John Owsley, MD, FACS enjoys a worldwide reputation as the originator of the SMAS-platysma bidirectional (deep layer or muscle) facelift, which revolutionized facelift surgery. This is the procedure that motivates so many patients to travel to Dr. Owsley's San Francisco/Bay area offices for facelift surgery. Dr. Owsley developed the SMAS technique to address what he considered to be the limitations of the standard facelift — a tight, pulled appearance, earlier-than-expected recurrence of lines around the mouth, and sagging skin at the jaw line.
Dr. Owsley's goal in developing the SMAS-platysma facelift was to provide his patients with a more natural-looking and longer-lasting result. His approach, grounded in solid surgical principles and based on his deep understanding of complex facial anatomy, resulted in this innovative procedure that changed the standard of excellence in facelift surgery.
Dr. Owsley has continued to refine the state-of-the-art SMAS-platysma procedure, adding, for instance, a technique to soften the formerly intractable deep folds that develop beside the mouth. The SMAS-platysma facelift is now recognized as the most effective, anatomically correct way to address the signs of facial aging.
Acknowledged as the SMAS-platysma facelift expert, Dr. Owsley possesses superior surgical skill and extensive experience. The natural appearance and enduring quality of the results he provides with SMAS-platysma facelift surgery have consistently met the highest expectations of patients at his San Francisco offices in Northern California's Bay Area. This premier facelift surgery has provided thousands of patients with a refreshing and natural change.
The skin of the cheek and anterior (front) neck is comprised of three interconnected layers. The three layers of the facial skin are:
The SMAS has multiple fibrous extensions that attach through the subcutaneous fat to the superficial epidermal-dermal layer of the skin, and these connections cause the three layers to move together as a unit. The SMAS attachment to the epidermal-dermal layer is particularly notable at the lines on each side of the upper lip and mouth — the nasolabial creases.
In the neck, the SMAS membrane incorporates the platysma muscle, which extends from the lower jaw area to the collarbone. The platysma, which is one of the several facial muscles included in the skin unit, functions in certain expressive movements involving the lower face and neck. Chronic spastic contraction of the platysma muscle produces neck cords, which with aging can gradually create persistent vertical folds of skin beneath the chin and on the upper anterior neck.
Where the platysma muscle terminates in the cheek, the SMAS membrane continues as a layer of smooth fibrous tissue that reaches to the cheekbone below the eye and attaches to the bone as it extends in front of the ear area. The presence of a gliding plane between the SMAS and the underlying structures of the face allows free movements of the skin unit to create expressions of facial animation. The movements are produced by the superficial muscles of expression that are contained in the SMAS membrane and attach at the corner of the mouth.
As facial skin ages, there is a gradual loss of elasticity in the epidermal-dermal layer of the skin as well as in the SMAS membrane. Gravity produces sagging of the cheek skin unit along the jaw, creating fleshy "jowls," and often a double chin appears. This is due to the drooping of the fatty portion of the lax skin unit along the anterior and lateral jaw area.
At the nasolabial crease, the cheek fat sags forward with aging to increase the prominence of the nasolabial fold, which ultimately extends downward below the mouth, lateral to the chin, to become continuous with the jowl. Sagging of the subcutaneous fat and the gliding SMAS membrane contributes as much to the appearance of facial aging as the loss of elasticity in the superficial epidermal-dermal layer.
If aging has brought similar changes to your face, you may want to consider a SMAS-platysma facelift by Dr. Owsley at his San Francisco Bay Area clinic. Schedule a facelift surgery consultation at the offices of Aesthetic Plastic Surgery to discuss with Dr. Owsley how this advanced procedure can benefit you.
The classic or "traditional" skin facelift surgery achieves its correction by lifting and tightening only the superficial epidermal-dermal layer of the skin unit . The separation and lifting of the epidermal-dermal layer from the subcutaneous fat (called undermining) does not alter the position of the sagging subcutaneous fat and SMAS-platysma layer. Widely freeing the superficial epidermal-dermal layer and pulling it tightly achieves only some improvement of the two deeper layers of the skin unit, by compression. However, this very tight skin lift sometimes produces an unattractive stretched or "pulled" look. The use of deep sutures to gather up the fat and SMAS layers (plication) has been found to add no appreciable long-term improvement to the correction achieved with the standard skin facelift alone.
With the SMAS-platysma facelift technique originated by Dr. Owsley, the results of surgery are notably improved, with a more natural appearance that is not pulled. Follow-up observation indicates that the benefits of surgery can be expected to last 10 or more years.
In the SMAS-platysma operation, the three-layer unit of facial and neck skin is freed by undermining at the level of the natural gliding plane just beneath the SMAS layer.
After undermining, all three layers are lifted upward together with the tension being placed on the underlying SMAS layer.
The SMAS is sutured after trimming away the redundant fat at the level of the SMAS incision, which is hidden beneath the skin. The traction placed on the SMAS layer lifts the sagging neck fat and brings the overlying skin layer to an improved lifted position as well. Placing the tension of the lift on the deeper supporting SMAS layer produces a snug, lasting lift in the chin and jawline that is not pulled in appearance.
Since it is not necessary to place excessive tension on the superficial epidermal-dermal cheek layer in front of the ear, the skin incision can be placed inside the ear canal, making that incision invisible.
Liposuction is a safe and effective supplemental procedure to remove excess fat deposits in the neck and beneath the chin in conjunction with the SMAS facelift. In selected younger patients liposuction of the neck may be beneficial without requiring a facelift.
A recently developed technique of correcting the deep fold lines on the side of the nose and mouth adds lifting of the mid-cheek fat pad (the malar fat pad) with suspension sutures to the correction of the jaw and chin line with the deep SMAS-platysma lift. This technique is the bidirectional facelift as performed by Dr. Owsley. Dr. Owsley can also explain the SMAS-platysma facelift as performed at his San Francisco clinic in comparison with the secondary facelift and revision facelift procedures.
In summary, the SMAS-platysma facelift has been shown over an extended experience to provide an improved, more natural-appearing result that is long-lasting. There have been fewer problems with bleeding, bruising, or excessive scar formation than those formerly encountered with the standard skin facelift.
The SMAS-platysma facelift is sought by people in the public eye and those who just want the most natural-looking, longest-lasting facelift possible. At Dr. John Owsley's San Francisco Bay Area practice, this facelift surgery has delighted thousands of clients with its excellent outcome. You can obtain the same benefits when you contact the offices of Aesthetic Plastic Surgery to begin your rejuvenation.
John Q. Owsley, MD, FACS
45 Castro Street Suite 111
San Francisco, California 94114
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Phone
415.861.8040
Fax
415.861.0626
For more information about our San Francisco Bay Area practice, including facelift surgery, contact us today.