neck |
| Components | SMAS technique (with optional add-ons) | Composite: deep plane + brow lift + blepharoplasty + fat grafting + neck lift |
| Anatomical layer | SMAS | Sub-SMAS plus multiple other layers |
| Surgical time | 2 to 3.5 hours | 5 to 7 hours |
| Return to desk work | 2 weeks | 3 to 4 weeks |
| Indicative cost | From around $25,000 | Around $45,000 |
| Best for | Isolated lower-face changes, early-to-moderate ageing | Multi-zone whole-face ageing |
A SMAS facelift and a Vertical Restore Facelift sit at opposite ends of the facelift spectrum in scope. SMAS facelift focuses on the lower face. Vertical Restore integrates brow, eyelid, midface, lower face and neck work in a single comprehensive operation. The choice depends on which facial zones show ageing changes and whether the patient prefers a focused or a comprehensive procedure.
Who is a Suitable Candidate?
Candidacy for SMAS facelift depends on the degree and pattern of facial ageing rather than chronological age. Typical SMAS facelift candidates are in their late 40s through 50s, though some younger patients with early changes and older patients in good general health may also be suitable.
Considerations assessed at consultation include:
- Pattern of ageing. Lower-face and jowl changes predominant, without significant midface descent or deep nasolabial folds.
- Skin quality. Adequate elasticity for redraping over the lifted SMAS.
- Neck involvement. Limited platysmal banding or submental fullness. Significant neck changes may indicate a deeper technique or a combined approach.
- General health. Suitable for general anaesthesia.
- Smoking status. Non-smoker, or willing to cease nicotine for at least six weeks before and six weeks after surgery.
- Body mass index. Within a range appropriate for elective surgery.
- Realistic expectations. Understanding that the procedure addresses structural change in the SMAS layer but does not address midface descent or skin surface concerns.
- Recovery time available. Minimum of 2 weeks for desk-based work return.
A face-to-face consultation following GP referral is required to determine candidacy and select the most appropriate SMAS variant.
Optional Combined Procedures
A SMAS facelift can be combined with complementary procedures in a single operation, reducing overall recovery time compared to staging separately.
- Upper blepharoplasty. Addresses excess upper-eyelid skin.
- Lower blepharoplasty. Addresses under-eye fat herniation and lower-eyelid skin laxity.
- Brow lift. Corrects brow descent.
- Neck lift. For patients with platysmal banding or submental fullness.
- Facial fat grafting. Volume restoration in the midface and temples using fat harvested by liposuction. See facial fat transfer for the standalone procedure.
When ageing changes span multiple facial zones, the Vertical Restore Facelift integrates these components as a single comprehensive procedure rather than combining individual procedures with a SMAS facelift.
SMAS Facelift Recovery Timeline
Recovery from a SMAS facelift follows a predictable pattern. Individual recovery varies based on age, general health, technique selected and adherence to post-operative instructions.
- Day 1. Hospital stay of 1 night (or day surgery for shorter techniques). Drains placed if used. Head elevation maintained.
- Days 2 to 3. Drains removed at 24 to 48 hours. Light walking encouraged. No bending or lifting.
- Days 4 to 7. Peak swelling and bruising. Sleeping upright remains important.
- Day 7 to day 14. Sutures removed in staged fashion. Swelling begins to settle.
- Week 2. Most patients return to desk-based work. Mineral makeup may be used to camouflage residual discolouration.
- Weeks 3 to 4. Visible bruising resolves. Light exercise resumed with surgeon approval.
- Month 3. Most of the swelling has settled.
- Months 6 to 12. Final tissue settling, scar maturation and the long-term result become apparent.
A SMAS facelift combined with blepharoplasty, brow lift or neck lift has a longer recovery than a SMAS procedure alone because the surgical area is broader.
Risks and Complications
All surgery carries risk. Risks specific to SMAS facelift discussed at consultation include:
- Haematoma. A collection of blood beneath the skin, most common in the first 24 hours.
- Facial nerve injury. Temporary or, less commonly, permanent weakness of the muscles of facial expression.
- Wound healing complications. Increased in patients who smoke or have poorly controlled medical conditions.
- Infection. Uncommon in clean facial surgery but possible.
- Scarring. Incisions heal over months. Hypertrophic or keloid scarring is uncommon but possible.
- Asymmetry. Minor asymmetry may persist after surgery.
- Hair loss near incisions. Usually temporary.
- Sensory changes. Numbness around the ears and cheeks is normal in the early post-operative period and typically improves over months.
- Earlier need for revision. Because SMAS techniques address the SMAS layer rather than the deeper retaining ligaments, the long-term result may not be as durable as a deep plane approach in patients with more significant structural ageing. This is a consideration in technique selection.
Risk is reduced by smoking cessation, optimisation of general health, careful surgical technique, accredited private hospital setting and structured follow-up. Detailed risk discussion is part of every consultation.
SMAS Facelift Cost in Sydney
The indicative cost of a SMAS facelift in Sydney with Dr Turner is from around $25,000 all-inclusive when performed alone. A SMAS facelift combined with blepharoplasty, brow lift, neck lift or fat grafting will be higher, with the final fee depending on the combination selected.
The all-inclusive fee covers the surgeon, assistant surgeon, anaesthetist, accredited private hospital fee, garments and standard post-operative care. Final fees are quoted after consultation. Medicare and private health insurance rebates do not apply for cosmetic facelift surgery. A consultation fee applies.
A complete cost breakdown including comparison with deep plane and Vertical Restore Facelift pricing is available in the Facelift Cost Sydney 2026 guide.
Consultations in Bondi Junction and Manly
SMAS facelift consultations with Dr Scott J Turner are available at two Sydney locations.
The Bondi Junction clinic is located at 39 Grosvenor Street, a short distance from Bondi Junction station and Westfield. The Manly clinic is located in Suite 504, Level 5, 39 East Esplanade, close to Manly Wharf.
A GP referral is required before booking a consultation, in line with Medical Board and AHPRA requirements introduced for cosmetic surgery in Australia. Dr Turner conducts a minimum of two consultations before proceeding with surgery, both personally, with no patient representatives.
To request a consultation, contact the practice on (02) 9387 3900 or [email protected], or visit the contact us page.
Frequently Asked Questions
What is a SMAS facelift?
A SMAS facelift is a facelift technique that tightens or repositions the Superficial Musculoaponeurotic System (SMAS), the deeper support layer beneath the facial skin, to address jowls, jawline definition and lower-face laxity. SMAS facelift is a category rather than a single operation; the term covers SMAS plication, SMASectomy, high SMAS and extended SMAS variants. Dr Scott J Turner performs SMAS facelift surgery at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What is the difference between SMAS plication, SMASectomy, high SMAS and extended SMAS?
SMAS plication folds the SMAS on itself with permanent sutures, tightening without cutting tissue. SMASectomy removes a strip of SMAS and sutures the edges together for a tightening effect. High SMAS releases the SMAS as a flap and re-suspends it at a higher position, providing more elevation. Extended SMAS extends that flap further forward, approaching the retaining ligaments without releasing them. Selection between these variants is made at consultation based on the degree of SMAS descent, skin quality and the patient’s anatomy.
How does a SMAS facelift differ from a deep plane facelift?
A SMAS facelift works on the SMAS layer itself, folding (plication), excising (SMASectomy) or elevating (high SMAS or extended SMAS) the SMAS to address descent. A deep plane facelift dissects beneath the SMAS, releases the retaining ligaments that anchor the SMAS to the facial skeleton, and lifts the SMAS, fat compartments and skin as a single composite. The SMAS technique is appropriate when the lower face and jowls are the primary concern and midface descent is minimal. The deep plane technique is appropriate when midface descent is a significant component of the ageing pattern.
Is a SMAS facelift better than a deep plane facelift?
Neither technique is universally better. The right technique depends on the patient’s individual anatomy and the layer responsible for the visible changes. A SMAS facelift is appropriate when the lower face and jowls are the primary concern, skin quality is good, and midface descent is minimal. A deep plane facelift is appropriate when the midface descends significantly and the nasolabial fold or marionette lines are pronounced. Selection between the two is made at consultation based on facial anatomy, not on a ranking of techniques.
Does a SMAS facelift treat the neck?
A SMAS facelift on its own provides limited correction of the neck. The platysma muscle is continuous with the SMAS, so some neck improvement results from the SMAS lift. For patients with significant platysmal banding, submental fullness or cervicomental angle changes, a formal neck lift component is added to the SMAS facelift. Surgical time and recovery are longer when a neck lift component is included.
What age is best for a SMAS facelift?
There is no single best age. SMAS facelift candidates are typically in their late 40s through 50s, though some younger patients with early changes and older patients in good general health may also be suitable. Candidacy depends on the pattern of ageing (whether the lower face and jowls predominate, without significant midface descent), skin quality, general health and other individual factors assessed at consultation. Age alone is not a determining factor.
How visible are SMAS facelift scars?
Incisions are placed in natural creases around the ear and extended into the hairline. The pre-tragal or post-tragal incision in front of the ear, the incision around the earlobe and the incision into the temporal and posterior hairline are designed to be camouflaged once healed. Short-scar SMAS techniques use a more limited incision pattern. Scars appear pink initially and typically fade over months to become difficult to see with normal hair styling. Individual scar healing varies, and hypertrophic or keloid scarring, while uncommon, is possible.
What is the recovery timeline for a SMAS facelift?
Recovery from a SMAS facelift progresses in stages. Day 1 involves a hospital stay or day surgery, depending on the technique used. Drains, if used, are removed at 24 to 48 hours. Days 4 to 7 show the peak of swelling and bruising. Sutures are removed in stages between day 7 and day 14. Most patients return to desk-based work at around 2 weeks. Visible bruising typically resolves by weeks 3 to 4 with the assistance of mineral makeup. Final tissue settling continues over 6 to 12 months. Recovery is longer when the procedure is combined with blepharoplasty, brow lift or neck lift components.
What does a SMAS facelift cost in Sydney?
The indicative cost of a SMAS facelift in Sydney with Dr Turner is from around $25,000 all-inclusive when performed alone. A SMAS facelift combined with blepharoplasty, brow lift, neck lift or fat grafting will be higher, with the final fee depending on the combination selected. The all-inclusive fee covers the surgeon, assistant surgeon, anaesthetist, accredited private hospital fee, garments and standard post-operative care. Final fees are quoted after consultation. Medicare and private health insurance rebates do not apply for cosmetic facelift surgery. A consultation fee applies.
Where does Dr Scott J Turner perform SMAS facelift surgery?
Dr Scott J Turner consults from two Sydney clinics, Bondi Junction (39 Grosvenor Street) and Manly (Suite 504, Level 5, 39 East Esplanade). SMAS facelift surgery is performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why, both accredited Sydney private hospitals. Dr Turner also consults from Brisbane (Herstellen Clinic, Spring Hill) and Canberra (Campbell), with surgery performed in Sydney for patients travelling from interstate.
Related Guides
Compare facelift techniques: Facelift Surgery Sydney (the hub covering all eight techniques), Deep Plane Facelift, Vertical Restore Facelift, Short Scar Facelift, Lower Facelift, Endoscopic Facelift, Ponytail Facelift and Revision Facelift.
Component and complementary procedures: Facial Fat Transfer, Buccal Fat Removal, Lip Lift Surgery.
Reading more: Difference Between Vertical Restore and Deep Plane Facelift Surgery, Facelift Cost Sydney 2026, Deep Plane Facelift Recovery Timeline and Is a Deep Plane Facelift Worth It.
